桂枝加苓术附汤渊源与案例分析

Origin and Case Analysis of Guizhi Lingzhu Decoction

桂枝加苓术附汤首见于日本汉医学者汤本求真的《日医应用汉方释义》,学术来源于张仲景《伤寒论》,由桂枝汤加白茯苓、白术、制附片组成。据方义理解,加白术、茯苓健脾化湿,淡渗水湿;加附子补脾肾真阳。原书举医案仅1例,但列出的治疗范围涉及西医疾病名称。该文作者通过诸多相近古方的比较,阐述治疗的异同,并列举名医中桂枝加苓术附汤相近医案及笔者的治疗医案对比,观察各适应证的效果差异,总结治疗经验。

Guizhi Lingzhu Decoction is first discovered in the Interpretation of the Application of Chinese Prescriptions in Japanese Medicine by Yumoto Kyushin,a Japanese Han medicine practitioner.Academic source comes from the Treatise on Cold Pathogenic Diseases by Zhang Zhongjing.This prescription is composed of Guizhi Decoction plus white poria cocos,atractylodes macrocephala and prepared tablets.Based on the understanding of the prescription,the addition of atractylodes macrocephala and poria cocos can strengthen spleen and remove dampness,promote diuresis with drugs of tasteless flavor;the addition of radix aconiti lateralis preparata can tonify spleen and kidney yang.There is only a case of medical recorded cited in the original book.But the treatment scope listed involves western medicine disease names.By comparing many similar ancient prescriptions,author of the article expounds the similarities and differences in treatment,and lists similar medical records of Guizhi Lingzhu Decoction among famous doctors and compare them with the author's treatment medical records,observes the differences in effectiveness for indications and summarizes treatment experience.