《金匮要略》薏苡附子败酱散治法刍议

Discussion on the Reatment of Yiyi Fuzi Baijiang Powder in Synopsis of Golden Chamber

当代医家及注家将《金匮要略》薏苡附子败酱散处方归类为泻下剂。文章通过重新厘清条文本义,回溯历代医家观点,分析处方中药物功效,从“脓已成”时使用攻下法可能造成肠穿孔的风险出发,应用“治未病”决策思路,理论联系实际,认为薏苡附子败酱散处方当为“利小便”给邪以出路,而非“通大便”泻下攻积。教材将此方归为下法应当是忽略了仲景风险防范的处方策略。

The prescription of Yiyi Fuzi Baijiang powder in Synopsis of the golden chamber is classified as purgative method by contemporary doctors and commentators.From the historical point of view,the author analyzes the drug efficacy in the prescription,discusses the original meaning of the original text,and analyzes the decision-making thinking of Zhongjing s“preventive treatment”,and thinks that the prescription of Yiyi Fuzi Baijiang powder should be diuretic rather than purgative.In the textbook,the prescription strategy of risk prevention of Zhongjing was ignored.