浅析温病初起辛温与寒凉配伍应用的发展规律
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摘要
辛温药在治疗外感病初起时其配伍应用经历了单纯使用辛温药、辛温苦寒相配、辛温与辛凉相配的3个变化过程。萌芽阶段(战国到晋唐)、成长阶段(宋金元)与形成阶段(明清)是温病学派形成过程中的3个重要时期,随着温病学派的崛起,辛温药由最初的辛温峻烈之品到后来的微辛温之品,其与寒凉药的比例也不断变化。本文对三个时期温病初起时辛温与寒凉的配伍应用进行了梳理,强调根据病机临证处方用药,注重寒温并用、性味合化的组方思路,辨治温病初起时可体现为辛温与寒凉药物配伍,意在使用辛温开郁达邪,与清热凉解祛邪相结合,根据气机郁闭与热邪炽盛的程度决定选药与用量。为临床辨治温病时辛温药与辛凉药的配伍应用提供思路。
The combination of pungent-warm medicinal has experience 3 changing processes during initial stage of warm diseases: simply using pungent-warm medicinal,combination of pungent-warm with bittercold medicinal and combination of pungent-warm with pungent-cool medicinal. There were 3 important periods during the formation of warm disease school,which were infancy stage(period from Warring States to Jin and Tang Dynasties),growth stage(periods of Song,Jin and Yuan Dynasties) and forming stage(periods of Ming and Qing Dynasties). With the deuolopment of warm disease school,the use of pungent-warm medicinal altered from hot to slight warm,and proportion of pungent-warm medicinal and cold-cool medicinal changed continuously. The combination administration of pungent-warm and cold-cool medicinal for treating febrile diseases at the initial stage was summed up,clinical prescribing according to pathogenesis was emphasized,and thinking train of property-flavor combination was stressed. The combination of pungent-warm and cold-cool medicinal aimed at releasing depression and eliminating pathogen combined with clearing heat,cooling and dispelling pathogen at the initial stage of warm diseases. The selection and dosage of medicinal should be determined according to the degree of depression of qi movement and intense heat toxin. The thought of combination of pungent-warm and cold-cool medicinal should be thought of when practicing and treating warm diseases in chinic.
The combination of pungent-warm medicinal has experience 3 changing processes during initial stage of warm diseases: simply using pungent-warm medicinal,combination of pungent-warm with bittercold medicinal and combination of pungent-warm with pungent-cool medicinal. There were 3 important periods during the formation of warm disease school,which were infancy stage(period from Warring States to Jin and Tang Dynasties),growth stage(periods of Song,Jin and Yuan Dynasties) and forming stage(periods of Ming and Qing Dynasties). With the deuolopment of warm disease school,the use of pungent-warm medicinal altered from hot to slight warm,and proportion of pungent-warm medicinal and cold-cool medicinal changed continuously. The combination administration of pungent-warm and cold-cool medicinal for treating febrile diseases at the initial stage was summed up,clinical prescribing according to pathogenesis was emphasized,and thinking train of property-flavor combination was stressed. The combination of pungent-warm and cold-cool medicinal aimed at releasing depression and eliminating pathogen combined with clearing heat,cooling and dispelling pathogen at the initial stage of warm diseases. The selection and dosage of medicinal should be determined according to the degree of depression of qi movement and intense heat toxin. The thought of combination of pungent-warm and cold-cool medicinal should be thought of when practicing and treating warm diseases in chinic.
引文
[1]郭小鸽,肖子曾,卢芳国.麻杏甘石汤方、证、药、煎法的研究进展[J].湖南中医杂志,2013,29(4):120-122.Guo XG,Xiao ZZ,Lu FG.Research progress of formula,pattern,medicinals and decocting method of Maxing Ganshi Tang[J].Hunan Journal of Traditional Chinese Medicine,2013,29(4):120-122.
[2]曹生海.大青龙汤证机与石膏作用析疑[J].国医论坛,2015,30(5):4-5.Cao SH.To resolve doubt of pattern pathogenesis and effect of gypsum of Daqinglong Tang[J].Forum on Traditional Chinese Medicine,2015,30(5):4-5.
[3]李宇铭,李致重.论越婢汤属太阳温病代表方(上)[J].中华中医药学刊,2011,29(12):2756-2758.Li YM,Li ZZ.Discussion of Yubi Decoction being the topical prescription of Taiyang Warm Disease(One)[J].Chinese Archives of Traditional Chinese Medicine,2011,29(12):2756-2758.
[4]朱红梅,林丽珍.浅探《伤寒论》辛温药在烦躁病证中的运用[J].中医杂志,2010,51(7):663-664.Zhu HM,Lin LZ.Application of pungent-warm medicinals in Shanghan Lun for irritable pattern[J].Journal of Traditional Chinese Medicine,2010,51(7):663-664.
[5]石玥.辛凉解表剂之“解表”质疑[D].北京:北京中医药大学,2014.Shi Y.The arguments on formulas for relieving exterior patterns with pungent-cool medicinals[D].Beijing:Beijing University of Chinese Medicine,2014.
[6]辛凤志.防风通圣散功效考[J].辽宁中医药大学学报,2007,9(3):26-27.Xin FZ.On effect of Fangfeng Tongsheng San[J].Journal of Liaoning University of Trational Chinese Medicine,2007,9(3):26-27.
[7]吴利利.从防风通圣散论刘完素治疗火热病思想[J].中医学报,2011,26(5):570-574.Wu LL.Exploring Liu Wansu’s academic thoughts about treating the hot disease from Fangfengtongsheng San[J].China Journal of Chinese Medicine,2011,26(5):570-574.
[8]赵绍琴,彭建中,赵爱华,等.赵绍琴温病讲座[M].北京:学苑出版社,2008:18.Zhao SQ,Peng JZ,Zhao AH,et al.Zhao Shaoqin’s lecture on febrile diseases[M].Beijing:Academic Press,2008:18.
[9]邓中甲.方剂学[M].北京:中国中医药出版社,2003:43-44.Deng ZJ.Formula Science of Traditional Chinese Medicine[M].Beijing:China Press of Traditional Chinese Medicine,2003:43-44.
[10]杨进.温病学[M].北京:中国中医药出版社,2004:189-241.Yang J.Warm Disease Study[M].Beijing:China Press of Traditional Chinese Medicine,2004:189-241.
[11]张思超.浅谈辛温药在温病发热中的应用[J].中医函授通讯,1997,6(1):10.Zhang SC.Application of pungent-warm medicinals in febrile warm diseases[J].Correspondence Journal of Traditional Chinese Medicine,1997,16(1):10.
[12]王兴华.温病初起能否应用辛温药辨析[J].黑龙江中医药,1985,14(5):7-9.Wang XH.Whether pungent-warm medicinals can be used for warm diseases at initial stage[J].HeilongjiangJournal of Traditional Chinese Medicine,1985,14(5):7-9.
[13]李晓丽,宋振华.温病初起治疗用药之探讨[J].山东中医杂志,2003,22(2):75-76.Li XL,Song ZH.Discussion on medication for warm diseases at initial stage[J].Shandong Journal of Traditional Chinese Medicine,2003,22(2):75-76.
[2]曹生海.大青龙汤证机与石膏作用析疑[J].国医论坛,2015,30(5):4-5.Cao SH.To resolve doubt of pattern pathogenesis and effect of gypsum of Daqinglong Tang[J].Forum on Traditional Chinese Medicine,2015,30(5):4-5.
[3]李宇铭,李致重.论越婢汤属太阳温病代表方(上)[J].中华中医药学刊,2011,29(12):2756-2758.Li YM,Li ZZ.Discussion of Yubi Decoction being the topical prescription of Taiyang Warm Disease(One)[J].Chinese Archives of Traditional Chinese Medicine,2011,29(12):2756-2758.
[4]朱红梅,林丽珍.浅探《伤寒论》辛温药在烦躁病证中的运用[J].中医杂志,2010,51(7):663-664.Zhu HM,Lin LZ.Application of pungent-warm medicinals in Shanghan Lun for irritable pattern[J].Journal of Traditional Chinese Medicine,2010,51(7):663-664.
[5]石玥.辛凉解表剂之“解表”质疑[D].北京:北京中医药大学,2014.Shi Y.The arguments on formulas for relieving exterior patterns with pungent-cool medicinals[D].Beijing:Beijing University of Chinese Medicine,2014.
[6]辛凤志.防风通圣散功效考[J].辽宁中医药大学学报,2007,9(3):26-27.Xin FZ.On effect of Fangfeng Tongsheng San[J].Journal of Liaoning University of Trational Chinese Medicine,2007,9(3):26-27.
[7]吴利利.从防风通圣散论刘完素治疗火热病思想[J].中医学报,2011,26(5):570-574.Wu LL.Exploring Liu Wansu’s academic thoughts about treating the hot disease from Fangfengtongsheng San[J].China Journal of Chinese Medicine,2011,26(5):570-574.
[8]赵绍琴,彭建中,赵爱华,等.赵绍琴温病讲座[M].北京:学苑出版社,2008:18.Zhao SQ,Peng JZ,Zhao AH,et al.Zhao Shaoqin’s lecture on febrile diseases[M].Beijing:Academic Press,2008:18.
[9]邓中甲.方剂学[M].北京:中国中医药出版社,2003:43-44.Deng ZJ.Formula Science of Traditional Chinese Medicine[M].Beijing:China Press of Traditional Chinese Medicine,2003:43-44.
[10]杨进.温病学[M].北京:中国中医药出版社,2004:189-241.Yang J.Warm Disease Study[M].Beijing:China Press of Traditional Chinese Medicine,2004:189-241.
[11]张思超.浅谈辛温药在温病发热中的应用[J].中医函授通讯,1997,6(1):10.Zhang SC.Application of pungent-warm medicinals in febrile warm diseases[J].Correspondence Journal of Traditional Chinese Medicine,1997,16(1):10.
[12]王兴华.温病初起能否应用辛温药辨析[J].黑龙江中医药,1985,14(5):7-9.Wang XH.Whether pungent-warm medicinals can be used for warm diseases at initial stage[J].HeilongjiangJournal of Traditional Chinese Medicine,1985,14(5):7-9.
[13]李晓丽,宋振华.温病初起治疗用药之探讨[J].山东中医杂志,2003,22(2):75-76.Li XL,Song ZH.Discussion on medication for warm diseases at initial stage[J].Shandong Journal of Traditional Chinese Medicine,2003,22(2):75-76.