论太阴病宜服“四逆辈”

Discussion of Taiyin Disease Should Be Treated with"Sini Formula"

张仲景在《伤寒论》原文第277条中提到了太阴病的治疗,此条指出太阴病下利的基本病机是太阴脾脏虚寒,因此仲景在治疗上选用四逆辈,其“辈”为类之意,即四逆汤类的温里散寒之剂。选用四逆汤类方治疗太阴病及相关的变化,既可以提高疗效,又可以防微杜渐,体现了张仲景在临床上治未病和保阳气的思想。张仲景不拘泥一方,而用类方也体现了其临床精于辨证论治和灵活用药。张仲景在临床过程中对于四逆辈运用的灵活和严谨,及善于掌握脉证分析,对于现在临床的辨病和诊治都有指导意义。

Zhang Zhongjing mentioned the treatment of Taiyin disease in Article 277 of the original text of the Treatise on Febrile Diseases,which pointed out that the basic pathogenesis of Taiyin disease with diarrhea is deficiency of cold in the spleen of Taiyin.This prescription was chosen because of the treatment of Taiyin disease with Sini decoction and its related changes,which can not only improve the efficacy,but also prevent microscopic and gradual changes,reflecting Zhongjing’s idea of treating the undiseased and preserving Yang Qi in clinical practice.The fact that Zhongjing did not stick to one side but used similar formulas also reflects his clinical expertise in diagnosis and treatment and flexible use of medicine.Zhongjing’s flexibility and rigor in the clinical process for the four inverse generations and his skill in pulse-Syndrome analysis are of guidance for clinical diagnosis and treatment nowadays.