从寒热虚实气机失调浅析小柴胡汤、乌梅丸、半夏泻心汤的异同

Analysis on Similarities and Differences of Xiaochaihu Tang,Wumei Wan and Banxia Xiexin Tang from Insufficiency of Cold and Heat

小柴胡汤、乌梅丸、半夏泻心汤为《伤寒杂病论》中寒温同调、攻补兼施的方剂,三方共同的病机为寒热错杂、气机失调,病位可涉及太阴脾经和阳明胃经。三方的不同之处在其虚寒郁热的程度和邪气入侵的部位。小柴胡汤和半夏泻心汤的病位主要在三阳经,邪入不深,正损不重,寒热虚实比较均衡;乌梅丸病位主要在厥阴,可累及三阴,阳气损伤较重虚寒更甚。由于症状病机存在共同点,在临床辨证上容易混淆,故需要从寒热虚实、气机失调的角度浅析这三个方的异同之处,以供临床借鉴。

Xiaochaihu Tang,Banxia Xiexin Tang,and Wumei Wan are all prescriptions in“Treatise on Febrile and Miscellaneous Diseases”that consideration is given to both Cold and Heat,tonification and purgation in combination.The three prescriptions all have Cold-Heat syndrome and Qi dysfunction.The disease location may involve the Taiyin and Yangming.The difference of the three parties lies in the degree of its deficiency and Cold stasis and the place of Evil invasion.The disease location of Xiaochaihu Tang and Banxia Xiexin Tang was mainly in the Three Yang Meridian,the Evil was not deep,the positive damage was not serious,Cold and Heat were balanced.The disease location of Wumei Wan was mainly in Jueyin,which could involve the three Yin,and the damage of Yang Qi and Cold were severe.Because of the common points of symptoms and pathogenesis,it was easy to be confused in clinical differentiation.Therefore,it is necessary to analyze the similarities and differences of the three prescriptions from the perspective of cold and Heat deficiency and Qi dysfunction for clinical reference.