摘要：在中医治疗过程中，患者常常会遇到一种特殊的现象——瞑眩反应。这种现象看似病情加重，实则是身体正气与邪气激烈对抗的表现，预示着疾病即将好转或痊愈。瞑眩反应不仅是中医治疗中的特有现象，更是疾病向愈的重要标志。本文将从瞑眩反应的定义、表现、机制及护理等方面，深入探讨

在中医治疗过程中，患者常常会遇到一种特殊的现象——瞑眩反应。这种现象看似病情加重，实则是身体正气与邪气激烈对抗的表现，预示着疾病即将好转或痊愈。瞑眩反应不仅是中医治疗中的特有现象，更是疾病向愈的重要标志。本文将从瞑眩反应的定义、表现、机制及护理等方面，深入探讨这一现象的科学性与合理性。

一、瞑眩反应的定义与历史渊源

瞑眩反应，又称“好转反应”，最早见于《尚书·说命》：“若药不瞑眩，厥疾弗瘳。”这句话的意思是，重病或久病之人，如果服药后没有出现不适反应，说明药物未能有效驱邪，疾病难以痊愈。瞑眩反应的出现，恰恰说明药物正在发挥作用，身体的正气在与邪气进行激烈对抗。

医圣张仲景在《伤寒论》中也提到：“服药已，微除，其人发烦目瞑，剧者必衄，衄乃解。”这表明，在治疗过程中，患者可能会出现烦躁、头晕、甚至鼻出血等症状，这些反应实际上是邪气被驱除的表现。

二、瞑眩反应的表现与机制

瞑眩反应的表现因人而异，通常分为轻度与重度两种：

1. 轻度好转反应：患者可能出现喉干舌燥、头昏、腹泻等症状。腹泻通常表现为一天数次软便，伴有放屁增多，但一般不伴有绞痛。这些反应说明身体正在通过排泄的方式将邪气排出体外。

2. 重度好转反应：部分患者可能会出现头痛、发烧、湿疹、关节痛、气短、呕吐、食欲不振等现象。这些症状看似严重，实则是正气与邪气激烈对抗的结果。随着治疗的深入，这些反应会逐渐减轻，最终消失。

瞑眩反应的机制在于中药通过其寒热温凉的药性，纠正身体的寒热失衡。在纠正过程中，身体内会形成“两军交战”的态势，正气逐渐恢复，有力驱邪外出。这一过程虽然短暂不适，但却是疾病好转的必经之路。

三、瞑眩反应与副作用的区别

瞑眩反应与药物副作用的表现非常相似，但二者有本质区别。瞑眩反应是一种好转反应，通常由重到轻，随着疾病的减轻而逐渐消失。而副作用则是一种不良反应，会随着药物的持续服用而加重。

最可靠的区分方法是向专业医生反馈，医生会根据患者的具体情况判断是否为瞑眩反应。因此，患者在服药过程中应密切关注身体的细微变化，并及时记录，以便在复诊时提供准确信息，帮助医生调整治疗方案。

四、瞑眩反应的护理与注意事项

虽然瞑眩反应预示着疾病向愈，但患者在出现这一反应时仍需注意正确的护理方法。瞑眩反应的发生与邪正相搏密切相关，正气与邪气对抗时，双方都可能受损。如果护理不当，瞑眩反应的效果可能会大打折扣。

1. 保持心态平和：患者应正确认识瞑眩反应，避免因短暂的不适而中断治疗。瞑眩反应是疾病好转的征兆，坚持治疗才能取得良好效果。

2. 合理饮食与休息：在瞑眩反应期间，患者应注意饮食清淡，避免辛辣刺激性食物，保证充足的休息，以帮助身体恢复正气。

3. 及时反馈与调整：患者应定期向医生反馈身体状况，医生可以根据反应的程度调整药物剂量或治疗方案，确保治疗顺利进行。

五、案例分析：瞑眩反应的实际应用

在临床中，瞑眩反应的应用十分广泛。例如，一位受寒后咳嗽不止的患者，服用疏风散寒、补正气的中药后，咳嗽症状反而加重。患者误以为病情恶化，但实际上，咳嗽是正气与寒邪对抗的表现。经过一段时间的治疗，咳嗽逐渐减轻，最终痊愈。

另一个案例是脓疱疮患者，服用补正气的药物后，脓疱疮出现短暂的破溃流脓、局部红肿、疼痛等症状。这些看似“加重”的反应，实际上是邪气被排出的表现。坚持服药后，病情很快好转。

六、结语：瞑眩反应的科学性与中医智慧

瞑眩反应是中医治疗中的一种独特现象，体现了中医“正邪相争”的理论精髓。它不仅是疾病好转的征兆，更是中医治疗科学性的一种体现。通过瞑眩反应，患者可以直观感受到身体正气逐渐恢复、邪气被驱除的过程。

然而，瞑眩反应的出现也提醒我们，中医治疗并非一蹴而就，而是需要一个循序渐进的过程。患者在治疗过程中应保持耐心，正确认识瞑眩反应，积极配合医生的治疗，才能最终战胜疾病，恢复健康。

中医的智慧在于，它不仅关注疾病的表象，更注重身体的整体调节与平衡。瞑眩反应正是这种整体观念的体现，它让我们看到，治疗疾病不仅仅是消除症状，更是帮助身体恢复自我调节的能力。正如打扫房间一样，只有将垃圾彻底清除，房间才能真正焕然一新。

参考文献：

1. 王建辉, 王伶改, 黄利兴. 论瞑眩反应特点及其机制与意义[J]. 中华中医药杂志, 2022.

2. 施岚尔, 吴志桂, 凌云, 赵鸣芳. 浅谈“药不瞑眩, 厥疾弗瘳”[J]. 中医药导报, 2018.

3. 赵俊波, 张广中. “瞑眩”病机探讨及病案举隅[J]. 北京中医药, 2017.

4. 欧永胜, 郑盼盼, 薛鸾. 治乱安危谈“瞑眩”[J]. 中华中医药杂志, 2020.

作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。

Liang Shijie: "Symptoms of improvement" in therapeutic Chinese medicine

In the course of traditional Chinese medicine, patients often encounter a special phenomenon - the somnolence reaction. This phenomenon, which appears to be an aggravation of the disease, is actually a sign of the fierce confrontation between positive and evil spirits of the body, indicating that the disease is about to improve or heal. The vertigo response is not only a characteristic phenomenon in traditional Chinese medicine, but also an important sign of the healing of the disease. This article will explore in depth the scientificity and rationality of the phenomenon in terms of definition, manifestation, mechanism and care.

I. Definition and historical roots of the haptic reaction

The somnolence reaction, also known as the "improved reaction," is first seen in the Book of Fortune: "If the medicine does not somnolence, the seizure shall not be cured." This sentence means that if a seriously ill or chronically ill person does not experience an unpleasant reaction after taking the medication, it means that the medication has not effectively expelled the evil and the illness is difficult to cure. The emergence of a dizziness reaction is precisely a sign that the drug is working, and the body's positive qi is fiercely fighting against evil qi.

The sage Zhang Zhongjing also mentioned in his Theology of Typhoid: "After taking the medication, the person who feels annoyed and forgets, the playmaker will become sick, and sickness is a cure." This suggests that during treatment, patients may experience symptoms such as irritability, dizziness, and even nasal bleeding, which are actually signs that the evil has been expelled.

II. The manifestation and mechanism of the dizziness reaction

The manifestations of the dizziness reaction vary from person to person and are usually divided into two types: mild and severe:

1. mildly improved response : The patient may experience symptoms such as dry throat, dizziness, and diarrhea. Diarrhoea is usually characterized by a soft bowel movement several times a day, accompanied by an increase in fart, but is generally not accompanied by cramping. These reactions indicate that the body is expelling the evil spirit from the body through excretion.

2. Severe improvement reaction : Some patients may experience headache, fever, eczema, joint pain, shortness of breath, vomiting, loss of appetite, etc. These symptoms may seem severe, but they are the result of a fierce struggle between good and evil. As treatment progresses, these reactions gradually decrease and eventually disappear.

The mechanism of the dizziness response lies in the fact that traditional Chinese medicine corrects the imbalance between the body's heat and cold through its medicinal properties of cold and cold. During the corrective process, the body will form a situation of "war between armies," and the right spirit gradually recovers, effectively driving the evil out. This process, although briefly unpleasant, is a must-have for the disease to improve.

Third, the difference between dizziness and side effects

Dizziness and drug side effects are very similar in performance, but there are essential differences between them. A vertigo response is an improved response that usually goes from severe to mild and gradually disappears as the disease abates. The side effect is a side effect that can get worse with continued use of the drug.

The most reliable way to distinguish is to give feedback to a specialist physician who will determine whether there is a haptic reaction based on the patient's specific situation. Therefore, patients should pay close attention to the subtle changes in the body during medication and record them in time to provide accurate information upon re-visit to help the doctor adjust the treatment plan.

IV. Care and precautions for paralyzing reaction

Although the haptic reaction is a sign of a progressive healing of the disease, patients need to pay attention to the right care when this reaction occurs. The occurrence of the haptic reaction is closely related to the fight between evil and right, and both sides may be damaged when good and evil are opposed. If the care is not proper, the effect of the somnolence response may be greatly diminished.

1. Maintain a peaceful mindset : Patients should correctly recognize the paraplegic reaction and avoid interrupting treatment due to temporary discomfort. The vertigo response is a sign of the improvement of the disease, and adherence to treatment is required to achieve good results.

2. Reasonable diet and rest : During the paralyzing reaction, patients should pay attention to eating a light diet, avoid spicy and irritating foods, and ensure adequate rest to help the body regain its vigor.

3. Timely feedback and adjustment : Patients should regularly report their physical condition to their doctor, who can adjust the drug dose or treatment plan according to the extent of the response to ensure that the treatment progresses smoothly.

V. Case analysis: practical application of the haptic response

In clinical practice, the use of vertigo response is widespread. For example, a patient who coughed repeatedly after being cold, after taking Chinese medicine to clear the cold and rejuvenate his breath, his cough symptoms worsened. The patient mistakenly thinks that the condition is worsening, but in reality, the cough is a sign of the fight between good breath and cold evil. After a period of treatment, the cough gradually lessened and eventually healed.

Another case was a patient with blistering sores, who developed a brief breakdown and discharge, local redness and pain after taking medication to rejuvenate their bodies. These seemingly "aggravated" reactions are actually signs that evil is being expelled. After taking the medication, the condition quickly improved.

VI. CONCLUSIONS: Scientificity of the hypnotic reaction and the wisdom of Chinese medicine

The vertigo response is a unique phenomenon in traditional Chinese medicine, reflecting the essence of the theory of "right and wrong" in traditional medicine. It is not only a sign of the improvement of the disease, but also a manifestation of the scientific nature of traditional Chinese medicine. Through the haptic reaction, the patient can intuitively feel the process of the body's positive qi gradually restoring and the evil qi being expelled.

However, the emergence of the haze response also reminds us that traditional Chinese medicine does not take place overnight, but requires a gradual process. Patients should remain patient during treatment, correctly recognize the paraplegic reaction, and actively cooperate with the doctor's treatment, so as to eventually defeat the disease and restore health.

The wisdom of traditional Chinese medicine is that it focuses not only on the appearance of diseases, but also on the overall regulation and balance of the body. The haptic response is a reflection of this holistic view, which allows us to see that treating disease is not just about eliminating symptoms, but helping the body restore its ability to regulate itself. Just like cleaning a room, it is only by getting rid of the garbage completely that a room can truly be refreshed.

References:

1.Wang JH, Wang LG, Huang LX. Characteristics and mechanism of dizziness response [J]. Chinese Journal of Medicine, 2022.

2.Shi Laner, Wu Zhigui, Ling Yun, Zhao Mingfang. On "Medicine Does Not Dizziness, Jue Ji Fu Liu" [J]. Chinese Medicine Herald, 2018.

3.Zhao Junbo, Zhang Guangzhong. Pathogenesis and case study of "dizziness" [J]. Beijing Traditional Chinese Medicine, 2017.

4.OU Yongsheng, ZHENG Panpan, XUE Luan. On "Dizziness" in Managing Chaos and Safety [J]. Chinese Journal of Medicine, 2020.

Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.

来源：首都专家梁世杰