《备急千金要方》以寒热为纲治痢的方药特点探析

Discussion in Invaluable Prescriptions for Ready Reference for recurrent dysentery from cold-heat syndrome

《备急千金要方》所载的治痢篇为现存最早的治痢专篇。孙思邈以寒热为纲将"痢病"分为"热痢""冷痢",其治疗"痢病"先辨寒热,治热痢常以黄连为主药加减组方,善用消法开滞破结;治冷痢以温中散寒止痛为主,兼以固涩。孙思邈治"痢病"又常寒热并用,以平调寒热、制性存用,或以温下法治久痢通下破积,并根据药物的不同制法调节寒热偏盛。文章旨在从寒热角度分析《备急千金要方》治痢篇的遣方用药特点,以期对现代中医学"久痢""痢疾"等疾病的临床治疗提供参考。

The treatise on the treatment of dysentery recorded in Invaluable Prescriptions for Ready Reference is the earliest existing treatise on dysentery.According to the therapeutic theory used by SUN Si-miao,dysentery was divided into‘heattype diarrhea’and‘cold-type dysentery’based on nature of cold and heat.SUN Si-miao followed the principle of discriminating cold and heat when treating dysentery.To be specific,the heat-type dysentery was generally treated by using a modified prescription based on Coptis chinensis,and SUN Si-miao was good at using the method of elimination to relieve stagnation and disperse lumps in the course of treatment.Simultaneously,cold-type dysentery was managed by warming middle-jiao to dispel cold and relieve pain,combined with inducing astringency.Meanwhile,SUN Si-miao often emphasized on the balance between cold and heat in the treatment of dysentery,with the aim to achieve a balanced regulation of cold and heat,to control the property of a drug while play its proper function through the compatibility of drugs.Alternatively,SUN Si-miao also applied the warm and purgation method for the treatment of chronic dysentery to dredge intestines and improve food accumulation.Besides,SUN Si-miao paid attention to regulate the excessive cold and heat according to the different drug preparation methods.This paper discussed‘cold and heat’in Invaluable Prescriptions for Ready Reference,expecting to provide clinical reference for the treatment from the theory of cold and heat.