《伤寒论》大黄炮制方法及应用探析

Analysis of Processing Methods and Application of Rhubarb in Shang Han Lun

炮制中药的使用是中医临床用药的特色之一。《伤寒论》作为中医经典学习的基础,不仅在对理法方药的分析方面具有深刻的启示作用,同时对于临床炮制药物的应用也具有重要的指导意义。大黄为《伤寒论》收载方剂中最常用的药物之一,《伤寒论》收载了酒洗、去皮、生用及麻沸汤渍之4种大黄的炮制方法。药物的炮制方法与其临床疗效密切相关,酒洗多用于伴有上焦神志改变的阳明热结证及瘀血重证,去皮多用于气分病证及制成丸剂,生用多用于不伴神志改变的热证和积证,麻沸汤渍之多用于清中焦无形邪热。本文从《伤寒论》涉及大黄的15首方剂的主治病机、配伍药物及药物炮制的关系切入,探讨大黄不同炮制方法的内涵及应用特点,以期挖掘经典指导临床,同时以大黄为例,为中医经典著作指导中药临床特色用药的思维体系构建提供借鉴。

The use of processing Chinese medicine is one of the characteristics of Chinese medicine clinical medicine.Shang Han Lun,as the basis for the study of the classics of traditional Chinese medicine,not only has profound enlightenment for the analysis of principles,methods,prescriptions,and medicines but also has important guiding significance for the application of clinically processed drugs.Rhubarb is one of the most commonly used herbs in the prescriptions included in.Shang Han Lun.Shang Han Lun contains four methods of processing rhubarb,including wine washing,peeling,raw use and the application of the decoction of Ma Fei Boiling.The clinical efficacy of prescriptions is closely related to drug processing.Wine washing is mainly used for Yang ming heat deposition and blood stasis syndrome accompanied by the change of upper focus consciousness.Peeling is usually used for air separation and made into pills.Raw rhubarb is mainly used for heat syndrome and accumulation syndrome of unconsciousness change.The application of the decoction of Ma Fei Boiling is used to clear the invisible heat of coke.To explore the connotation and application characteristics of four processing methods to explore classics and guide clinical practice,this article elaborated the relationship between the attending pathogenesis of fifteen rhubarb prescriptions of rhubarb in Shang Han Lun,compatible drugs and drug processing.Meanwhile,this paper intends to provide a reference for the construction of the thinking system of traditional Chinese medicine in guiding the clinical use of traditional Chinese medicine by taking an example of Rhubarb.