金匮肾气丸方证内涵探寻

Exploration of the Connotation of Jingui Shenqi Pill Prescription Syndrome

肾气丸是医圣张仲景的经典名方,见于《金匮要略》中的“中风历节病脉证并治”“血痹虚劳病脉证并治”“痰饮咳嗽病脉证并治”“消渴小便不利淋病脉证并治”“妇人杂病脉证并治”5篇,临床应用广泛。仲景本意肾气丸为补肾气而非补肾阳之方。后世医家临床应用中,多将熟地黄替代生地黄;肉桂替代桂枝,增大附桂在方中的比例,部分医家认为其为温补肾阳之剂,而且现代方剂学教材也将其归为温补肾阳剂范畴。文章通过对肾气丸在《金匮要略》中的原文进行梳理,将药物组成以及方义进行分析,结合作者对其功效的见解,探讨肾气丸方证内涵。

Shenqi pill is a classic prescription of Zhang Zhongjing,which is widely used in clinical practice.It is found in the five chapters of Synopsis of Golden Chamber,stroke and lijie diseases and pulse syndromes and treatment,blood bi deficiency diseases and pulse syndromes and treatment,phlegm and drink cough pulse syndromes and treatment,diabetes mellitus and dysuria and gonorrhea pulse syndromes and treatment,and women miscellaneous diseases and pulse syndromes and treatment.Zhongjing’s original intention of Shenqi pill is tonify kidney qi rather than tonify kidney yang.In the clinical application of later generations of doctors,Rehmannia glutinosa was mostly replaced by Rehmannia glutinosa,cinnamon instead of cassia twig,increase the proportion of attached cassia in the party,some doctors think that it is the warming kidney yang agent,and the modern’prescription textbook also classified it as warming kidney yang agent category.In this paper,the original text of Shenqi pills in Synopsis of Golden Chamber was sorted out,the composition of drugs and the meaning of prescriptions were analyzed,and the connotation of Shenqi pills was discussed in combination with the author’s views on its efficacy.