《伤寒杂病论》三承气汤方证再辨

Further Discussion on Syndromes of Three Chengqi Decoctions in Treatise on Exogenous Febrile and Miscellaneous Diseases

通过研读《伤寒杂病论》条文，认为以痞满燥实坚之程度与有无分辨大、小、调胃三承气汤证之法有失偏颇。热与实，是区别三承气汤证的两大要素。大承气汤治疗大热大实证，小承气汤治疗小热小实证，调胃承气汤治疗燥热初结而未实证。三承气汤的应用要点是：把握使用时机、区别病机差异、动态调整用量、严格掌握煎服法。

Many doctors distinguish the syndromes of three Chengqi Decoctions by distention,fullness,dry,excess and hard,which has certain limitations after we studied the clauses of Treatise on Exogenous Febrile Disease and Miscellaneous Diseases. Heat and excess are the two elements to distinguish the syndromes of three Chengqi decoctions. Dachengqi Decoction treats the severe heat and excess syndrome,Xiaochengqi Decoction is suitable for the mild heat and excess syndrome,Tiaowei Chengqi Decoction is suitable for the dryness-heat syndrome. The application key points of the three Chengqi Decoctions are：grasping when to use,distinguishing the pathogeneses, adjusting the dosage and controlling the decocting methods.