张志远临证运用白术经验

ZHANG Zhiyuan's Experience in Using Baizhu(Atractylodes macrocephala)in Clinical Practice

总结国医大师张志远运用白术的经验。临证除取通便之效时选用白术生品,其余多将其土炒后入药。认为白术功善利水祛湿,将其用于苓桂类方剂中或自拟止泻汤以治疗泄泻;大剂量应用白术可塞因塞用治疗水肿,自拟疏肝祛水汤或以理中汤加减治疗肝硬化腹水;强调白术祛除痰饮之效,常以泽泻汤加减治疗实证眩晕;认为白术亦能健脾消胀和胃,对于虚实腹胀皆可应用,常以补润汤治疗虚实夹杂之腹胀,以枳术汤加减或自拟调中汤治疗虚性腹胀。

Professor Zhang Zhiyuan,a master of Chinese medicine,made good use of Baizhu(Atractylis macro⁃cephala(Koidz.)).Except for defecation in clinical practice,he usually prescribed processed Baizhu after stir-frying with soil.Baizhu is good at excreting water and removing dampness,so applied it in the formula series with Fuling(Poria cocos)and Guizhi(Cassia Twig)or self-made decoction for diarrhea.High-dose Baizhu could be used for edema by treating obstructive syndrome with tonics,so Baizhu were added in self-made Shugan Qushui Decoction(疏肝祛水汤)or modified Lizhong Decoction(理中汤)for liver cirrhosis ascites.It was emphasized that Baizhu could eliminate phlegm,so added it in modified Zexei Decoction(泽泻汤)for excess syndrome of vertigo.It was also acknow-ledged that Baizhu could strengthen the spleen and stomach,and was suitable for deficiency or excess syndrome of abdomi⁃nal distension,so applied it in Burun Decoction(补润汤)for abdominal distension with deficiency-excess in complexity,and applied it in Zhizhu Decoction(枳术汤)or self-made Tiaozhong Decoction(调中汤)for deficient abdominal distention.