基于“四位一体”探析黄芪桂枝五物汤治疗中风后遗症思路

Analysis of Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤)in Treatment of Sequelae of Apoplexy Based on Four-in-one Theory

在经方方证分类研究过程中,从“性、位、势、证”四要素即“四位一体”理论出发,对黄芪桂枝五物汤进行总结分析,并在此基础上分析中风后遗症的病因病机。黄芪桂枝五物汤的方性为辛甘温;方位为桂枝汤的营卫,着重于肌肤、经络、四肢;方势为通补固,着重于通筋脉经络,补营卫之气,固肌表腠理;方证为血痹重症、风痹等一类阴阳气血俱虚的病证。故黄芪桂枝五物汤对应治疗因正气亏虚、血脉瘀阻而致的中风后遗症。从“性、位、势、证”的角度对张仲景经方及对应证进行论述,能使其中原理更加全面立体,从而能方证对应地对仲景方进行辨证分析,也有利于更好地将方证理论与临床结合。

In the process of study on the classification of classical formulas and syndromes,starting from the four elements of“property,location,tendency and syndrome”,that is,four-in-one theory,this paper summarized and analyzed Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤).On the basis,the etiology and pathogenesis of sequelae of apoplexy were analyzed.The property of Huangqi Guizhi Wuwu Decoction is pungent,sweet and warm.The location is in the nutrient-defense of Guizhi Decoction(桂枝汤),focusing on the skin,meridians,and limbs.The tendency is dredging,tonifying and consolidating,focusing on dredging tendons and meridians,tonifying nutritive and defensive qi,consolidating exterior,striae and interstices.The formula syndrome is deficiency syndromes of yin,yang,qi and blood in severe blood impediment and wind impediment,etc.Therefore,Huangqi Guizhi Wuwu Decoction is used to treat the sequelae of apoplexy caused by deficiency of healthy qi and stasis obstructing blood vessels.Analyzing ZHANG Zhongjing’s classical formulas and their corresponding syndromes from the perspective of“property,location,tendency and syndrome”can make the principles more comprehensive and three-dimensional,so that the syndrome differentiation analysis of Zhongjing’s formulas can be conducted correspondingly to the syndromes,which is also conducive to better understanding the combination of formula and syndrome theory and clinical practice.