《王绵之方剂学讲稿》学术思想探微

On the Academic thought of WANG Mianzhi’s Lecture Notes on Prescriptions

王绵之先生是现代中医方剂学的创始人之一。《王绵之方剂学讲稿》是王老的心血之作,字里行间透露着王老扎实的理论和临证功底。结合经典原文,对王老的一些论述进行总结和扩充。首先从"医者善用意也"展开,方剂的构成需要医者组方配伍,如心为君主,主宰五脏六腑的运行,医者用药亦同此理,需意会君臣佐使、升降浮沉等等;第二从"用药圆机活法"展开,用药组方并非一成不变,需圆机活法,药味药量以及剂型需根据患者的具体情况作出相应变化,以期收到更好疗效;第三从"临证治病求本"展开,临证之时始终围绕患者体内的阴阳变化,不能被外在的表象所迷惑,错施方药延误病情;第四从"用药标本兼顾"展开,不仅需要考虑患者的疾病情况,更要为患者的预后和转归情况所考虑。处方用药是一方面,更需要照顾患者的情绪使之配合治疗,医患的良好配合使方药发挥更好的作用;第五从"注重整体观念"展开。王老始终强调治疗的是病人,不是疾病,不能把目光仅停留在治疗疾病之上,要将病人置于自然-社会-个体,这样一个更广阔的视野之中去论治,只有这样才能做到中医的整体观念和整体论治,这一点也是中医的特色所在。文章分别从上述五个方面分别论述了王老方剂学讲稿的一些学术思想,不足之处,望不吝赐教。

Mr.WANG Mianzhi is one of the founders of modern science of TCM formulas."WANG Mianzhi prescription lecture notes"is WANG Lao’s painstaking efforts,between the lines reveals WANG solid theory and clinical foundation.Combined with the classical text,this paper summarizes and augments some of WANG’s dissertations.First of all,"the healer is good at meaning".The composition of prescription needs the compatibility of the healer.For example,the heart is the monarch,the control of the operation of the viscera,The same is true of medicine.we should understand Monarch,Minister,Assistant,Guide and ascending,descending and so on.Second,starting from the"Flexible use of drugs",the prescription is not invariable,it needs flexible administration,the dosage and dosage form of the medicine should be changed according to the specific situation of the patient,in order to get better clinical effect.Thirdly,starting from"searching for the primary cause of disease in treatment",clinical practice always centers on the changes of Yin and Yang in the patient’s body,and the healer should not be confused by external appearances,and The wrong medication may delay the disease.Fourth,from the"Prescription balance the incidental and fundamental",not only needs to consider the patient’s disease,but also needs to consider the prognosis and outcome of the patient.Prescription medication is on the one hand,it is more necessary to take care of patients’emotions to make them cooperate with the treatment,and good cooperation between doctors and patients makes the prescription play a better role;Fifth,"pay attention to the holistic concept".WANG has always emphasized that the treatment should pay attention to the patient,not the disease.We should not only focus on the treatment of the disease,but put the patient in a broader view of nature-society-and-individuall.Only in this way can the holistic concept and holistic treatment of TCM can be achieved,which is also the feature of TCM.This paper discusses some of WANG Lao’s prescription lecture notes from the above five aspects respectively.We are looking forward to your advice on our shortcomings.