“诸病通用药”的体例构建及辨治模式探析

季文达; 马骏; 肖正; 白敏; 杨晓轶; 李应存

doi:10.14148/j.issn.1672-0482.2024.0013

“诸病通用药”的体例构建及辨治模式探析

doi: 10.14148/j.issn.1672-0482.2024.0013

季文达^1,,
马骏¹,
肖正¹,
白敏²,
杨晓轶¹,
李应存^{1, 2, ,}

1.
甘肃中医药大学基础医学院，甘肃兰州 730000
2.
敦煌医学与转化省部共建教育部重点实验室，甘肃兰州 730000

基金项目:

国家社会科学基金一般项目 14BYY017

国家中医药管理局十二五重点学科敦煌医学学科项目 DHYXXK2023

甘肃省高校人文社科重点研究基地敦煌医学文献整理与应用研究中心 DHYXJD2023

详细信息

作者简介:
季文达，男，博士研究生，E-mail：137394562@qq.com

通讯作者:
李应存，男，教授，博士生导师，主要从事敦煌医学文献与临床应用的研究，E-mail：1418831670@qq.com

中图分类号: R242
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-30
- 网络出版日期: 2024-01-24
- 发布日期: 2024-01-10

Analysis of the System Construction and Differentiation and Treatment Model of "Common Medicines for Various Diseases"

JI Wenda^1
,,
MA Jun¹,
XIAO Zheng¹,
BAI Min²,
YANG Xiaoyi¹,
LI Yingcun^{1, 2
, ,}

1.
School of Basic Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China
2.
Key Laboratory of Dunhuang Medicine and Transformation Jointly Established by the Ministry of Education, Lanzhou 730000, China

摘要

摘要: 《本草经集注》序录中的“诸病通用药”以其独特的“病-药”纲目体例及其临床实用性，受到医家追捧推崇，而被后世本草学著作和方书收录及发挥，为“专病专方”“专病专药”的研究与发展奠定了基础。陶弘景以《神农本草经》之“大病之主”为基础框架，以《伤寒杂病论》之方药为参考，以自身及他医用药经验为扩充创建了“诸病通用药”体例，将当时具有代表性的病症与药物主治之长进行联系、归纳和总结，创建了“病-药”纲目体例。“诸病通用药”体例的构建开辟了“专病专方”“专病专药”的先河，为临床辨治提供新的组方思路。
- 诸病通用药 /
- 辨治模式 /
- 专病专方 /
- 专病专药 /
- 本草经集注
Abstract: The "common medicines for various diseases" in the preface of Collective Commentaries on the Classic of Materia Medica has been highly praised by medical practitioners for its unique "disease-medicine" outline and clinical practicality, and has continued to be included and developed in later works on materia medica and prescriptions, laying the foundation for the research and development of "specialized prescriptions for specialized diseases" and "specialized medicines for specialized diseases". Tao Hongjing used "the root of major diseases" in Shen Nong's Classic of the Materia Medica as the basic framework, referred to the prescriptions and medicines in Treatise on Cold Damage and Miscellaneous Diseases, and expanded his own and other medical experience to create the "common medicines for various diseases" system, relating and summarizing the representative diseases and main therapeutic effects of medicines, and creating a "disease-medicine" outline system. The construction of the "common medicines for various diseases" system has opened up the precedent of "specialized prescriptions for specialized diseases" and "specialized medicines for specialized diseases", providing new prescription ideas for clinical differentiation and treatment.

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表 1 《神农本草经》“大病之主”与《集注》 “诸病通用药”近似病症名称比对

Table 1. Comparison of similar disease and symptom names between "the root of major diseases" in Shen Nong's Classic of the Materia Medica and "common medicines for various diseases" in Collective Commentaries on the Classic of Materia Medica

“大病之主”	“诸病通用药”
中风	中风脚弱
寒热	大热
肠澼下痢	腹澼下利
大小便不通	大便不通；小便淋沥
咳逆	上气咳嗽
留饮	痰饮
癖食	宿食
坚积、癥瘕	积聚癥瘕
鬼疰	鬼注、尸注
喉痹	喉痹痛
目盲	目肤翳
痈	痈疽
男子五劳七伤、虚乏羸瘦	虚劳男女
血闭	月闭

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表 2 仲景方与“诸病通用药”药物组成比对

Table 2. Comparison of composition between Zhongjing formula and "common medicines for various diseases" medicine groups

仲景方	药物组成	“诸病通用药病”对应病症	“诸病通用药病”药物组成
蜜煎导方	食蜜	大便不通	蜜煎、牛胆、大黄、巴豆、大麻子
雄黄熏方	雄黄	恶疮	雄黄、蛇床子、雌黄、胡粉、硫黄、矾石、松脂等
蛇床子散	蛇床子
皂荚丸	皂荚	声音哑	皂荚、菖蒲、钟乳、孔公孽等
桅子鼓汤	栀子、淡豆豉	心烦	栀子、豉、石膏、滑石、杏仁等
赤石脂禹余粮汤	赤石脂、禹余粮	腹澼下利	赤白石脂、禹余粮、龙骨、牡蛎等
蒲灰散	蒲灰、滑石	小便淋沥	蒲黄、滑石、衣中白鱼、乱发、冬葵子根、白茅根等
滑石白鱼散	滑石、乱发、白鱼
橘皮汤方	橘皮、生姜	呕吐	橘皮、生姜、人参、半夏、麦门冬、白芷等
小半夏汤	半夏、生姜
大乌头煎	乌头	心腹冷痛	乌头、附子、干姜、甘草、白术、人参、芍药、当归、桔梗等
四逆汤	甘草、干姜、附子
通脉四逆汤方	甘草、干姜、附子
芍药甘草附子汤	芍药、甘草、附子
理中丸	人参、甘草、干姜、白术
小半夏汤	半夏、生姜	痰饮	半夏、大黄、枳实、浓朴、甘遂、生姜、橘皮、茯苓、人参、白术、芒硝、荛花等
厚朴三物汤	厚朴、大黄、枳实
小半夏加茯苓汤	半夏、生姜、茯苓
橘枳姜汤	橘皮、枳实、生姜
厚朴大黄汤	厚朴、大黄、枳实
茯苓饮	茯苓、人参、白术、枳实、橘皮、生姜
下瘀血汤	大黄、桃仁、蟅虫	瘀血	大黄、桃仁、水蛭、蟅虫、虻虫、蜚蠊、蒲黄等
抵当汤	水蛭、虻虫、桃仁、大黄
抵当丸	水蛭、虻虫、桃仁、大黄

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表 3 “心腹冷痛”药组于《神农本草经》及《集注》中的相关叙述

Table 3. Relevant descriptions of the "heart and abdominal cold pain" medicine groups in Shen Nong's Classic of the Materia Medica and Collective Commentaries on the Classic of Materia Medica

药物名称	《神农本草经》	《集注》
当归	未见相关叙述	温中止痛；虚冷
人参	未见相关叙述	疗肠胃中冷；心腹鼓痛
白芍	邪气腹痛	邪气腹痛；缓中；中恶腹痛
桔梗	未见相关叙述	利五脏肠胃；温中消谷
干姜	温中	温中；治寒冷腹痛
蜀椒	温中	温中；产后余疾腹痛；除六腑寒冷；心腹留饮
吴茱萸	温中下气	温中下气；止痛；腹内绞痛；诸冷实不消；心腹痛
附子	温中	温中；心腹冷痛
白术	未见相关叙述	暖胃
甘草	五脏六腑寒热邪气	五脏六腑寒热邪气；温中下气
矾石	未见相关叙述	未见相关叙述

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