叶天士与薛生白治疗湿热下利的用药特色分析

Comparison between Ye Tianshi and Xue Shengbai in treatment of diarrfea with damp-heat

叶天士与薛生白是同一时期的2位温病大家,而对于湿热下利的治疗,2位又有着不同的用药思路。笔者借助中医传承辅助平台系统对2位医家治疗湿热下利的医案进行研究,通过对治疗湿热下利时所用药物的统计与分析,总结叶薛两家治疗湿热下利用药关联和用药模式的异同。对于湿热下利,叶天士与薛生白都认为是由湿热邪气阻遏气机,致使脾胃传导失常所致,治疗时均从中焦阳明太阴入手,集中使用温药、寒药,少用凉性和热性药,较多使用苦、辛、甘味药;叶天士较多使用黄芩、白芍、黄连、猪苓、茯苓、泽泻;薛生白常用的药物有茯苓、陈皮、厚朴、藿香、甘草、当归、白芍、白扁豆、葛根、乌梅、草果、砂仁以及黄连、黄柏。2位医家在治疗中用药差异为临床治疗湿热下利提供了借鉴思路。

Ye Tianshi and Xue Shengbai are two febrile disease specialists in same time,and for the treatment of dampness and heat,they have different medication ideas. With the help of traditional Chinese medicine（ TCM）,author has studied two specialists＇ consilias of dampness and heat,through the statistics and analysis of their medicine during the treatment of dampness and heat,summarizes the similarities and differences of Ye and Xue＇s medicine application＇ s assoations and models. Ye Tianshi and Xue Shengbai were both thought that the reason of dampness and heat was damp heat pathogenic factors,for this reason,the spleen and stomach conduction disordered,They both treated from the middle-jiao of Yangming and Taiyin,focused on warm-natured medicine,cold-natured medicine,used less cool-natured and heat-natured medicine,and more bitter,pungent,sweet medicine; Ye Tianshi usually use Scutellariae Radix,Paeoniae Radix Alba,Coptidis Rhizoma,Polyporus,Poria,Alismatis Rhizoma; Xue Shengbai commonly use Poria,Citri Reticulatae Pericarpium,Magnoliae officinalis Cortex,Patchouli,Glycyrrhizae Radix et Rhizoma,Angelicae Sinensis Radix,Paeoniae Radix Alba,Lablab Semen Album,Puerariae Lobatae Radix,Mume Fructus,Tsaoko Fructus,Amomi Fructus,Coptidis Rhizoma and Phellodendri Chinensis Cortex. The differences between the two masters in medicine application provide a reference for the clinical treatment of dampness and heat.