朱丹溪与张景岳治疗痰证用药特点探析

Analysis of the Aimilarities and Differences of Chinese Herbal Medicine Used by Zhu Danxi and Zhang Jingyue for Phlegm Syndrome

目的:探析朱丹溪与张景岳治疗痰证的用药特点。方法:应用中医传承计算平台V 3.0软件,对两位医家治疗痰证的遣方用药进行统计分析,比较两者之间的异同。结果:朱丹溪用方共147首,含中药149味,得到药物组合33个,方剂聚类为4类;张景岳用方共197首,含中药188味,得到药物组合31个,方剂聚类为4类。用药方面二人均以温药为主,多用辛、苦、甘味,多归于脾、胃、肺经,但在应用具体药物上有所不同,二者均常用半夏、陈皮、茯苓、生姜、白术、甘草、胆南星,朱丹溪还常用黄芩、苍术、香附、川芎,张景岳较多用人参、熟地黄、当归、干姜。结论:朱丹溪和张景岳在治疗痰证时均以二陈汤为基础方,朱丹溪重视脾胃,强调顺气为先,痰瘀同治,张景岳重视脾肾,强调扶正治本、补益元气。二人治疗痰证的异同,对临床实际有一定的指导价值。

Objective:To explore the medication characteristics of Zhu Danxi and Zhang Jingyue in treating phlegm syndrome.Methods:Software of TCM Inheritance Computing Platform V 3.0 was used to analyze the prescription and medication of two physicians in the treatment of phlegm syndrome,and the similarities and differences between the two were compared.Results:A total of 147 prescriptions were used by Zhu Danxi,including 149 herbs,33 drug combinations,and 4 prescription clusters;197 prescriptions were used by Zhang Jingyue,including 188 herbs,31 drug combinations,and 4 prescription clusters.The frequency of warm drugs was the highest in both patients,and the drugs were mainly spicy,bitter and sweet.The medication of the two patients was mostly attributed to the spleen meridian,stomach meridian and lung meridian.However,there are some differences in the application of specific drugs,both commonly used Pinellia,Tangerine peel,Poria cocos,Ginger,Atractylodes rhizoma,Licorice,Bile arisaema.Zhu Danxi often used Scutellaria baicalensis,Atractylodes rhizome,Xiangfu,Rhizoma coptidis,while Zhang Jingyue used Ginseng,Cooked Rehmanniae Radix,Angelica sinensis and Dried Ginger.Conclusion:Both Zhu Danxi and Zhang Jingyue take Erchen Decoction as the basic prescription in the treatment of phlegm syndrome.Zhu Danxi attaches importance to the spleen and stomach,emphasizes qi-regulating first with simultaneous treatment of phlegm and blood stasis.Zhang Jingyue attaches importance to the spleen and kidney,emphasizes strengthening vital energy and tonifying primordial Qi.The similarities and differences in the treatment of phlegm syndrome between them have certain guiding value to clinical practice.