《伤寒论》攻瘀三方研究

The Study of the Three Blood Statsis Removal Decoction in ShangHanLun

[目的]探讨仲景使用攻瘀三方桃核承气汤、抵当汤及抵当丸的思路。[方法]搜集历代注家对有关攻瘀三方条文的解释及方解并进行分析整理,结合《内经》的中医基础理论、训诂学知识及个人体会,总结仲景使用三方的本意。[结果]桃核承气汤主以泻热而次于化瘀,主治邪热由表陷里,与血初结而出现之少腹急结,其人如狂之证;抵当汤为攻坚逐瘀之峻剂,主治瘀热深结而出现之少腹硬满,其人发狂,喜忘,身黄,脉沉而微之蓄血重证;抵当丸为抵当汤之轻剂,主治蓄血之轻者。[结论]比较攻瘀三方,当以"浅深"二字区别桃核承气汤证与抵当汤证、以"轻重"二字区分抵当汤及抵当丸,较之近世以"轻重"区分前二者、"缓急"分别后二者,庶几更为准确。

[Objective]To investigate the thought of manipulating The Three Blood Statsis Removal Decoctions（Taohe Chengqi Decoction, Di Dang Decoction,Di Dang Pills） of ZHANG Zhongjing.[Method]Collect and analyse the explanations of the scriptures involving the Three Blood Statsis Removal Decoctions of Shang Han Lun interpreters from past to nowadays, combine with the theory said in Huang Di Nei Jing, knowledge of exegetics and personal view, in order to summarise the original intention of manipulating the Three Blood Statsis Removal Decoctions by ZHANG Zhongjing. [Result] The main purpose of Taohe Chengqi Decoction is to purge heat, since heat is the main reason of stagnation of blood. It applies to the preliminary stage of combination of heat and blood clot. The main purpose of Di Dang Decoction is to attack the rigid blood-heat stagnation in lower-energizer, it is applied to the late stage of combination of heat and blood clot. Di Dang Pill is the milder prescription of Di Dang Decoction, which is applied to the milder situation of blood-heat combination.[Conclusion]Comparing the Three Blood Statsis Removal Decoctions,＂Superficial＂and＂deep＂words should be used to differentiate the application of Taohe Chengqi Decoction and Di Dang Decoction, while＂light＂and＂severe＂words should be used to differentiate that of Di Dang Decotion and Di Dang Pills.