桂枝汤“解肌”与“建中”功用探析

Analysis on the Function of “Releasing Flesh” and “Strengthening the Middle” of Guizhi Decoction

着眼《伤感杂病论》原文，分析桂枝汤的功能主治特点。桂枝汤证属正气不足的表证，病机特点为卫气失和，玄府开闽失司，主症汗出即是汗孔开张、营阴外泄的表现；桂枝汤可助脾胃达营卫，药后之汗即是营卫和合之象。由此提出，“解肌”体现了桂枝汤解表发汗的功能特点。通过对桂枝汤从脾胃达营卫之理、桂枝汤与小建中汤的联系、建中理中法三方面的分析。认为桂枝汤是以甘温补脾之品建中化水谷，具有表里兼顾、补中寓汗之用。并从《伤寒杂病论》表里营卫失和病证方面论述了解肌建中法的应用，得出桂枝汤解肌建中法可调和表里内外之营卫的结论。

This paper starts with the original clause of Treatise on Exogenous Febrile Disease and Miscella- neous Diseases,analyzing the function and characteristics of Guizhi Decoction. The indication of Guizhi Decoction is the exterior syndrome caused by deficient healthy qi,the pathogenic characteristic is defensive qi disharmony and sweat pore failing to open and close. Sweating is the appearance of sweat pore opening causing nutrient yin discharge. Guizhi Decoction helps regulate the spleen and stomach,nutrient and defensive qi,and sweating after taking medicine is the appearance of harmonious nutrient and defensive qi. Releasing flesh shows the function of releasing flesh and inducing sweating. Guizhi Decoction is analyzed from three aspects：regulating the spleen and stomach,nutrient and defensive qi,relationship with Xiaojianzhong Decoction,invigorating and regulating the middle methods. It is believed that Guizhi Decoction with sweet in taste and warm in nature invigorates the spleen,strengthens the middle,transforms water and food,has the function of treating both the exterior and interior and both tonifying and sweating. Releasing flesh and strengthening the middle methods are analyzed from the exterior,interior,nutrient and defensive disharmony syndrome of Treatise on Exogenous Febrile Disease and Miscellaneous Diseases. So releasing flesh and strengthening the middle methods of Guizhi Decoction can regulate the exterior,interior,nutrient and defensive qi.