《脾胃论》君臣佐使法浅析

An Analysis of Method of Sovereign and Minister and Assistant and Guide in Treatise on Spleen and Stomach

李东垣认为,君药是方剂中用量最大且力度最强的药物,君臣佐使之间应有明显的层次性,才能相互宣散和收敛。其著作《脾胃论》中所立方药,君药多为辛温或甘温药物,如人参、黄芪、白术等,这是由其“内伤脾胃,百病由生”的疾病观决定的。李东垣十分注重药物的气味配伍,认为药物气味所具有的偏性即其药性,也正是药物的作用之性,甘温除热法便是其体现。《脾胃论》注重风药的使用,一方面取风药升散的特性,升举清阳,助脾气升清;另一方面是风药能行气发散,宣散湿浊,健运脾阳。从《脾胃论》的君臣佐使法可知,治疗脾胃相关疾病应以扶正为主,祛邪为辅,以治其本;治疗其他系统疾病时,应注意其他脏腑与脾胃的关系,在遣方用药时注意顾护脾胃,以不伤正。

According to Li Dong-yuan,sovereign medicinal is the most widely used and powerful medicinal in a prescription.Only when there are obvious levels between sovereign,minister,assistant and guide,can they disperse and converge each other.In his Treatise on Spleen and Stomach,sovereign medicinal is mostly pungent and warm,or sweet and warm,such as Renshen(Radix Ginseng),Huangqi(Radix Astragali)and Baizhu(Rhizoma Atractylodis Macrocephalae),etc.,which is determined by his disease view of"internal injury to the spleen and stomach leading to all kinds of diseases".Li Dong-yuan attaches great importance to the compatibility of drugs'smell,and thinks that the bias of drugs'smell is the property of drugs and the function of drugs,and the method of"relieving fever with sweet and warm"is its embodiment.It is in accordance with Li Dong-yuan's views that"spleen and stomach are the source of nourishing original qi"and"spleen and stomach are the hinge of qi ascending and descending".In Treatise on Spleen and Stomach,wind medicinal is paid more attention to.On the one hand,it takes the characteristics of ascending and dispersing of wind medicinal to lift lucid yang,which helps the spleen qi to ascend.On the other hand,wind medicinal can move qi,and disperse dampness and turbidity to strengthen spleen yang.It can be seen from sovereign,minister,assistant and guide in Treatise on Spleen and Stomach,in the treatment of diseases related to spleen and stomach,we should give priority to strengthening healthy qi,with the elimination of pathogenic factors as the supplement in order to treat the primary cause;in the treatment of other systems'diseases,we should pay attention to the relationship between other viscera and the spleen and stomach,and the protection of the spleen and stomach so as to"not hurt the healthy qi".