基于“法象思维”探颐药对“款冬花-百合”在慢性阻塞性肺疾病治疗中的应用

An analysis of the application of matched medicines Kuandonghua-Baihe in treating chronic obstructive pulmonary disease based on the Faxiang thinking

法象思维是古人通过效法取象的方式将物象维度上升至意象维度,探讨分析药物功效的思维模式。中医药学在法象思维的指导下源远流长,应用广泛。法象思维在历代医家最初识药、辨药,以及临床诊察疾病、遣方用药过程中起到不可替代的作用,同时也促进中国古代哲学文化体系不断丰富。现代流行病学调查显示,当下慢性阻塞性肺疾病的防治仍面临严峻形势,该病常迁延日久,致使气道郁滞,痰瘀内生,肺损及肾,迁延不愈,耗伤正气,最终导致本虚标实,肺肾亏虚。药对“款冬花-百合”取自《济生方》百花丸一方,两者作为临床经典药对常相须为用。本研究基于法象思维的指导,从药物名称、取材、阴阳卦象的角度对款冬花、百合药对的药“象”加以剖析,探寻治疗慢性阻塞性肺疾病法“象”用药的作用途径,认为百合与款冬花相合,款冬花温而不燥,卦象呈“坎中含阳”肾之水象,温散之力主化痰之功,升发之力使肺中痰瘀散化,上焦宣通则浊阴自下;百合甘寒凉润,卦象显“离中含阴”心之火象,下通之力可助脏腑痰瘀得泄,凉润之性使热阻得清、肺燥得润,合于百脉之性,通于心肺,润肺宁心,二药一清一润,款冬花携肾象坎中之阳气上达于肺,百合随心象离中之阴血下达于肾,阴血下则肾阴得复,肾气升则肺气得降,共奏理嗽之效。

The Faxiang thinking(法象思维)is a mode of thinking in which the ancients raised the dimension of object image to the image dimension and discussed and analyzed the efficacy of medicines by imitating the way of image.Traditional Chinese medicine has a long history and is widely used under the guidance of the Faxiang thinking.The Faxiang thinking plays an irreplaceable role in the process of the initial identification and differentiation of medicines to the clinical disease diagnosis and prescribing prescriptions of medical practitioners in the past dynasties.The Faxiang thinking also promotes the continuous enrichment of ancient Chinese philosophical and cultural system.According to the modern epidemic disease survey,the current prevention and treatment of chronic obstructive pulmonary disease is still facing a grim situation.The disease often delays for a long time,resulting in airway stagnation,endogenous phlegm and blood stasis,lung and kidney damage,delayed healing,consumption of vital energy,and ultimately leads to the deficiency of the lung and kidney.Kuandonghua(Flos Farfarae)-Baihe(Bulbus Lilii)were taken from Baihua Wan(百花丸)in Jisheng Fang(《济生方》).As a classic medicine pair,the two medicines are often used together.Based on the guidance of the Faxiang thinking,the author analyzes the“Xiang(象)”of Kuandonghua and Baihe from the aspects of the name of the medicine,the materials selected,and the Yin(阴)and Yang(阳)images.By exploring the way of action of medication in treating COPD,it is believed that Baihe and Kuandonghua are compatible.Kuandonghua is warm but not dry,the trigrams show the water sign of kidney,the force of warming and dispersing is in charge of resolving phlegm,the force of ascending and sending is in charge of dispersing phlegm and blood stasis in the lung,the upper energizer diffuses general turbid Yin from descending.Baihe is sweet and cold,and the trigrams show the fire image of the heart,which helps the viscera to discharge phlegm and blood stasis.The heat resistance of the lung is clear,the lung dryness is moist,thus obtain the effects of moistening the lung and tranquilizing the heart.The two medicines are one clear and one moist,the Yangqi(阳气)in the kidney is up to the lung by Kuandonghua,and Baihe descends to the kidney with Yin blood in the heart image.When Yin blood descends,kidney Yin can be restored,and when kidney Qi rises,lung Qi can be lowered,which will play the effects of relieving coughing.