浅议真武汤若下利 去赤芍 留白芍

Discussion on Zhenwu Decoction“If Dysentery,Removing Peony Root,Keeping Debark Peony Root”

真武汤出自张仲景的《伤寒论》,是治疗肾阳虚衰、水邪泛滥的著名方剂。芍药是经方常用药物。此文通过论述真武汤的病因病机、芍药的分类,理解分析原文中“若下利,去芍药”的含义,论述白芍补肾阳及真武汤的现代应用,提出仲景时代所用的芍药大多为现代的赤芍,而在真武汤的现代应用中,以白芍应用居多,且在真武汤中具有不可或缺的作用,因此,笔者认为“或下利,去芍药”当为“若下利,去赤芍,留白芍”。

Zhenwu decoction,in Treatise on Febrile Diseases written by Zhang Zhongjing,is a famous prescription for treating the deficiency of kidney yang and the flooding of water evil.Peony is commonly used in classical prescriptions.Through the analysis of the etiology and pathogenesis of Zhenwu decoction,the classification analysis of peony,the understanding of“if dysentery,removing peony root,keeping debark peony root”,the white peony tonifying kidney yang,the modern application of Zhenwu decoction and other knowledge,it is found that peony used in Zhongjing era is mostly equivalent to modern red peony,and in the modern application of Zhenwu decoction,white peony is mostly used,and it has an indispensable role in Zhenwu decoction,so“or dysentery,removing peony root,keeping debark peony root”,should be“if dysentery,removing peony root,keeping debark peony root”.