《伤寒论》治疗下利证用药规律分析

Medication Rules of Treating Dysentery in Shanghanlun

目的:分析《伤寒论》中治疗下利证的遣方用药规律,为临床诊治下利病证提供思路与方法。方法:筛选归纳《伤寒论》中治疗下利证的相关条文与方剂,对“下利”相关词的出现频次、中医治法、治疗下利证方药出现的频次、频率以及药物性味、脏腑归经进行统计分析。结果《:伤寒论》中与“下利”相关的经文95条,治疗下利的方剂共有33首,一共用药48味,其中甘草、干姜二药运用最多,治法以和、温二法为主,归脾经药物最多,占26.53%,其次为肺、胃、心经;性味以甘、温之品为多。结论《:伤寒论》中治疗下利证的总原则为“阴阳自和”,首辨阴阳,再辨六经,后辨方证;用药主以甘、温,常配伍甘草、干姜,注重“保胃气,存津液”;着重调理脏腑气机,主要从脾、胃、肺、心论治,以恢复气机升降,做到“审察病机,气机为要”。

Objective:To provide thinking and methods for clinical diagnosis and treatment of dysentery by analyzing the medication laws and the prescription of treating the disease in Shanghanlun(Treatise on Febrile Diseases).Methods:The relevant articles and prescriptions of treating the disease were screened and summarized,the frequency of occurrence of the words related to dysentery,TCM therapeutic methods,the frequency of the prescription and medicine of treating dysentery,the nature and flavor,meridian entropism were statistically analyzed.Results:There were 95 articles related to dysentery,33 prescriptions of treating the disease in Shanghanlun,and 48 herbs were used,among them,Gancao and dried ginger were the most applied,therapeutic methods adopted harmonizing and warming mainly,and the herbs of entering the spleen meridian were the most,reaching 26.53%,the next the meridians of lung,stomach and heart;the herbs were sweet in taste and warm in nature mostly.Conclusion:The general principles of treating dysentery in Shanghanlun are"natural harmony between Yin and Yang",the first to distinguish Yin and Yang,differentiate six meridians,and then the prescriptions and the syndromes;the drugs are sweet in taste and warm in nature,usually combining with Gancao and dried ginger,importance should be attached to"protecting the stomach Qi and preserving body fluid";regulating Qi movement of the viscera should be emphasized,mainly from spleen,stomach,lung and heart,so as to restore the ascending and descending of Qi movement,that is,"Qi movement is key in examining the pathogenesis".