探讨《伤寒论》三阴三阳病用药特点

A discussion on the medication characteristics of Sanyin and Sanyang diseases in Shanghan Lun

目的:探讨《伤寒论》三阴病与三阳病用药特点,以期能更好地传承经方用药特点。方法:收集《伤寒论》中所载的方剂,依托中医药传承辅助平台V2.5分别建立三阴三阳病方药数据库,对录入的数据进行分析。结果:三阳病数据库最终录入84方,涉及药物65味。其中1/5以上的方剂均使用过炙甘草、大枣、生姜、桂枝、白芍五味药。三阴病数据库最终录入34方,涉及药物50味。其中1/5以上方子都出现过的药物分别是炙甘草、白芍、桂枝、附子、生姜、干姜、大枣。二者在四气方面均以温性药使用频次最多;五味方面均以甘、辛、苦味药使用频次最多;归经方面均以归脾经、胃经的药物使用频次最多;药物组合方面则是以桂枝汤方内配伍组合使用最多。结论:《伤寒论》善用甘温之品,重视顾护阳气,同时不忘保护脾胃,治疗三阳病偏重宣通阳气,三阴病又注重温补阳气。《伤寒论》处方药简力宏,临证要细细体会,知常达便。

Objective:The medication characteristics in the treatment of Sanyin(三阴)and Sanyang(三阳)diseases in Shanghan Lun(《伤寒论》)was analyzed in this paper,in order to better inherit the medication characteristics of classical TCM prescriptions.Methods:The prescriptions in Shanghan Lun were collected,and the database of prescriptions for treating Sanyin and Sanyang diseases was established based on the traditional Chinese medicine inheritance support system platform V2.5,and the input data were analyzed.Results:Finally,a total of 84 prescriptions were recorded in the database of Sanyang diseases,involving 66 kinds of medicines.Among them,more than one-fifth of the prescriptions all used 5 medicines,namely,Zhi Gancao(roasted licorice),Dazao(jujube),Shengjiang(ginger),Guizhi(cinnamon stick),and Baishao(white peony root).A total of 34 prescriptions were recorded in the database of Sanyin diseases,involving 51 kinds of medicine.Among them,more than one-fifth of the prescriptions all used Zhi Gancao,Baishao,Guizhi,Fuzi(aconite carmichaeli),Shengjiang,Ganjiang(dried ginger)and Dazao.In terms of medicinal property,Warm medicines were used most frequently;in terms of medicinal flavor,sweet,acrid and bitter medicines were used most frequently;in terms of meridian tropism,the medicines most frequently flowed into spleen meridian and stomach meridian.In the aspect of medicine combination,the Guizhi decoction(桂枝汤)was used most frequently.Conclusion:Shanghan Lun makes good use of sweet and warm medicines,pays attention to protecting Yangqi(阳气),and does not forget to protect spleen and stomach at the same time.It is emphasized to promote Yangqi activity in the treatment of Sanyang diseases,and to warm and tonify Yangqi in the treatment of Sanyin diseases.The prescriptions in Shanghan Lun are simple,but the effects are significant.It should be carefully understood in clinical practice.