从复杂性辨证论治思维论黄连阿胶汤

Discussion on Huanglian Ejiao Decoction(黄连阿胶汤)Based on Complex Syndrome Differentiation and Treatment Thinking

复杂性辨证论治思维是中医临床辨证方法的“变法”思维,是一种灵动性的辨证方法。黄连阿胶汤本是张仲景少阴热化方,然从复杂性辨证论治思维思之,本方主治病机为升降失因、枢机不利、开阖失常、阴阳失和、中土失畅。因此,黄连阿胶汤在调和阴阳、交通心肾的同时,注重调理中焦、枢转气机,使之一气周流,进而使阴升阳降、水火互融。方中鸡子黄为中土斡旋、通达心肾之要药,其功效既可枢转中轴气机以带动四维运转,又可上行下达恢复气机之龙虎回环,使阴阳升降协调有序,充分体现了“变法”思维的灵动性,也为临床上灵活应用黄连阿胶汤解决疑难性和复杂性疾病提供新思路。

Complex syndrome differentiation and treatment thinking is the“changing method”thinking of traditional Chinese medicine clinical syndrome differentiation method and it is a kind of flexible syndrome differentiation method.Huanglian Ejiao Decoction(黄连阿胶汤)is originally from ZHANG Zhongjing Shaoyin heat transformation prescription.However,from the perspective of complex syndrome differentiation and treatment thinking,the pathogenesis of this prescription is the loss of normal ascending and descending,the mechanism is unfavorable,and the opening and closing are abnormal,the imbalance of yin and yang,and the disharmony of spleen and stomach in middle-jiao.Therefore,Huanglian Ejiao Decoction,while harmonizing yin and yang and communicating the heart and kidney,pays attention to regulating the middle-jiao and pivot qi,making qi circulate,and then making yin ascend and yang descend and harmonizing water and fire.Jizihuang in the prescription is an important medicine for mediating middle-jiao and communicating the heart and kidney,which can not only pivot the central qi to drive the four-dimensional operation,but also restore qi circulation,which is similar to the dragon and tiger loop,so as to coordinate the ascending and descending of yin and yang,which fully reflects the flexility of the thinking of“changing method”and provides a new idea for the flexible application of Huanglian Ejiao Decoction to solve difficult and complicated diseases in clinic.