基于《柳宝诒医案》浅探柳宝诒以药制药学术思想

Brief Analysis of Academic Thought of Using Particular Chinese Herbs to Process Other Chinese Herbs Based on LIU Baoyi’s Medical Cases

目的:对《柳宝诒医案》中使用以药制药炮制法的医案进行统计分析,探析龙砂医家柳宝诒以药制药的规律与经验。方法:统计使用以药制药炮制法的医案门类,以及使用了以药制药法炮制的药物频次。结果:全书共37个医案门类,使用以药制药法的药物种类共计65种。以药制药法使用频次在9次以上,排在前10位的医案门类分别是疝气、呕哕、肢体痛、妇人、痰饮、小儿、伏温、肝风、咳血、肝火。使用以药制药法频次排在前10位的药物分别为金铃子、阿胶、黄连、青皮、牛膝、黄柏、白芍、生地黄、瓜蒌皮、黄芩。结论:柳宝诒在使用以药制药炮制法的过程中体现出的特点有:使用广泛,用法多样;祛邪为先,护胃为要;以药引经,增效减毒;效用为主,以制为配;煎汤代水,增效扩效等,对中药的配伍、使用、炮制、服药等方面均有一定启示。

Objective:To analyze the rules and experience of LIU Baoyi,a Chinese medicine practitioner in Longsha Area,in the application of the method of using particular Chinese herbs to process other Chinese herbs in medical cases in LIU Baoyi’s Medical Cases.Methods:The categories of medical cases which reflected the method of using particular Chinese herbs to process other Chinese herbs and the frequency of Chinese herbs processed by this method were analyzed.Results:There were 37 categories of medical cases in the whole book,and 65 kinds of Chinese herbs were used by this method.The categories of medical cases which recorded more than nine times of use and ranked at the top ten were hernia,vomiting and retching,limb pain,women,phlegm rheum,children,latent warmth,liver wind,hemoptysis and liver fire.The top ten Chinese herbs in the frequency of use were Fructus Toosendan,Colla Corii Asini,Rhizoma Coptidis,Pericarpium Citri Reticulatae Viride,Radix Achyranthis Bidentatae,Cortex Phellodendri Chinensis,Radix Paeoniae Alba,Rehmannia Glutinosa,Pericarpium Trichosanthis and Radix Scutellariae.Conclusion:The characteristics of the method of using particular Chinese herbs to process other Chinese herbs are as follows.Firstly,the method is widely used and varied in usage.Secondly,the priority should be given to dispelling pathogen and combined with protecting the stomach.Thirdly,the effects of other herbs are guided to specific channels and the effects are improved while the toxin reduced.Fourthly,the effects of herbs are mainly focused,and the medicinal processing supports.Fifthly,the decoction takes the place of drinking water to improve the effects.It is found that this method has some enlightenment to the compatibility,use,processing and-medicine-taking of Chinese herbs.