方剂应用中“欲阳先阴,欲阴先阳”思维刍议  

Discussion of the idea of "First Considering Yin to Achieve Yang Effect and First Considering Yang to Achieve Yin Effect" in the Application of Prescriptions

作　　者：赵志恒[1] 穆超超 时圣瑞 

机构地区：[1]天津中医药大学,天津300193 [2]天津北辰北门医院,天津300400

出　　处：《河南中医》2017年第11期1884-1886,共3页Henan Traditional Chinese Medicine

基　　金：天津市北辰区科技发展计划项目(编号:bc2014-19;bcws2013-05)

摘　　要：针对病情的寒热用寒凉以清热、用温热以散寒。寒热并用之法为证候之复杂多变而设,但因病情复杂,单用寒热往往难附合病情而需寒热并用,以达"欲寒先热、欲热先寒"之功。在临床上五脏多为虚证,应治以补法,但不可纯补、峻补、壅补,应该补中寓通,静中有动,"欲补先泻",对于外感六淫及内伤饮食等造成的脏腑实证,应祛邪扶正,但不可滥用攻伐耗气之品,应泻中有补,"欲泻先补"。"欲散先收、欲收先散",制其标而复其本,去其邪而不伤其正。在药物配伍中,扬己所长,避己所短,于阴阳矛盾中达到实质上的有机结合。治疗热病,用寒凉的方药,在药汤尚温热时服用;治疗寒性病证,应用热性方药,必待药汤凉后再服用。中医学之"欲阳先阴、欲阴先阳"即组方配伍能正确把握药势,在具体应用中能达到气机升降、寒热并用、补泻兼施、散收相使之功,在服药中可以防止药证格拒。For cold or heat syndrome of a disease,cold and cool drugs are used to clear heat while warm and heat herbs to dispel cold. Simultaneous application of cold and heat herbs is for complicated disease condition to achieve the effects of ＂ First warming to achieve cooling effect or first cooling to achieve warming effect＂. Clinically,diseases of the five zang-organs are mostly deficiency syndrome and should be tonified. But pure tonification may lead to stagnation or obstruction,so it is advisable to ＂ first purging to achieve tonifying effect＂. For the visceral excess syndrome due to exogenous six climatic pathogens or improper diet,the method of removing pathogens and reinforcing the healthy qi should be conducted but purgation should be combined with tonification. ＂ First astringing to achieve dispersing effects or first dispersing to achieve astringing effect＂ is a method to treat both the manifestations and root cause,eliminating the pathogens without impairing healthy qi. For the treatment of heat syndrome,cold and cool drugs are used but the decoction should be taken in warm state; for the treatment of cold syndrome,heat drugs are used but the decoction should be taken after cooling down. In TCM, ＂ First considering yin to achieve yang effect,or first considering yang to achieve yin effect＂ means that the drug effects can be correctly mastered in composition of prescriptions and drug compatibility. In concrete application,the effects of ascending and descending of qi movement,simultaneous application of cold and heat drugs,combined tonification and purgation,combined dispersing and astringing can be achieved to prevent the repulsion between the drugs and syndromes.

关 键 词：方剂 阴阳 升降 寒热 补泻 散收 

分 类 号：R222.16[医药卫生—中医基础理论]