从承制角度认识补中益气汤应用进展

A review on the application of the Buzhong Yiqi decoction from a mutually restrictive standpoint

文章主要探究与认识补中益气汤临床应用范围广泛的原因与机理,一是从承制角度分析补中益气汤的方药组成、配伍模式;二是举证百家案例并加以分析;三是从药理方面分析本方的作用机理。本方具有补中益气、升阳举陷之功,不仅主治脾虚不升所致头晕目眩、耳鸣耳聋,以及中气下陷之内脏下垂等病证,还可以治疗痿证、尿浊、遗精、飧泻、癃闭、痞满和便秘等病症。本方可通过多种作用机制发挥免疫调节、抗肿瘤、抗炎等作用,影响胃肠功能、心功能和肌张力。本方与四君子汤、升陷汤均为补气之方,但补中益气汤侧重于解决中气下陷,升陷汤则偏重于治疗大气下陷,因二者具有阴阳相对、承制相因的特点,故比四君子汤应用更广泛。补中益气汤具有寒温并用、攻补兼顾、升降相因之特点,其中前两者属于辨证施治的范畴,后者属于承制施治的内容,此为其能够治疗内、外、妇、儿之症的原因所在。在符合基本方证的前提下,以此为组方思路加减应用,必将使其发挥更大的治疗作用。

In this article,the reasons and action mechanisms of the widespread clinical application range of the Buzhong Yiqi decoction(补中益气汤)are mainly explored and understood.The first is to analyze the prescription composition and compatibility mode of the Buzhong Yiqi decoction from a mutually restrictive standpoint.The second is to provide many application cases as evidences and analyze them.The third is to analyze the action mechanism of this prescription from the pharmacological perspective.This prescription has the ability to strengthen spleen and stomach for elevating Yang(阳),not only is used to treat dizziness,tinnitus and deafness caused by spleen deficiency,and visceral prolapse caused by Zhongqi(中气)sinking,but also can treat symptoms such as flaccidity syndrome,cloudy urine,nocturnal emission,diarrhea,uroschesis,distention and fullness,and constipation.This prescription can exert immune regulation,anti-tumor,anti-inflammatory and other effects through various action mechanisms,affecting gastrointestinal function,cardiac function,and muscle tension.The Buzhong Yiqi decoction,the Sijunzi decoction(四君子汤)and the Shengxian decoction(升陷汤)are all prescriptions for tonifying Qi(气).The Buzhong Yiqi decoction focuses on ascending Zhongqi,while the Shengxian decoction focuses more on treating Daqi(大气)depression.Due to their characteristics of relative Yin(阴)and Yang,as well as mutual restriction,the two prescriptions are more widely used than the Sijunzi decoction.The Buzhong Yiqi decoction has the characteristics of using both cold medicines and warm medicines,balancing attack and supplement,and considering the factors of rise and fall,among which the former two belong to the category of syndrome differentiation and treatment,and the latter belongs to the content of treatment from the mutually restrictive standpoint,which is the reason why it can treat internal disease,external disease,women disease and children disease.Under the premise of meeting the basic prescription requirements,the addition and subtraction of this prescription will undoubtedly play a greater therapeutic role.