陈延基于肝脾阴虚病机拓展资生丸的临床运用

Experience of CHEN Yan in Expanding the Clinical Application of Zisheng Pills based on the Pathogenesis of Liver and Spleen Yin Deficiency

资生丸为明代名医缪希雍治疗妇女阳明脉衰、胎无所养之胎堕而创立的方剂,具有益气安胎的功效。该方由人参、白术、茯苓、淮山药、莲子肉、芡实、陈皮、桔梗、炒薏苡仁、白扁豆、白豆蔻、藿香叶、泽泻、黄连、山楂、麦芽、甘草组成。陈延主任立足资生丸治疗阳明脉衰的本意,深入分析该方适用病证的病位、病机,认为资生丸适用病证的关键病位在肝脾,关键病机在于肝脾阴虚,对临床因肝脾阴虚而出现的不思食、食入难化、腹部胀满、大便溏薄、小便频数、四肢无力、肌肉萎缩、形体消瘦、面色无华、少气懒言等病症,可加减运用资生丸以治阳明厚肝体(补脾以养肝阴缓肝急)。陈延主任对资生丸的古方新用,进一步拓展了该方的临床应用范围,为临床诊疗及用药提供了思路。

Zisheng Pills were established by practitioner MIAO Xi-Yong in the Ming Dynasty for the treatment of abortion due to the decline of Yangming Meridian and the malnutrition of fetus.The recipe is composed of Radix Ginseng,Rhizoma Atractylodis Macrocephalae,Poria,Rhizoma Dioscoreae,Semen Nelumbinis,Semen Euryales,Pericarpium Citri Reticulatae,Radix Platycodonis,stir-baked Semen Coicis,Semen Lablab Album,Fructus Amomi Rotundus,Folium Pogostemonis,Rhizoma Alismatis,Rhizoma Coptidis,Fructus Crataegi,Fructus Hordei Germinatus and Radix Glycyrrhizae,and has the actions of replenishing qi and preventing miscarriage.Physician CHEN Yan has probed into the location of disease and the pathogenesis of the indications of Zisheng Pills based on the fundamental pathogenesis of the decline of Yangming Meridian,and believes that the indicated syndrome of Zisheng Pills involves the liver and spleen,and the deficiency of liver and spleen yin contributes to the pathogenesis of the indications of Zisheng Pills.For the treatment of clinical manifestations of poor appetite,lack of appetite,indigestion,abdominal distention and fullness,loose stool,frequent urination,weakness of the extremities,myatrophy,emaciation,lusterless complexion,and shortness of breath with reluctance to talk caused by the deficiency of liver and spleen yin,the modification of Zisheng Pills can be used to invigorate the spleen for nourishing liver yin and relieving the hyperactivity of the liver.The novel use of ancient prescription of Zisheng Pills by CHEN Yan expands the clinical application,and will supply thoughts for clinical treatment and medication.