《名医类案》“伤寒门”小柴胡汤应用辨析

Analysis of Minor Bupleurum Decoction of "Cold Damage Category" in Classified Case Records of Famous Physicians

《名医类案》在大量保存明代及以前临床各科验案的同时,也广泛记载了张仲景经方在古代的应用情况。小柴胡汤为临床最常用的经方之一,掌握其辨证精髓是临证灵活运用的前提,历代所存医案较为丰富。《名医类案》中小柴胡汤案25例,根据各案反映出的问题将25例医案分为五类,现从表里同病、或然证加减、瘥后复热、特殊诊断、汤散误用五个方面展示运用小柴胡汤时的辨证思维过程、方药加减方法以及服用注意事项,不求其全,但求其真,体现了作者"宣明往范,昭示来学"的初衷,临床运用小柴胡汤时值得借鉴。

Classified Case Records of Famous Physicians records a large number of various clinical cases of Ming dynasty and before Ming dynasty as well as the application of Zhang Zhongjing’s Classic prescriptions in ancient times. Minor Bupleurum Decoction is one of the most commonly used classic prescriptions. The master of the essence of the syndrome differentiation and treatment in this prescription is the precondition of clinical flexible application. There are 25 Minor Bupleurum Decoction cases and they are classified into five categories. The five aspects of simultaneous disease of the exterior and interior,complicated syndromes,fever after recovery,special diagnosis and misuse of decoction or powder are analyzed to explore the thinking process of syndrome differentiation,modification of the drugs and cautions in use,which may be worthy of reference in clinical application of Minor Bupleurum Decoction.