《伤寒论》痹证治疗用药规律探索

Exploration on the law of arthralgia syndrome treatment and drug use in Shanghan Lun

目的:通过分析《伤寒论》治疗痹证的用药规律,为临床运用经方治疗痹证提供依据与参考。方法:统计《伤寒论》中治疗痹证的方剂,对痹证相关词汇出现的频次,治疗痹证的方剂中药物使用的频数、频率,药物归经及四气五味进行了统计归纳,并进行了一定的分析。结果:《伤寒论》中与痹证相关的经文有53条,共有相关方剂29首,多集中在太阳病篇,频率达46.5%。方中药物配伍精当,精简意赅,共涉及35味中药。常用的13味药中以归脾经居多,可占24.4%;四气中以温性药最多(38.5%),而五味中则以甘味药频率最高(33.3%)。结论:《伤寒论》中治疗痹证多选用辛甘苦温之品;运用最多的5味中药正是桂枝汤的组成,可见治疗痹证可运用桂枝汤方加减;脏腑方面多从脾肺论治;八法之中又多以汗法与补法为主。

Objective:To provide evidence and reference for clinical application of classical prescriptions in the treatment of arthralgia syndrome by analyzing the medication regularity of arthralgia syndrome in treatise on Shanghan Lun.Methods:The prescriptions for arthralgia syndrome in Shanghan Lun were counted,and the frequency of occurrence of relevant words,the frequency number and frequency of the use of drugs,the meridians of drugs,four odors and five flavors of the prescriptions for arthralgia syndrome were summarized and analyzed.Results:There were 53 bi-syndrome-related texts in Shanghan Lun,with 29 related agents,mostly focusing on solar diseases and with a frequency of 46.5%.The prescription was well-matched and a total of 35 traditional Chinese medicines are used.Among the 13 commonly used medicines,24.4%were attributed to the spleen meridian,38.5%were warm medicines in the four qi,and 33.3%were sweet medicines in the five flavors.Conclusion:In Shanghan Lun,most of the drugs used to treat Bi syndrome are pungent,sweet,bitter and warm;the five most commonly used herbs are Guizhi Decoction.It seemed that Guizhi Decoction can be used to treat Bi syndrome;the treatment of viscera is mainly based on spleen and lung.Among the eight mothods of treatment,sweating and tonifying are the main methods.