从《傅青主女科》探傅青主用柴胡的规律

Rules of the application of radix bupleuri based on the record of Fu Qingzhu’s gynecology

目的总结归纳傅青主治疗妇科疾病中的柴胡用法,探索妇科疾病的发病规律,整理有利于提高临床实践的思路与方法,传承傅青主的有效经验。方法分析、对比傅青主的用药规律;研究柴胡在不同条件下的作用;通过柴胡的使用总结妇科疾病的发病特点,并进一步探索用药搭配。结果柴胡用小剂量主要用于升清,是调畅气机的重要手段;妇科疾病的发生跟带脉下陷关系密切,补气升陷在治疗中起着关键的作用;举陷升清不仅可以用柴胡,还可以用其他药物如陈皮、升麻、荆芥等。结论疏肝解郁历来被认为是妇科疾病治疗的重点,但是从傅青主用柴胡的规律来看,升清举陷才是其中的关键,在临床中需多关注这方面的方式方法,以期提高临床疗效。

Objective To analyze the application of radix bupleuri based on the record of Fu Qingzhu′s gynecology and explore the rules of the occurrence of gynecological diseases to contribute to the improvements in clinical practice and the inheritance the valuable experiences of Fu Qingzhu.Methods The rules of drug use were analyzed and compared.The function of radix bupleuri in different conditions was studyed.The characteristics of gynecological diseases based on the use of radix bupleuri was summarized so as to explore the drug composition.Results The radix bupleuri of small dose acted on ascending clear yang,which was the important means for qi regulation.The occurrence of gynecological diseases was closely related to the sinking of Dai meridian.Hence,tonifying qi and ascending the sunk qi was the key of treatment.Other herbs could be used for ascending the sunk qi and clear yang besides radix bupleuri,such as tangerine peel,cimicifuga rhizome and schizonepeta.Conclusion Generally,smoothing liver qi and removing stagnation is the key in treatment of gynecological diseases.But,in terms of the rules of the application of radix bupleuri by Fu Qingzhu,ascending clear yang and the sunk qi is also the key in treatment.Hence,in clinical practice,more attentions should be paid for the improvements of clinical effect.