炙甘草汤“由寒而温”轨迹疏暨方剂演进启示

Track “from Cold to Warm” of Fired Glycyrrhizae Decoction and The Evolutional Englightenment of Prescription

炙甘草汤自《伤寒论》起,后世医家对其证治由伤寒推广到杂病,明清时期更是拓展其在温病中的运用。炙甘草汤适用于气血阴阳不足之证,而该病机在伤寒、温病中均可出现,其方药涵盖气血阴阳四大类,调整其侧重则可使该方适应不同病情;伤寒以对立面的形式为温病提供病因学启示;二者传变次序一横一纵至少阴交汇,此阶段多气血阴阳不足,恰恰符合炙甘草汤适应证。进一步可得到以下启示,炙甘草汤的使用不必拘泥,只要病机吻合便可使用;通过法则的嬗变,炙甘草汤可应对多种临证场景,体现了寒温统一辨证观。

Since the Shanghan Lun of Fried Glycyrrhizae Decoction,later physicians have extended its treatment from Shanghan to miscellaneous diseases,especially in the Ming and Qing Dynasties which expanded its application in Febrile disease.Fried Glycyrrhizae Decoction is adapted to deficiency of Qi,blood,Yin and Yang,and both Shanghan and Febrile disease can occur.The prescription covers Qi,blood,Yin and Yang four categories.Adjusting the focus,the prescription can adapt to different conditions.Shanghan provides the aetiology for febrile diseases in the form of opposites.The transmission of Shanghan and Febrile disease are vertical and horizontal,joining at Shaoyin in which Qi,blood,Yin and Yang are all deficient,exactly conforming to the indication of Fried Glycyrrhizae Decoction.Further enlightenment can be obtained as follows:The use of Fried Glycyrrhiza Decoction need not be rigid,as long as the pathogenesis can be used;Through the evolution of the law,Fried Glycyrrhiza Decoction can cope with a variety of clinical scenarios;Embody the dialectical concept of unification of cold and warm.