《临证指南医案》柴胡应用探析

Application of Radix Bupleuri in Medical Records as Guidance of Clinical Practice

采用自行开发的历代医案计算机检索统计系统,对叶天士《临证指南医案》作整理分析研究,总结得出叶天士用柴胡的经验、特色。书中处方有柴胡的医案49例,应用柴胡治疗的主要病证有黄疸、乳房病、阳痿、郁证以及疟疾、泄泻、呕吐、胃脘痛、便血、鼓胀、胁痛、月经不调等。其证候特点是有发热,或有与肝郁、肝火、阳气虚陷、肝胆经络循行等相关的症状。柴胡主要配伍有:柴胡配鳖甲,柴胡配人参,柴胡配黄芩,柴胡配当归。组方主要有四逆散、小柴胡汤、鳖甲煎丸、逍遥散、补中益气汤等。并举医案2例以示柴胡应用经验。

Researching on the Medical Records as Guidance of Clinical Practice with the self-developed computer retrieval system of medical case records in history to summarize the expertise and characteristics of Ye Tian-shi in using Radix Bupleuri. There are 49 case records in the book about the treatment of diseases with Radix Bupleuri, The diseases include jaundice, mastosis, impotence, melancholia, malaria, diarrhea, vomiting, epigastralgia, hematochezia, tympanites, hypochondriac pain, menoxenia, etc, The corresponding pattern is characterized by the symptom of fever or the symptoms related to liver depression, liver-fire, yang-qi deficiency and sinking and the course of liver-gallbladder meridian, The Radix Bupleuri was often used with Carapax Trionycis, Radix Ginseng, Radix Scutellariae and Angelica Sinensis respectively, The main formulas containing Radix Bupleuri are ＂Sini Powder＂, ＂Xiaochaihu Decoction＂, ＂Biejiajian Pill＂, ＂Xiaoyao Powder＇and ＂Buzhong Yiqi Decoction＂, etc. Moreover, two medical records were numerated to introduce the experience in application of Radix Bupleuri.