吴鞠通“治未病”思想在银翘散中的应用
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摘要
银翘散主治上焦温病初起但热而不恶寒之证,从卫气营血辨证的角度来讲,病在卫分,此时用银翘散疏风解表,使邪从上焦肺卫而出,防止温邪传变入里。通过对银翘散的加减方、变方的分析,若病邪已经入里,而表邪未解,一方面要辨明邪之所在,在气者清气,入血者清血,一方面以银翘散加减透表达邪。吴鞠通在应用银翘散时遵循了叶天士"在卫汗之可也,到气才可清气,入营犹可透热转气"的指导思想,时时不忘给邪以出路,防止病邪深入传变,体现出了"治未病"中"既病防变"的治病思维;从三焦辨证来讲,对于人体的上焦而言,逐邪外出属于既病防变,对中焦而言,"先安未受邪之地"属于未病先防。
Lonicera and Forsythia Powder is mainly used to treat onset of febrile disease in sanjiao with fever but without aversion to cold. From the view of syndrome differentiation of defensive qi and ying blood,the disease is in weifen. At this time,Lonicera and Forsythia Powder can be used to disperse wind and release exterior syndrome so as to make pathogens come out of the lung in upper jiao and prevent pathogens from entering into the body. Through the analysis of Modified and Varied prescriptions of Lonicera and Forsythia Powder,it has shown that if the pathogenic factors are already inside the body and the exterior pathogenic factors are not removed. In such cases,on the one hand,the pathogenic factors should be identified in order to promote qi circulation or remove blood stasis. On the other hand,Modified Lonicera and Forsythia Powder can be used to eliminate the pathogenic factors in the exterior. When applying Lonicera and Forsythia Powder,WU Ju-tong followed Ye Tian-shi' s guiding ideology of sweating when disease exists in defensive qi,promoting qi circulation when there is qi stagnation,removing excessive heat when disease exists in ying-qi and never forgot to give the pathogenic factors a way out to prevent the disease from spreading in depth,which embodied the thinking of preventing diseases. According to the syndrome differentiation of sanjiao,for the human body' s upper jiao,removing pathogens out belongs to preventing diseases from changing worse. For middle jiao,keeping the viscera which has not been attacked belongs to prevention of disease. Lonicera and Forsythia Powder is praised as " the first prescription for febrile diseases" by later generations,and has been widely used in internal medicine,pediatrics,five-organ department,dermatology and so on. It has an important relationship with Wu Ju-tong's academic thought of preventing diseases.
Lonicera and Forsythia Powder is mainly used to treat onset of febrile disease in sanjiao with fever but without aversion to cold. From the view of syndrome differentiation of defensive qi and ying blood,the disease is in weifen. At this time,Lonicera and Forsythia Powder can be used to disperse wind and release exterior syndrome so as to make pathogens come out of the lung in upper jiao and prevent pathogens from entering into the body. Through the analysis of Modified and Varied prescriptions of Lonicera and Forsythia Powder,it has shown that if the pathogenic factors are already inside the body and the exterior pathogenic factors are not removed. In such cases,on the one hand,the pathogenic factors should be identified in order to promote qi circulation or remove blood stasis. On the other hand,Modified Lonicera and Forsythia Powder can be used to eliminate the pathogenic factors in the exterior. When applying Lonicera and Forsythia Powder,WU Ju-tong followed Ye Tian-shi' s guiding ideology of sweating when disease exists in defensive qi,promoting qi circulation when there is qi stagnation,removing excessive heat when disease exists in ying-qi and never forgot to give the pathogenic factors a way out to prevent the disease from spreading in depth,which embodied the thinking of preventing diseases. According to the syndrome differentiation of sanjiao,for the human body' s upper jiao,removing pathogens out belongs to preventing diseases from changing worse. For middle jiao,keeping the viscera which has not been attacked belongs to prevention of disease. Lonicera and Forsythia Powder is praised as " the first prescription for febrile diseases" by later generations,and has been widely used in internal medicine,pediatrics,five-organ department,dermatology and so on. It has an important relationship with Wu Ju-tong's academic thought of preventing diseases.
引文
[1]杨坤杰,赵静.卫气营血和三焦辨证中的“治未病”思想刍议[J].辽宁中医杂志,2010,37(1):16-17.
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[3]黄仕营,张志明,钟嘉熙.银翘散的方源考辨与背景理论思考[J].新中医,2010,42(1):100-101.
[4]吴振起,刘光华,王雪峰.从性味配伍探讨银翘散的组方特点[J].中华中医药学刊,2008,28(5):952-953.
[5]张保伟.银翘散中当有元参[J].国医论坛,1991,6(2):39.
[6]陈烨文,许琳.从“卫气营血”分析《温病条辨》银翘散加减进退[J].甘肃中医学院学报,2014,31(5):13-15.
[7]孙艳红,盖沂超.《温病条辨》银翘散煎服方法特色及意义[J].吉林中医药,2016,36(12):1286-1289.
[8]郭永胜.《温病条辨》银翘散组方思想探析[J].新中医2017,49(1):163-165.
[9]罗云,杨明,蔡瑛,等.从挥发性成分的动态变化规律探索银翘散“香气大出即取服”的科学内涵[J].中草药,2016,47(15):2650-2655.
[10]束雅春,秦昆明,陈亚军,等.不同煎煮方式对银翘散汤剂抗炎解热作用的影响[J].中华中医药杂志,2013,28(5):1413-1418.
[11]施雷,王文丽.银翘散方证分析与小儿温病[J].中国中西医结合儿科学,2016,8(3):361-363.
[12]徐子涵,王光耀.银翘散的临床应用研究[J].黑龙江中医药,2013,42(6):50-52.
[13]刘芳.银翘散加减治疗甲型H1N1流感180例疗效观察[J].中医药导报,2011,17(4):91.
[14]薛芳.银翘散去豆豉加细生地大青叶元参丹皮汤新解[J].新医学,1982,13(6):315-317.
[15]李俊,叶烨,奚小土.《温病条辨》银翘散及其变方的应用浅识[J].中医文献杂志,2006,24(1):14-15.
[16]夏鑫华.伍炳彩运用银翘马勃散经验[J].江西中医药,2003,34(10):5-6.
[17]周江.《温病条辨》银翘散及类方辨析[J].中国中医急症,2008,17(1):87-89.
[18]翟云云.从银翘散探析吴鞠通治病思想[J].中医药导报2017,23(5):4-6.
[2]吴宁川,叶瑜.以“治未病”思想指导银翘散防治三焦杂病[J].中医临床研究,2017,9(3):22-23.
[3]黄仕营,张志明,钟嘉熙.银翘散的方源考辨与背景理论思考[J].新中医,2010,42(1):100-101.
[4]吴振起,刘光华,王雪峰.从性味配伍探讨银翘散的组方特点[J].中华中医药学刊,2008,28(5):952-953.
[5]张保伟.银翘散中当有元参[J].国医论坛,1991,6(2):39.
[6]陈烨文,许琳.从“卫气营血”分析《温病条辨》银翘散加减进退[J].甘肃中医学院学报,2014,31(5):13-15.
[7]孙艳红,盖沂超.《温病条辨》银翘散煎服方法特色及意义[J].吉林中医药,2016,36(12):1286-1289.
[8]郭永胜.《温病条辨》银翘散组方思想探析[J].新中医2017,49(1):163-165.
[9]罗云,杨明,蔡瑛,等.从挥发性成分的动态变化规律探索银翘散“香气大出即取服”的科学内涵[J].中草药,2016,47(15):2650-2655.
[10]束雅春,秦昆明,陈亚军,等.不同煎煮方式对银翘散汤剂抗炎解热作用的影响[J].中华中医药杂志,2013,28(5):1413-1418.
[11]施雷,王文丽.银翘散方证分析与小儿温病[J].中国中西医结合儿科学,2016,8(3):361-363.
[12]徐子涵,王光耀.银翘散的临床应用研究[J].黑龙江中医药,2013,42(6):50-52.
[13]刘芳.银翘散加减治疗甲型H1N1流感180例疗效观察[J].中医药导报,2011,17(4):91.
[14]薛芳.银翘散去豆豉加细生地大青叶元参丹皮汤新解[J].新医学,1982,13(6):315-317.
[15]李俊,叶烨,奚小土.《温病条辨》银翘散及其变方的应用浅识[J].中医文献杂志,2006,24(1):14-15.
[16]夏鑫华.伍炳彩运用银翘马勃散经验[J].江西中医药,2003,34(10):5-6.
[17]周江.《温病条辨》银翘散及类方辨析[J].中国中医急症,2008,17(1):87-89.
[18]翟云云.从银翘散探析吴鞠通治病思想[J].中医药导报2017,23(5):4-6.