总结杨进教授从叶天士《温热论》“邪留三焦”理论治疗难治性发热的临证经验。认为难治性发热的核心病机为湿热痰浊之邪留于三焦，三焦气化失司，气机升降失调，提出以清泄少阳、分消痰湿、疏利三焦为基本治则，临证以蒿芩清胆汤为基础方，强调叶天士“随证变法”思想，兼风热外袭，肺失宣肃者，配合疏风宣肺法，用蒿芩清胆汤合银翘散加减；兼风邪束表，营卫不和者，配合疏风调卫法，用蒿芩清胆汤合桂枝汤加减；兼阳明气分有热，配辛寒清气养阴法，用蒿芩清胆汤合白虎汤加减；兼胆腑热郁，手足少阳经腑同病，枢机不利者，配和解攻里法，用蒿芩清胆汤合大柴胡汤加减。并附验案1则。

This paper summarizes Professor YANG Jin's clinical experience in treating refractory fever based on YE Tianshi's theory of “pathogens lingering in triple energizer” in Treatise on Epidemic Febrile Diseases. It is believed that the core pathogenesis of refractory fever is the retention of damp-heat,phlegm and turbidity pathogenic factors in triple energizer,causing triple energizer qi dysfunction and the disorder of qi movement. The basic treatment principle is to clear and purge the Shaoyang,disperse and eliminate phlegm and dampness,and promote the smooth flow of triple energizer. The clinical prescription is based on Haoqin Qingdan Decoction(蒿芩清胆汤),emphasizing YE Tianshi's idea of “adapting methods according to the syndrome”. For cases of wind-heat attacking superficies and lung qi loss in dispersion,the method of dispelling wind and ventilating lung should be combined,and modified combination of Haoqin Qingdan Decoction and Yinqiao Powder(蒿芩清胆汤合银翘散) is prescribed. For cases of wind pathogen blocking the exterior and disharmony between nutrient qi and defensive qi,the method of dispelling wind and regulating wei qi can be used in combination with the modified combination of Haoqin Qingdan Decoction and Guizhi Decoction(蒿芩清胆汤合桂枝汤). If there is heat in the Yangming qi,the method of nourishing yin and clearing qi with pungent and cold medicinals is combined. The modified combination of Haoqin Qingdan Decoction and Baihu Decoction(蒿芩清胆汤合白虎汤) is used. For those with concurrent heat stagnation in the gallbladder and bowels,concurrent diseases in the Shaoyang meridians of the hands and feet,and unfavorable cardinal organs,the method of harmonizing and attacking the interior should be formulated,and the modified combination of Haoqin Qingdan Decoction and Dachaihu Decoction(蒿芩清胆汤合大柴胡汤) should be used. And one test case is attached for verification.