张仲景禁用下法思路分析

Thinking method analysis on ZHANG Zhong-jing's contraindications of TCM purgative method

目的探讨下法的使用禁忌,为临床准确选方用药提供有力依据。方法通过对《伤寒论》中与下法有关的110余条原文进行分析,并结合历代医家相关解析,在理解原文的基础上,对禁用下法的情况进行分类和归纳,以揭示张仲景禁用下法的整体思路。结果禁用下法可分3种情况:(1)无向下病势禁用下法;(2)虚症禁用下法;(3)腑实未成禁用下法。结论临床治疗中,需要使用下法时,应在排除禁忌情况的前提下,综合分析疾病的病势、病位及患者的虚实情况后方可选方用药。

Objective To discuss the contraindications of TCM purgative method, so as to provide strong references for accurate selection of Chinese medicine in clinic. Methods By analyzing approximately 110 pieces of original text regarding purgative method in Treatise on Cold Damage, and with the interpretations of medical experts in the history, based on understanding the original text, the contraindications of purgative method were summarized and classified to reveal the thinking method of Zhang Zhong-jing＇ s contraindications of purgative method. Results The contraindications of purgative method could be classified into 3 conditions ： （ 1 ） purgative method was forbidden on diseases without downward tendency; （2） purgative method was forbidden on weakness diseases and （3） purgative method was forbidden on unprepared fu-organ syndromes. Conclusion During clinical treatment, when purgative method is necessary, medicine could only be selected and used on the premise that the contraindications are excluded, and after the disease＇ s situation and location and patient＇ s deficiency and excess are comprehensively analyzed.