摘要
《伤寒论》与《金匮要略》中所记载的甘草泻心汤药物组成不完全相同:《伤寒论》所载甘草泻心汤中的甘草为炙甘草,是否载有人参尚不明确;《金匮要略》所载甘草泻心汤中的甘草为生甘草,方中明确载有人参。从原文出发,《伤寒论》甘草泻心汤证为脾胃虚弱、痞利俱盛,用炙甘草补中和胃,且方中当有人参。《金匮要略》甘草泻心汤证为中焦湿热内蕴成毒,重用生甘草泻热解毒。二者虽有不同,但方药相通,均可用于中焦虚实寒热错杂、升降失调的多种病证,偏虚者宜用炙甘草,偏热者宜用生甘草,虚与热难分伯仲者,可兼用之。实证可为痰饮湿浊或饮食停聚,或已化热或未化热,临床当结合脉诊随证治之。
The medicinal composition of Licorice Heart-Draining Decoction recorded in Treatise on Cold Damage Diseases and Synopsis of the Golden Chamber is not exactly the same:the licorice in Licorice Heart-Draining Decoction contained in Treatise on Cold Damage Diseases is Zhigancao(Radix Glycyrrhizae Praeparata),and it is unclear whether it contains Renshen(Radix Ginseng).While the licorice in Licorice Heart-Draining Decoction contained in Synopsis of the Golden Chamber is raw Gancao(Radix Glycyrrhizae),and Renshen(Radix Ginseng) is clearly contained in the formula.Starting from the original text,the syndrome of Licorice Heart-Draining Decoction in Treatise on Cold Damage Diseases is that the spleen and stomach are weak,while stuffiness and purgation are excessive.Zhigancao is used to replenish the middle energizer and harmonize the stomach,and Renshen should be included in the formula.The syndrome of Licorice Heart-Draining Decoction in Synopsis of the Golden Chamber is that dampness-heat in the middle energizer is accumulated into toxin,and raw Gancao is heavily used to purge heat and remove toxin.Although the two are different,formula and medicines are interlinked.They can be used for a variety of diseases and syndromes of deficiency and excess,cold and heat in complexity,and imbalance of ascending and descending of the middle energizer.Those with excessive deficiency should use Zhigancao,while those with excessive heat should use raw Gancao.Deficiency and heat cannot be separated,so Zhigancao and raw Gancao can be used at the same time.The excess syndrome can be manifested as phlegm retention,dampness and turbidity or food stagnation,or the heat having changed or having not changed into heat.Therefore,in clinical practice,it is necessary to treat disease by connecting pulse diagnosis.
作者
谭颖
袁世清
杨智豪
陈佩欣
王海龙
TAN Ying;YUAN Shi-qing;YANG Zhi-hao;CHEN Pei-xin;WANG Hai-long(Chengdu University of TCM,Chengdu,Sichuan,China,611137)
出处
《河南中医》
2022年第4期495-497,共3页
Henan Traditional Chinese Medicine
基金
四川省科技创新苗子工程资助项目(2017051)
四川省应用基础研究项目(需求引导型)(2021YJ0154)。
关键词
甘草泻心汤
《伤寒论》
《金匮要略》
张仲景
Licorice Heart-Draining Decoction
Treatise on Cold Damage Diseases
Synopsis of the Golden Chamber
Zhang Zhong-jing
