从张仲景大方组方思路探析慢性难治病的辨治

Analysis on Differentiation of Syndromes and Treatment of Chronic Refractory Diseases from Thought in Formulating Complicated Prescriptions of ZHANG Zhongjing

《黄帝内经》提出大方理论,张仲景创鳖甲煎丸、薯蓣丸等寒热并投、攻补兼施之法,开大方治疗难治病之先河。张仲景用大方辨治难治病的思路主要在于:治虚,甘缓调中,养血生津;治瘀,善用虫药,推陈出新;治气,升降出入,疏通津血;治风,培本疏风,邪去正安。在服法上重视丸剂缓图,有方有守。张仲景大方的组方思路为临床辨治慢性难治病提供了可行性指导方法。

Since ancient times,people have uses complicated prescriptions for treating serious diseases. Inner Canon of Yellow Emperor 《黄帝内经》puts forward the theory of major prescriptions. ZHANG Zhongjing created Biejiajian Pills（ 鳖甲煎丸）,Shuyu Wan（ 薯蓣丸） and other prescriptions with the method of application of both cold and heat herbs,as well as reinforcement and elimination in combination. He was the forerunner who treat refractory diseases with complicated prescriptions. His thoughts mainly includes treating deficiency by regulating the middle with sweet and relieving herbs,nourishing blood and generating body fluid; treating stasis using insect drugs and bringing forth the new through the old; treating Qi by regulating ascending-descending-exiting-entering and dredging body fluid and blood; as well as treating wind by strengthening body resistance,dispelling wind to clear pathogenic factors and reinforce vital Qi. On methods of taking medicine,ZHANG emphasized that pills took effect slowly and mitigated drug property. Prescriptions corresponding to diseases should be applied and kept using. ZHANG Zhongjing＇ s thoughts of composing complicated prescriptions provided feasible guide for clinical differentiation of syndromes and treatment of chronic refractory diseases.