辛丑年三因司天方配伍应用探析

Exploring the Compatibility and Application of Xinchou year Sanyin Sitian Decoction

三因司天方是中医“运气方剂”的代表,是陈无择基于五运六气理论,根据每年岁运与岁气的变化所设立的运气方。2021年岁值辛丑年,其五运格局与六气格局极为相似,均存在土湿伤水而木复之的运气特点。气运皆为土盛水衰及木复,具有寒湿之邪淫盛、肾气损伤、肝旺成郁等病机特征。结合相关本草文献,分析辛丑年运气格局下五味子汤、备化汤的组方原则及药物配伍原理可知,备化汤、五味子汤两方均适用于病机特点为水土失调而木复之病,皆能补肾祛湿且预防复气致病。然而两方针对不同病机侧重而设,五味子汤所治病机特征在于肾之精气亏虚,组方思路为补肾兼祛寒湿;备化汤所治病机特征在于寒湿淫盛而伤肾气,组方思路为祛寒湿兼以扶正,临证时应根据不同病机侧重而辨证选方。

Sanyin Sitian Decoction,the representative of“Yunqi Prescription”in traditional Chinese medicine.,is established by CHEN Wuze according to five circuits and six qi theory.2021 is Xinchou year,as a result of the similarity of five circuits patterns and six qi patterns,both showed character of“earth restricting water”leading to“wood restricting earth”.It has pathogenesis characteristics such as excess of cold and dampness,damage of kidney qi,stagnation of liver hyperactivity,etc.By referring to relevant herbal literature,analyzing the five circuits and six qi in Xinchou year and reviewing the composition principles of Wuweizi Decoction(五味子汤)and Beihua Decoction(备化汤)and the principles of drug compatibility,we believe that both Wuweizi Decoction and Beihua Decoction are both applicable to disease with water and earth imbalance and wood restricts them,which can nourish kidney,remove dampness and prevent disease recurrence.However,the two prescriptions are designed for different pathogenesis.The main pathogenesis characteristic of Wuweizi Decoction is the deficiency of kidney essence,and the idea of formulating the prescription is to invigorate the kidney and remove cold-damp.The main pathogenesis of Beihua Decoction is characterized by excessive cold-dampness and impairment of kidney qi,and the idea of formulating the prescription is to diapersing cold-damp and furtheranceing healthy qi.Therefore,prescriptions should be selected according to different pathogenesis emphases during clinical syndrome differentiation.