小柴胡汤“和解少阳”临证体悟
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摘要
"和解少阳"之法是一个抽象的概念,此法可追溯至东汉仲景,明确提出则是在清代,沿用至今,它的具体涵义少有人阐明。小柴胡汤在临床被广泛应用,但其"和解少阳"的机理常常未被说明。结合临床体会,唯有清代周学海在《读医随笔》中讲到:"和解者,合汗、下之法,而缓用之者也",阐明和解少阳之法的机理,且与张仲景"半在里半在外"的病位论述相合。文章尝试从《伤寒论》原文出发,结合历代医家思想,阐明小柴胡汤以解表、通里的方法以解少阳之邪的机理,介绍小柴胡汤的临床应用体会。
The law of ‘reconciling shaoyang' is an abstract concept, which can be traced back to Zhong-jing in the Eastern Han dynasty. It was clearly put forward in the Qing dynasty, and its concrete meaning has seldom been elucidated since it was used. Xiaochaihu Decoction is widely used in clinic, but its mechanism of ‘reconciling shaoyang' is often not explained.Combining with clinical experience, only ZHOU Xue-hai in Qing dynasty said in his Essay on Medical Reading that ‘the reconciler, the method of combining perspiration and descending, and the slow-acting one', which explained the mechanism of the method of reconciling shaoyang, and it was consistent with Zhong-jing's ‘half-superficies and half-interior' discussion of the disease. Starting from the original text of Treatise on Febrile Diseases and combining with the thoughts of physicians of past dynasties, this paper tries to clarify the mechanism of Xiaochaihu Decoction in relieving the evil of shaoyang by means of relieving exterior and tongli, and introduces the clinical application experience of Xiaochaihu Decoction.
The law of ‘reconciling shaoyang' is an abstract concept, which can be traced back to Zhong-jing in the Eastern Han dynasty. It was clearly put forward in the Qing dynasty, and its concrete meaning has seldom been elucidated since it was used. Xiaochaihu Decoction is widely used in clinic, but its mechanism of ‘reconciling shaoyang' is often not explained.Combining with clinical experience, only ZHOU Xue-hai in Qing dynasty said in his Essay on Medical Reading that ‘the reconciler, the method of combining perspiration and descending, and the slow-acting one', which explained the mechanism of the method of reconciling shaoyang, and it was consistent with Zhong-jing's ‘half-superficies and half-interior' discussion of the disease. Starting from the original text of Treatise on Febrile Diseases and combining with the thoughts of physicians of past dynasties, this paper tries to clarify the mechanism of Xiaochaihu Decoction in relieving the evil of shaoyang by means of relieving exterior and tongli, and introduces the clinical application experience of Xiaochaihu Decoction.
引文
[1]田永衍,王庆其.张仲景“和”思想研究.中医杂志,2013,54(4):280-282
[2]邓中甲.方剂学.2版.北京:中国中医药出版社,2003(1):12-13
[3]田永衍,王庆其,凌鹏.张仲景之后医家对“和”法的发展.中医杂志,2013,54(19):1630-1632
[4]关庆亚,王付.“半表半里”与少阳病归属.河南中医,2017,37(3):388-389
[2]邓中甲.方剂学.2版.北京:中国中医药出版社,2003(1):12-13
[3]田永衍,王庆其,凌鹏.张仲景之后医家对“和”法的发展.中医杂志,2013,54(19):1630-1632
[4]关庆亚,王付.“半表半里”与少阳病归属.河南中医,2017,37(3):388-389