辛开苦降法源头-机理与临床  

Research Method of Opening by Acrid Medicine and Promoting Descent by Bitter Medicine and Clinical Application With It

作　　者：李健 

机构地区：[1]营口市西市区滨海社区卫生服务中心中医科,辽宁营口115003

出　　处：《实用中医内科杂志》2014年第10期75-77,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：辛开苦降发源于《素问·至真要大论》,除热淫于内均有辛苦相配;张仲景宗《内经》意,创建辛苦并用半夏泻心汤类方,首用方剂践行辛开苦降,叶天士提出"微苦以清降,微辛以宣通"和"仿内经苦与辛合,能降能通",进一步明确机理,后世医家阐述多依据于此。辛开苦降属寒热并用,热为阳,寒为阴,寒热并用体现阴阳互根互用辨证思维;味辛能行,味苦能泄,苦辛相和,能降能通,辛开苦降并非寒热药简单叠加,乃体现阴阳交感,化生万物之象。主要作用是恢复脏器功能,调畅气机。虽以仲景半夏泻心汤类方为辛开苦降代表,然并不局限于治虚痞,很多方剂中寒热药并用都体现出辛开苦降之意。气机不畅引起疾病,可用苦辛相和治疗。Xinkai Kujiang originated in ＂plain questions, to really to theory＂, in addition to heat her to have hard match ; Zhang Zhongjingzong ＂Neijing＂ meaning, create hard and Banxia Xiexin Decoction decoction, first using prescription practice xinkaikujiang, ye Tianshi proposed ＂to clear drop slightly bitter, pungent to Xuan Tong＂ and ＂imitation in the bitter and pungent, can drop to pass＂, to further clarify the mechanism, doctors later expounded based on this. Xinkai Kujiang belongs to cold and heat, the heat is Yang, Han Yin, yin and Yang Syndrome and reflects the interdependence of dialectical thinking; pungent flavor can, bitter taste can discharge, and can reduce the bitter, can pass, Xinkai Kujiang is not the simple superposition of cold and hot, but reflect the interaction between Yin and Yang, metaplasia all things like. The main role is to restore the function of organs, regulating qi. Although in Zhongjing Banxiaxiexin soup as xinkaiknjiang representative, but is not limited to the deficiency and cold hot, many prescriptions and embody xinkaikujiang meaning. Gas poor caused by illness, can be bitter and treatment.

关 键 词：辛开苦降法 和法 半夏泻心汤 推气散 内经 素问 伤寒论 温热论 

分 类 号：R242[医药卫生—中医临床基础] R289.5[医药卫生—中医学]