仲景苓术剂探讨

Exploration of ZHANG Zhongjing's Lingzhu Formula

  • 摘要: 从药物组成、主治病证、病因病机、作用部位等方面对《伤寒论》和《金匮要略》中含有茯苓和白术的方剂(简称为苓术剂)进行了对比和梳理,认为苓术剂主要治疗的是水液代谢异常的一类病证。根据水饮内停的病位不同,苓术剂的组成也相应不同,如:停在头项,则用桂枝去桂加茯苓白术汤;停在心下、胸胁,则用苓桂术甘汤、茯苓泽泻汤;停在膈上,则用猪苓散;停在腰腹,则用甘姜苓术汤;停在表里上下,则用五苓散。另外,兼阳虚寒甚者,用真武汤、附子汤;兼气虚者,用理中加茯苓汤;兼血瘀者,用当归芍药散。

     

    Abstract: From the aspects of drug composition, disease syndrome, etiology, pathogenesis and action sites, the prescriptions of Fuling (Poria) and Baizhu (Rhizoma atractylodis macrocephalae) (referred to as Lingzhu Formula) in Treatise on Cold Damage and Essentials from the Golden Cabinet were compared and combed. It is believed that the main treatment of Lingzhu Formula is a type of disease syndrome with abnormal water and liquid metabolism. According to the different positions of fluid retention, the composition of Lingzhu Formula is also different: If the fluid retention accumulated in the head, use Guizhi (Ramulus cinnamomi) Decoction removes Guizhi and add Fuling Baizhu Decoction. If the fluid retention accumulated in the epigastic, chest and rib-side, then use Linggui Zhugan Decotion, Fuling Zexie Decoction. If the fluid retention accumulated in the diaphragm, use Zhuling Powder; in the waist and abdomen, use Ganjiang Lingzhu Decoction; in the exterior and interior, use Wuling Powder. In addition, if the patient with yang deficiency and cold syndrome, it can use Zhenwu Decoction, Fuzi Decoction; with qi deficiency, use Lizhong and Fuling Decoction; with blood stasis, use Danggui Shaoyao Powder.

     

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