基于经方解构新说“石膏配伍解肌法”

Releasing Fresh Method of Gypsum Fibrosum by Compatibility:A New Interpretation Based on Analysis of Traditional Chinese Medicine Classical Prescriptions

石膏解肌之说由来已久,但限于矿物药的溶出及研究手段有限等现实问题,其临床推广及应用不足,深入探讨亦不足。该文通过梳理解肌法的脉络,总结出解肌法所针对的病机为“津液不足,兼表不和”,而石膏解肌的核心内涵为“清火存液,兼透表邪”;通过梳理解肌法的古今运用,结合配位化学的现代研究,从配伍角度入手,主以《伤寒论》和《金匮要略》中的经方为例,拓展了石膏解肌之内涵,总结出石膏的解肌作用不仅可以治疗外感后的肌肉不适症状,还可能影响脏腑功能,进而治疗内伤杂病,并由此提出“石膏配伍解肌法”,认为石膏与麻黄、葛根、防己、知母、人参、芍药、竹茹、生地黄、麦冬和葳蕤等药物配伍后,通过调整透散和清热的力度来更好地发挥解肌作用。该文附临床验案一则予以阐发,以期为石膏的临床运用提供参考,为其配伍使用的药物机制研究提供方向。

The idea that Gypsum Fibrosum can release flesh has a long history,but its clinical popularization,application,and in-depth discussion are insufficient due to the problems of mineral drug dissolution and limited research means.Through the analysis of releasing flesh method(RFM),this paper concluded that the RFM-targeted pathogenesis was deficiency of body fluid and disturbance in the exterior,and the core connotation of RFM of Gypsum Fibrosum was clearing heat to restore fluid and expelling pathogenic factors in the exterior.Based on the ancient and modern application of RFM and modern research on coordination chemistry,this paper enriched the connotation of RFM of Gypsum Fibrosum from compatibility with traditional Chinese medicine(TCM)classical prescriptions recorded in the Treatise on Cold Damage(《伤寒论》)and Synopsis of the Golden Chamber(《金匮要略》)as examples.Specifically,in addition to muscle discomfort symptoms after external contraction,RFM of Gypsum Fibrosum could also affect the function of internal organs,thereby treating internal injuries and miscellaneous diseases.Moreover,a new idea,RFM of Gypsum Fibrosum by compatibility,was proposed,that the fresh-releasing effect of Gypsum Fibrosum could be markedly exerted through compatibility with Ephedrae Herba,Puerariae Lobatae Radix,Stephaniae Tetrandrae Radix,Anemarrhenae Rhizoma,Ginseng Radix et Rhizoma,Paeoniae Radix Alba,Bambusae Caulis in Taenias,Rehmanniae Radix,Ophiopogonis Radix,and Polygonati Odorati Rhizoma by adjusting the expelling and heat-clearing intensity.A clinical case was presented to provide a reference for the clinical application of Gypsum Fibrosum and a direction for the study of drug mechanism of compatibility.