《辅行诀五脏用药法要》小补肝汤论治肝阳虚新悟

Research on the Xiaobugan Decoction recorded in the“Fu Xing Jue Wu Zang Yong Yao Fa Yao”treating liver-yang deficiency syndrome

肝阳虚证,是指肝阳虚衰、阴寒内生、机体失于温煦、气机升降枢机不利所表现的虚寒证候。历代医家对于肝阳虚证的证治存在争议。《辅行诀五脏用药法要》中记载的小补肝汤以五脏体用虚实理论、五味五行互含理论为理论基础立法成方。本研究通过条文缕析、方药探疑,从方药组成、制方原理探讨小补肝汤的制方内涵,发现小补肝汤可视作一首温肝阳的方剂;从情志之变、肝魂之变、气机之变,立足阳气温煦、推动、兴奋、升腾等功能作用认识小补肝汤证,发现小补肝汤一系列症状与肝阳虚病机契合。本研究结合以方测证及据症测证,全面探讨了《辅行诀五脏用药法要》小补肝汤论治肝阳虚证,为临床认识和辨治肝阳虚证提供临证思路和诊疗策略。

The syndrome of liver-yang deficiency refers to a deficiency of liver-yang,internal generation of yin-cold,failure of the body to be warmed and nourished,and impaired functioning of the pi vot for the ascending and descending of qi,manifesting as a cold syndrome.There has been controversy among medical practitioners throughout history regarding the diagnosis and treatment of liver-yang deficiency syndrome.The Xiaobugan Decoction recorded in the“Fu Xing Jue Wu Zang Yong Yao Fa Yao”is formulated based on the theories of the substantial and functional aspects of the five zang,as well as the mutual inclusion of the five flavors and five elements.On the method of text analysis and prescription research,this study delves into the composition and rationale behind the Xiaobugan Decoction,revealing it to be a formula that warms the liver-yang.Furthermore,by exploring the changes in emotions,liver spirit,and qi movement,and focusing on the warming,promoting,stimulating,and ascending functions of yang qi,this study study the syndrome treated by the Xiaobugan Decoction.This analysis uncovers a congruence between the series of symptoms addressed by the decoction and the pathogenesis of liver-yang deficiency.This study comprehensively explores the use of the Xiaobugan Decoction from the“Fu Xing Jue Wu Zang Yong Yao Fa Yao”in the treatment of liver-yang deficiency syndrome,integrating both the methods of syndrome differentiation based on prescription and syndrome differentiation based on symptoms.This paper would provide clinical insights and diagnostic and treatment strategies for the recognition and differentiation of liver-yang deficiency syndrome in clinical practice.