升降散君药刍议

Discussion on the Monarch Drug of Shengjiang Powder

[目的]探究升降散的君药及其理论依据,给临床应用提供参考。[方法]通过对《素问》《伤寒瘟疫条辨》等相关文献的研究,同时结合临床案例,探讨升降散君药的动态性。[结果]君药针对主要病机而立,病机的动态性决定君药的动态性,升降散方证根据不同的病机选用不同的君药,即以少阳郁热为主证,兼见阳明证,君药为僵蚕;以阳明胃热为主证,兼见少阳郁热证,则君药为大黄。所举两例患者,前者以少阳证为主,重在宣郁透热,故以僵蚕为君药;后者以阳明证为主,下焦不通、气机阻滞,故以大黄为君药。[结论]针对病机不同,升降散的君药既可为僵蚕,又可为大黄。

[Objective] To explore the theoretical basis of the monarch drug for Shengjiang Powder and provide reference for clinical application. [Methods]Using the methods of literature research on books concerned such as Huang di nei jing su wen and Distinguish about Typhoid and Epidemic, and clinical case study, to explore the dynamics of the monarch drug of Shengjiang Powder. [Results] The monarch drug is established according to the main pathogenesis, and the dynamics of the pathogenesis determine the dynamics of the monarch drug. The monarch drug of Shengjiang Powder should be chosen differently according to different pathogenesis, which means if the Shaoyang syndrome is the main symptom, also see the Yangming syndrome, the monarch drug should be Bombyx Batryticatus; and if the Yangming syndrome is the main symptom, the monarch drug should be Radix et Rhizoma Rhei.The Shaoyang syndrome was the main symptom in the former case, principle of treatment was removing depression and heat, so the monarch drug should be Bombyx Batryticatus. In the latter case, the Yangming syndrome was the main symptom, and it led to obstruction of lower energizer and congestion of Qi, so Radix et Rhizoma Rhei was monarch drug. [Conclusion] The monarch drug of Shengjiang Powder should be chosen differently according to different pathogenesis, which can be either Bombyx Batryticatus or Radix et Rhizoma Rhei.