基于《神农本草经》探究《伤寒论》茯苓量效规律

Investigating the dose-effect laws of Indian bread in Shanghan Lun based on Shennong Bencao Jing

《神农本草经》与《伤寒论》均为中医四大经典,张仲景用药多继承于《神农本草经》之功效。从《伤寒论》张仲景对茯苓的临证应用可知,张仲景深得《神农本草经》中茯苓功效之要义,并在其基础上多有发挥。互参《神农本草经》与《伤寒论》经文,将《伤寒论》中茯苓量效规律总结为3个层次:二两(31.2 g)及以上茯苓主利水化饮,平胃降气以伐水邪;一两至一两半(15.6~23.4 g)茯苓主利尿理气,健脾宁心以安心神;一两(15.6 g)及以下茯苓主健脾渗湿,通利三焦以散津液。将3个茯苓量效层次中蕴含的仲景对痰饮疾病的论治思想总结为温阳气,以标本兼顾;利小便,以通阳安神;存津液,以顾护正气。

Shennong Bencao Jing(Shennong's Classic of Materia Medica);Shanghan Lun(Treatise on Cold Pathogenic Diseases)both belong to the four classics of traditional Chinese medicine,and Zhang Zhongjing's medication mostly refers to the drug effects collected in the Shennong's Classic of Materia Medica.From his clinical application of Indian bread recorded in his masterpiece,it can be seen that he deeply grasps the essence of the drug's effects in the classic and has made many innovations based on those effects as well.By referring to and comparing the descriptions in the two classics,the study summarizes the dose-effect laws of Indian bread in Shanghan Lun into three levels:Two taels(31.2g)or more than two taels of the drug are mainly used for inducing diuresis and resolving fluid retention,soothing the stomach and descending qi to dispel water pathogen.One tael to 1 and a half taels of Indian bread(15.6-23.4g)is mainly used for promoting urination and regulating qi,and for strengthening the spleen and tranquilizing the heart so as to get the heart and mind at ease.One tael(15.6g)and less than one tael of the drug is mainly used for strengthening the spleen and eliminating dampness,and ventilating and activating the sanjiao to disperse fluids.In this paper,Zhang Zhongjing's thoughts on the treatment of phlegm-fluid induced diseases embodied in the three dosage levels of Indian bread are summarized as warming yang qi to treat both the manifestations and the root cause of a disease,promoting diuresis to stimulate yang and tranquilize the mind,and preserving fluids to take care of positive qi,in order to reveal the implications in Zhang Zhongjing's application of Indian bread at different dosage levels.