基于偏序形式结构可视化方法分析岭南伤寒派名家黎天祐运用四逆汤类方经验

Famous Doctor of Lingnan Shool of Cold Damage LI Tianyou’s Experience in Using Categorized Formulas of Sini Decoction(四逆汤):An Analysis based on Partial Order Structure Visualization

目的总结岭南伤寒派名家黎天祐运用四逆汤类方的经验。方法采集《伤寒论崇正编》和《黎庇留医案》中四逆汤类方所在条文中涉及的证候、治则治法、病患体质等信息,进行规范化表达,建立《伤寒论崇正编》《黎庇留医案》中记载的四逆汤类方方剂和方证数据库,基于偏序形式结构分析的可视化方法建立形式背景,生成属性偏序结构图,并与团队前期完成的《伤寒论》四逆汤类方方剂配伍整体群结构图和相应方证群结构图作对比。结果基于偏序形式结构分析群结构图可以发现黎天祐四逆汤类方、四逆汤方证、真武汤方证的特点,即黎天祐认为"脉沉微"为四逆汤脉之关键,重视手足寒或厥冷为四逆汤主症;在张仲景基础上,扩展了真武汤方证应用,增加在发热、腹痛、小便不利、四肢沉重疼痛、下利、全身无力、纳差、不寐等证候辨治。结论黎天祐运用四逆汤类方强调实证验经,强调脉证相参,强调扶阳救治危急重症。

Objective To summarize the experience of famous Lingnan School of cold damage doctor LI Tianyou in using categorized formulas of Sini Decoction(四逆汤).Methods The information on the syndromes,therapeutic principles and methods,and the constitution of the patients in relation to the categorized formulas of Sini Decoction were extracted from the Chongzheng Compilation of‘Treatise on Cold Damage’(《伤寒论崇正编》)and LI Biliu’s Medical Records(《黎庇留医案》),and were standardized to construct a database.Partial order structure visualization was used to establish the order background,and to generate a partial order attribute diagram,which would be compared with the overall group structure diagram and the corresponding prescription-syndrome group structure diagram previously finished by the authors on the categorized formulas of Sini Decoction recorded in Treatise on Cold Damage(《伤寒论》).Results The results of the partial order attribute diagram indicated the characteristics of LI Tiany-ou’s categorized formulas of Sini Decoction,Sini Decoction syndrome and Zhen Wu Decoction(真武汤)syndrome,that was,in LI Tianyou’s opinion,deep faint pulse and cold/reversal cold of the hands and feet(cold hands and feet with cold moving proximally to the elbows and knees)are the key manifestations of using Sini Decoction.Based on ZHANG Zhongjing’s,LI Tianyou extended the application of Zhen Wu Decoction in treating fever,abdominal pain,difficulty urinating,heavy pain in limbs,diarrhea,general weakness,poor appetite,insomnia based on syndrome differentiation.Conclusion LI Tianyou’s experience in using categorized formulas of Sini Decoction is characterized by the emphasis on the empirical and proven experience,the junction of pulse and syndromes,and the treatment of acute and critical cases with yang-reinforcing method.