龋病“虫蚀”病因及辨治源流考析*
作者：向春艳1，梅明秋1，于海悦1，刘雅芳2
单位：1.黑龙江中医药大学基础医学院，黑龙江 哈尔滨 150040； 2.浙江中医药大学基础医学院，浙江 杭州 310053
引用：引用：向春艳，梅明秋，于海悦，刘雅芳.龋病“虫蚀”病因及辨治源流考析[J].中医药导报,2025,31(10):203-207.
DOI：10.13862/j.cn43-1446/r.2025.10.037
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摘要：本文在考证龋病古籍文献的基础上，梳理龋病“虫蚀”理论的源流，从“虫蚀”角度探讨龋病“虫”的成因及防治方法。历代医家论及龋病病因，以“虫蚀”牙齿为主。考其源流，龋病“虫蚀”病因理论萌芽于先秦两汉时期，理论框架形成于晋唐时期，全面发展于宋至明清时期。自宋以来，医家深入探讨龋病“虫”的成因，提出由风、湿、热、火之邪作用于机体而生虫，龋病病因病机内涵逐渐丰富。治疗上遵循辨证论治，注重标本兼顾、内外兼治，以杀虫驱虫、祛风除湿、清热泻火、清热祛湿、取虫牙等法随证治之；日常注重叩齿、刷牙、漱口等预防调护，颇具特色。
关键词：龋病；虫蚀；病因病机；源流；文献考证
Abstract：
Based on the textual research of ancient Chinese medical literature on dental caries, this article sorts out the origin and development of the "worm erosion" theory of dental caries, and explores the cause of "worms" in dental caries and corresponding prevention and treatment methods from the perspective of "worm erosion". Throughout history, medical experts have discussed the etiology of dental caries, with "worm erosion" of teeth being the main cause. Tracing its origin and development: the "worm erosion" etiology theory of dental caries germinated in the Pre-Qin, Han Dynasties, formed its theoretical framework in the Jin and Tang Dynasties, and achieved comprehensive development from the Song Dynasty to the Ming and Qing Dynasties. Since the Song dynasty, medical practitioners have delved into the etiology of "worms" in dental caries, proposing that these pathogens arise from the effects of wind, dampness, heat, and fire pathogens on the body, thereby gradually enriching the understanding of the pathogenesis of dental caries. In terms of treatment, the principle of syndrome differentiation and treatment is followed, with emphasis on addressing both the root cause and symptoms as well as combining internal and external treatments. Therapeutic methods include insecticidal and vermifuge treatments, wind-dispelling and dampness-eliminating therapies, heat-clearing and fire-purging techniques, heat-clearing and dampness-removing approaches, and worm-extraction procedures, all tailored according to specific syndromes. In daily care, preventive measures such as tooth tapping, brushing, and gargling are emphasized, which are quite distinctive.
Key words：dental caries; worm erosion; etiology and pathogenesis; origin and development; textual research
发布时间：2026-01-08
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