从性味配伍理论探析吴鞠通运用金银花连翘经验

Analysis of Wu Jutong’s experience of using Lonicerae and Forsythiae from the perspective of medicinal combination theory based on properties and flavor

性味理论是中医学基础理论之一,依据性味理论组方用药,称为性味配伍。基于温病卫气营血的辨证体系分别叙述金银花、连翘(简称银翘)在各方证中的运用,具体为:卫分证辛凉苦甘法,用银翘疏散风热。气分证用银翘清热解毒:温热病辛凉甘寒法、辛凉合甘苦合化阴气法;温毒病辛凉微苦法;湿热病辛凉芳香法。营分证用银翘透热转气:初入营分辛凉甘寒芳香法;邪炽营分咸寒甘苦法;邪陷心包咸寒甘苦法。血分证辛凉芳香法,用银翘清络。并以性味配伍理论分析组方规律,在《吴鞠通医案》中寻找对应的医案辅以解析。

The theory of properties and flavors is one of the basic theories of traditional Chinese medicine. Composing formulas under its guidance is referred to as medicinal combination based on properties and flavors. This study describes the application of Lonicerae and Forsythiae in various prescriptions for syndromes based on the syndrome differentiation system of in wei-qi-ying-blood pattern identification of warm diseases. For wei level patterns, acrid-cool and bitter-sweet medicinals are preferred, and Lonicerae and Forsythiae are used to scatter and dissipate wind-heat. For qi level patterns, the two herbs can clear heat and resolve toxins;warm febrile diseases are treated with acrid-cool and sweet-cold medicinals, and the combined use of acrid-cool medicinals and the approach of transforming yin qi with sweet-bitter medicinals;acrid-cool and slightly bitter medicinals are preferred for warm toxin diseases;and acrid-cool and aromatic medicinals for damp heat diseases. In the treatment of ying level patterns, Lonicerae and Forsythiae eliminate heat in the ying level through the qi level;when pathogenic heat starts to enter the ying level, acrid-cool, sweet-cold, and aromatic medicinals should be considered;as the pathogenic heat grows intense in the ying level, and eventually overwhelms the pericardium, salty-cold and sweet-bitter medicinals should be chosen. Blood level patterns are to be treated with acrid-cool and aromatic medicinals, combined with Lonicerae and Forsythiae which clear heat from collateral channels. The rules for creating prescriptions were analyzed in this study from the perspective of medicinal combination based on properties and flavors, and corresponding clinical records were discovered in Wu Jutong’s Case Records as examples.