基于《里中医案》探究李中梓遣方用药特点

Analysis on the Medication Characteristics of LI Zhongzi Based on“Collation of Traditional Chinese Medical Cases”

[目的]基于《里中医案》,探究明代医家李中梓遣方用药的特点。[方法]纳入李中梓《里中医案》中所载医案134例,整理其中所载方剂和药物,建立临床方药数据库,描述方药频数并进行分析。[结果]《里中医案》的134例医案,使用方剂共53种,中药共203味。方剂使用频数最高的前8位依次是补中益气汤、六君子汤、肾气丸、十全大补汤、理中汤、六味地黄丸、归脾汤、参附汤。两方合用共出现27次,其中两方均为补益剂17次,补益剂与泻实剂合用9次,两方均为泻实剂1次。用药频数最高者分别为人参、甘草、姜、白术、陈皮、茯苓、当归、黄芪、肉桂、熟地、附子、升麻、柴胡等。[结论]李中梓遣方用药具有脾肾双补、偏重补脾,两方合用、偏于补益,用药灵活、细致精准三个特点,其遣方用药特点值得深入研究和借鉴。

[Objective]To explore the medication characteristics of LI Zhongzi in Ming Dynasty based on“Collation of Traditional Chinese Medical Cases”.[Methods]One hundred and thirty-four cases of medical cases in“Collation of Traditional Chinese Medical Cases”by LI Zhongzi were included,the prescriptions and medicines contained in it were sorted out,a database of clinical prescriptions was established,the prescriptions and medicines frequency was described and analyzed.[Results]A total of 134 medical cases were included,including 53 prescriptions and 203 medicines.The top 8 prescriptions with the highest frequency are Buzhong Yiqi Decoction,Liujunzi Decoction,Shenqi Pill,Shiquan Dabu Decoction,Lizhong Decoction,Liuwei Dihuang Pill,Guipi Decoction,Shenfu Decoction.The two prescriptions were used together 27 times,including 17 times when both were tonic,9 times when tonic and reducing method were used together,and 1 time when both were reducing method.The top 13 traditional Chinese medicines were Ginseng Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma,Zingiber officinale Roscoe,Atractylodis Macrocephalae Rhizoma,Citri Reticulatae Pericarpium,Poria cocos,Angelicae Sinensis Radix,Astragali Radix,Cinnamomi Cassiae Cortex,Rehmanniae Radix,Aconitum carmichaeli Debx,Cimicifugae Rhizoma and Bupleuri Radix.[Conclusion]The application of LI Zhongzi's prescription and medication has three characteristics:Tonifying both the spleen and the kidney,especially the spleen;two prescriptions used together,emphasizing on tonifying;flexible,meticulous and accurate medicine using.The medication characteristics of LI Zhongzi deserve further study and reference.