浅析《伤寒论》水饮病治法

Analysis of Treatise on Febrile Disease for the Treatment of Edema

张仲景在《伤寒论》中提出:"病痰饮者,当以温药和之",对痰饮病的治疗分为扶正利水、祛邪利水、和解利水,扶正利水中以茯苓桂枝甘草大枣汤温心利水、以小青龙汤温肺蠲饮、茯苓桂枝白术甘草汤、桂枝去桂加茯苓白术汤、理中丸健脾祛湿、茯苓甘草汤温胃散饮、真武汤温肾行水、五苓散化气行水、猪苓汤育阴行水;祛邪利水分寒下和热下,寒下中以大陷胸汤、大陷胸丸泻热开结逐水、十枣汤攻下开结逐水、牡蛎泽泻散清热软坚利水、热下中以三物白散散寒破结逐水、瓜蒂散涌吐寒实;和解利水中以小柴胡汤、柴胡桂枝干姜汤和解少阳、生姜泻心汤和胃散水、四逆散调畅气机。

Zhang Zhongjing put forward that：＂ the patients with edema should be treated with harmonizing drugs. The therapeutic principles for edema include reinforcing the healthy qi and inducing diuresis, eliminating pathogen and promoting urination, har- monizing to induce diuresis. For the first one, Fuling Guizhi Gancao Dazao Tang can be used to warm the heart and promote diure- sis, Xiaoqinglong Tang to warm the lung and eliminate the retained fluid, Fuling Guizhi Baizhu Gancao Tang, Guizhi Tang Without Guizhi plus Fuling Baizhu Tang and Lizhong Pellet can strengthen the spleen and dispel dampness;Fuling Gancao Tang can warm the stomach and dispel the ~tained fluid;Zhenwu Tang can warm the kidney to promote the water flow;Wuling Powder can pro- mote the generation of qi and fluid flow ;Zhuling Tang can nourish yin and promote fluid flow. The method of eliminating pathogen and promoting water includes cold purging and heat purging. For cold purging, Daxianxiong ＇Fang or Daxianxiong Pellet is used to purge heat and relieve edema, Shizao Tang to purge excessive fluid, Muli Zexie Powder to clear heat, soften hardness and promote dim^sis. For heat purging, Sanwu Baisan is used to dispel cold, break the mass and relieve edema, Gualou Powder to promote vom- iting the excessive cold. For harmonizing to induce diuresis, Xiaochaihu Tang and Chaihu Guizhi Ganjiang Tang can be used to harmonize the Shaoyang, Shengjiang Xiexin Tang, Weisanshui, Sini Powder to regulate qi activity.