国医大师张琪教授大方、复法临证要诀

Clinical experience of TCM master ZHANG Qi in using large prescription and complex method

张琪教授从医70余载,所遇之证,有单方治验者,亦有经方获效者,更有大方、复法愈顽疾、重症者。张琪指出,大方、复法者,集两种以上治法,选药12味以上,多则几十味,主要针对复合病证及疑难杂病,所拟制的综合性汤方。其符合时代的特征,随时代疾病谱的变化应运而生。大方、复法的配伍规律及组方原则,符合传统君臣佐使和七情和合理论。但大方、复法亦有其局限性,其虽能治愈复杂病证及疑难杂病,但并非临床所有疾病均宜应用大方、复法。但若病因病机简单、病情轻浅的常见病、多发病,亦离不开经方、小方。倘若动辄大方、复法,一者非能驱疾,反而误病,重则引发药源性、医源性之坏病或药害。再者无形之中增加了患者的经济负担,于此造成了中药资源的浪费。张琪强调,大方、复法虽能治愈顽疾,但亦非万能,临证应繁、简结合,尊重临床实际,合理应用单方、经方、大方复法,才能逐愈百疾。

Professor ZHANG Qi works as a doctor for over 70 years. Through his entire career, Professor ZHANG had achieved good efficiency by using the simple recipe, classical prescriptions, large prescription and complex method. Large prescription and complex method pointed out by professor ZHANG Qi of ten were consisted of two or more treatment methods and over 12 kinds of Chinese materia medica, which were used to aim at curing the difficult diseases. Large prescription and complex method conformed to the characteristics of the times and modern spectrum of disease, and the composition rule was in line with the principle of monarch, minister and seven emotions. However, large prescription and complex method also had limitations that they could cure complex and difficult diseases, but were not suitable for all diseases. Optional application of large prescription and complex method could lead to iatrogenic or drug-induced disease and increasing the economic burden of patients and the waste of Chinese traditional medicine. Professor ZHANG Qi pointed out that large prescription and complex method could cure disease, but the most important point was conformity with the clinical syndromes and put it into proper usage.