《伤寒论》“缓治法”探析

Analysis of"Slow Treatment Method"Proposed in Treatise on Febrile Diseases

《伤寒论》“缓治法”主要体现在立法以图缓、剂型以谋缓两个方面。治虚者,若证属阴液亏虚,以芍药甘草汤、小建中汤柔肝缓急止痛;若属阳虚阴盛,以甘草附子汤缓温经脉散邪。治实者,若见阳明腑实之证,可依据腑实津伤之程度选用调胃承气汤和麻子仁丸缓泻热结;若见瘀血化热之证,桃核承气汤和抵挡丸均可缓以逐瘀;若见饮停胸胁、腰下有水气之证,十枣汤和牡蛎泽泻散分别有益气补中和急药缓用之意。治虚实错杂者,气虚甚则以甘草泻心汤缓补脾胃消痞;热邪甚则以大黄黄连泻心汤缓泻心下热结。《伤寒论》“缓治法”的使用不拘于病证之虚实寒热,选方用药多以炙甘草、大枣等甘味药物或补虚和中,或制约峻药。此外,根据病因病势等不同,应用丸、散剂,更突显缓势。

The"slow treatment method"proposed in Treatise on Febrile Diseases is mainly reflected in the two aspects,namely,treatment policy of slow down the process and formulation application to realize the slowing down.For example,in treatment of Yin deficiency syndrome,Shaoyao Gancao Decoction and Xiao Jianzhong Decoction can be used to soft liver and to relieve liver pain;in treatment of Yang deficiency and Yin excessiveness syndrome,Gancao Fuzi Decoction can be used to relax the meridians and disperse the evil factors.In treatment of excessiveness syndrome,esp.Yangming Fu excessiveness syndrome,Tiaowei Chengqi Decoction and Ma Ziren Pills can be used to relieve heat stagnation by slow purgation according to the degree of Fu excessiveness and Jin injury;in treatment of blood stasis induced Heat syndrome,Taohe Chengqi Decoction and Didang Pills can be used to slowly remove the blood stasis;in treatment of Jin retention in the chest syndrome,with water retention around the waist,Shizao Decoction and Muli Zexie Powder are beneficial for tonifying Qi by using emergency medicine in slow manner.In treatment of deficiency and excessiveness mixing syndrome,Gancao Xiexin Decoction can be used to slowly tonify the spleen and stomach to dissolve distension in case of severe Qi deficiency,while Dahuang Huanglian Xiexin Decoction can be used to slowly remove the heat stagnation in case of severe heat syndrome.The use of"slow treatment method"illustrated in Treatise on Febrile Diseases is not limited to any syndrome of cold or heat as well as deficiency or excessiveness of the syndrome.The choice of drugs is mostly sweet drugs such as Zi Gancao(licorice),Da Zao(jujube)and other supplements to tonify the deficiency or restrict the fierce effect of other drugs.In addition,depending on the etiology and pathogenesis,the use of pills and powders can help to achieve slower yet safer clinical efficacy.