真武汤及其辨证

Zhenwu Decoction and Its Syndrome Differentiation

82条之真武汤证,为太阳病过汗、损伤阳气,无形之水气凌心;316条之真武汤证,则是病程较长,阳气久虚,水饮停滞。该方不仅能够通利表里上下、上中下三焦之水,又能温补三焦、表里之阳气。方中芍药能够利血脉、泄孙络、通泄筋脉肌肉中的水气。真武汤证水气内停兼阳虚,故以附子生姜配白术二苓,既利水化气,又温扶肾阳;而猪苓汤证是水热内停而兼阴虚,故除以滑石泽泻配二苓清热利水外,且加阿胶入肾滋阴。前者温阳化气行水以治水停兼寒,后者育阴清热利水以治水停兼热。而附子汤证与真武汤证比较,虽同属阳虚有寒,水湿泛滥,但一为有形之寒水,泛滥于三焦表里上下;一为无形之湿气,弥漫于筋肉骨节之间。二者皆有身体疼痛,但真武汤证偏于四肢沉重,附子汤证偏于筋骨疼痛。

Item 82 Zhenwu Decoction syndrome in Treatise on Febrite Disease is characterized by over-sweat of Taiyang disease damaging yang-qi,and the attach of the beart by retained fluid,while Item 316 Zhenwu Decoction syndrome by long process of disease,long-term deficiency of yang qi and retention of excessive fluid,The preseription can not only promote the water in three-jiao and both exterior and interior,but also warm and rocuperate yang qi in three jiao and both interior and exterior.Peony root in the prescription can induce blood vessel,expel the minute colleterals and the retained fluid in muscles.Zhenwu Decoction syndrome bears retention of excessive fluid along with yang deficiency,therefore aconite and fresh ginger together with bigbead atractylodes,rhizome,poria are used to induce diursis and disslove qi and warm and recuperate the kidney-yang,Zhuling Decoction syndrome bears retention of hear within body along with yin deficjency.therefore,telcum powder and rhizome and poria are used to clear away hear and promote diuresis,and donkey-hide gelation is used to noruish the kidney-yin.The former has the function of warming yang to resolve qi,while the latter clearing away beat and promoting diuresis.Compared with each other,although both Zhenwu Decoction syndrome and Fuzi Decoction syndrome belong to syndrome of yang deficlency with cold and retention of exccssive fluid,the former has the visible cold water widesprend in three jiao and both interior and exterior,the latter has the invisible damp pathogen pervading in the muscles and joints.Both have the pain of body,but Zhenwu Decoction syndrome foeuses on heavy linbs,while fuz Decoction syndrome on arthralgia and myalgia.