试论麻黄汤和桂枝汤乃为壮人和虚人外感而设

Discussion on Mahuang Decoction and Guizhi Decoction Which Are Respectively Set for Strong People and Weak People Invaded by Exogenous Pathogens

目的:探讨《伤寒论》中麻黄汤、桂枝汤在适应人群上的差异。方法:对麻黄汤和桂枝汤原文、相关类方、方药及药后调养等方面进行对比分析。结果:平素身体壮实的患者本身营卫充盛、卫外正常,只有感受较重之风寒才会发病,正邪关系以邪盛为主,外寒去而营卫自和,故不需调补营卫而适用麻黄汤;平素体质虚弱的患者则本身营卫不足、卫外低下,稍感风邪即会发病,邪实与正虚并存,故须在疏散表邪的同时调和营卫而适用桂枝汤。结论:麻黄汤和桂枝汤乃仲景分别为壮人和虚人外感而设,他对患者体质差异的重视值得进一步探索。

Objective：To discuss the differences of the indicated people between Mahuang Decoction and Guizhi Decoction in Shihan Lun.Methods：Several aspects of the Mahuang Decoction and Guizhi Decoction were compared and analyzed such as the original text,related similar decoctions,formula composition and recuperation after medication etc.Results：Usually,sturdily built men had abundant nourishing qi and defending qi and the defending function was normal who would get sick only when they were invaded by severe wind-cold pathogenic factors.In this situation,the evils were predominant in the relationship between the evil and the health.If the exogenous pathogenic cold was eliminated,the nourishing qi and defending qi would restore harmony,so it would not necessary to regulate and supplement the nourishing qi and defending qi and Mahuang Decoction was suitable.Patients with weak constitution were deficient in nourishing qi and defending qi and weak in defending the exogenous pathogenic factors.They will be sick when invaded by slight wind pathogenic factors with the coexistence of sufficient evil qi and insufficient health qi,so Guizhi Decoction was suitable with its function of soothing and dispersing the exogenous pathogenic factors and regulating and harmonizing nourishing qi and defending qi at the same time.Conclusion：Mahuang decoction and Guizhi decoction created by Zhang Zhongjing are set respectively for the strong and the weak people.His emphasis on differences of individual′s constitution deserves our further exploration.