《东垣试效方》内科中的风药运用

Application of Wind Medicine in Internal Medicine of LI Dongyuan’s Proven Formulas

风药即“药类法象”中的“风升生”药,具有上升外浮、发散疏达等特点。风药的运用贯穿了《东垣试效方》的始终,应用于内外妇儿五官各科,尤以内科最为突出。头痛头眩,风药上行,疏风散邪;脾胃病,以风药益气升阳、疏木达土、疏壅消滞、健脾除湿;劳倦发热,以风药升发脾胃清阳,疏散下流伏火;风湿腰痛,以风药祛风除湿散寒;消渴燥热,以风药发散郁热;瘟毒郁火,以风药发散瘟毒郁火。风药与不同药配伍可发挥不同效用,防风配伍柴胡、升麻升提脾气,配伍白术、黄芪治虚证外感,配伍白术、白芍、陈皮柔肝疏肝达脾,伍羌活疏肝息风,伍以祛风、活血药祛风通痹止痛。柴胡、升麻配伍,可发散少阳、阳明二经郁火或脾经郁火,或升提脾胃清阳。东垣对风药的运用灵活,风药或作为君药,或作为引经药、臣佐药,在临床应用中发挥重要作用。风药思想在宋代已有发端,金元时期得以发展,近代张锡纯之升陷汤用风药,乃是对东垣风药思想之承续与创新。

Wind medicine refers to the herbal medicine of“wind rising and germinating”in the“medicine category based on image”,with the characteristics of rising,floating,dispersing and expelling.The application of wind medicine runs through LI Dongyuan’s Proven Formulas,and is applied to various departments of internal medicine,surgery,genecology,pediatrics,ophthalmology and otorhinolaryngology,especially internal medicine.For headache and dizziness,wind medicine is applied to rise up,dispersing wind and dissipating pathogen.For spleen and stomach disorder,wind medicine is used to replenish qi and elevate yang,soothe liver and regulate spleen,dredge congestion and resolve stagnation,invigorate spleen and remove dampness.For overstrain and fever,wind medicine is applied to elevate clear yang of spleen and stomach,disperse downward latent-fire.For rheumatic low back pain,use wind medicine to dispel wind,remove dampness and dissipate cold.For consumptive thirst and dryness heat,use wind medicine to dissipate stagnant heat.For pestilence,toxin and stagnant fire,use wind medicine to dissipate pestilence,toxin and stagnant fire.Wind medicine can play different effects when combined with different medicines,such as Fangfeng(Saposhnikoviae Radix),combined with Chaihu(Bupleuri Radix)and Shengma(Cimicifugae Rhizoma)can elevate spleen qi,combined with Baizhu(Atractylodes)and Huangqi(Astragali Radix)can treat external contraction of deficiency syndrome,with Baizhu,Baishao(Paeoniae Radix Alba)and Chenpi(Citri Reticulatae Pericarpium)can soften liver,soothe liver and regulate spleen,with Qianghuo(Notopterygii Rhizoma et Radix)can soothe liver and extinguish wind,with medicinals for dispelling wind and activating blood circulation can dispel wind,dredge impediment and relieve pain,the compatibility of Shengma and Chaihu can dissipate the stagnant fire of Shaoyang and Yangming meridians,or the stagnant fire of spleen meridian,or elevate clear yang of spleen and stomach.LI Dongyuan applied wind medicine widely,as sovereign medicine,meridian guiding medicine or minister and assistant medicine,which plays an important role in clinical practice.Wind medicine thought originated in the Song Dynasty and developed in the Jin and Yuan Dynasties.In the modern times,ZHANG Xichun using wind medicine in Shengxian Decoction(升陷汤)was a continuation and innovation of Dongyuan’s thought of wind medicine.