茯苓《伤寒论》《金匮要略》应用辑要  

Application of Poria in Treatise on Febrile Diseases

作　　者：王哲[1] 

机构地区：[1]天津中医药大学中医学院,天津300193

出　　处：《实用中医内科杂志》2017年第5期46-47,61,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：茯苓易与他药配伍,治疗领域宽广,被历代医家推崇。《伤寒杂病论》中并没有茯苓单味药方剂,配伍后创制出诸多方剂;典型药对配伍为茯苓-桂枝、茯苓-白术以及茯苓-干姜。茯苓作用其一为安神定志,如酸枣仁汤;其二为淡渗水湿,如五苓散、甘草干姜茯苓白术汤,因其自身甘淡性平,所以可配伍到寒温不同属性方剂,发挥不同作用。经典配伍:茯苓+桂枝-茯苓桂枝甘草大枣汤-水饮上逆、茯苓+白术-甘姜苓术汤-湿邪困脾、茯苓+干姜-小半夏加茯苓汤-水邪内停。茯苓在《伤寒论》及《金匮要略》中用量有较大差异,单付药用量最大属苓桂甘枣汤、小半夏加茯苓汤、茯苓戎盐汤等,达半斤(125g);用量最少当属五苓散,只用十八铢(11.70g),平均用量在四两(45.9g)。汉代一两相当于当今15.625g,目下临床每付药茯苓用到45g也是有依据的。苓桂术甘汤为《伤寒论》运用茯苓名方,含"茯苓-桂枝""茯苓-白术"配伍,实脾土、燥脾湿,现代学者拓展用途,加味治疗内耳性眩晕、加活血益气药治疗充血性心衰、加宣肺解表药治疗小儿哮喘、与二至丸合方治疗胆汁返流性胃炎、加活血益气药治疗产后尿潴留等,取得满意效果。Poria is easy to compatibility with other medicine, the field of treatment is widely praised by ancient doctors. ＂Treatise on miscellaneous diseases＂ and no Poria single flavor prescription, compatibility after crealing a number of prescriptions; typical drug compatibility for Poria-Guizhi, Poria-Atractylodes and Poria-ginger. Poria is a soothing spirit, such as Suanzaoren soup; the second is light water wet, such as Wuling San, licorice dry ginger Poria white soup, because of its own nature, so it can be compatibility to cold temperature different properties prescription , Play a different role. Classic compatibility： Poria＋Guizhi- Poria Guizhi licorice jujube soup-water on the anti, Poria＋Atractylodes-Gan Jiang Ling surgery soup - wet evil spleen, Poria＋ginger-small half summer plus Poria soup-water evil stop. Poria in the ＂Treatise on Febrile Diseases＂ and ＂Golden Chamber＂ in the amount of a large difference, the largest amount of single drug is Linggui Gan jujube soup, small Banxia plus Poria Decoction, Poria Rong Rong salt soup, up to half a tally （125g）; The amount of the least was undoubtedly Wuling San, only eighteen haht, the average amount in four （45.9g）. Han one or two equivalent to today＇s 15.625g, today＇s clinical use of Poria to pay 45g is also a basis for guidance. Ling Guizhi Gan Tang for the ＂Treatise on＂ the use of Poria name, with ＂Poria-Guizhi＂ ＂Poria-Atractylodes＂ compatibility, real spleen, dry spleen wet, modern scholars to expand the use of flavored treatment of inner ear vertigo, Gas treatment of congestive heart failure, plus Xuanfei solution for the treatment of children with asthma, and two to pill treatment of bile reflux gastritis, plus blood circulation Qi medicine treatment of postpartum urinary retention, and achieved satisfactory results.

关 键 词：茯苓 安神定志 酸枣仁汤 淡渗水湿 五苓散 甘草干姜茯苓白术汤 茯苓桂枝甘草大枣汤 水饮上逆、甘姜苓术汤 湿邪困脾 小半夏加茯苓汤 水邪内停 苓桂术甘汤 伤寒论 金匮要略 

分 类 号：R222.2[医药卫生—中医基础理论]