小柴胡汤证识未了  

Understanding of Syndrom of Minor Decottion of Radix Bupleuri

作　　者：黎崇裕 刘志龙 LI Chong-yu;LIU Zhi-long(Zhuhai City Hospital of Integrated Traditional Chinese and Western Medicine,Zhuhai, Guangdong, China,519000)

机构地区：[1]珠海市中西医结合医院,广东珠海519000

出　　处：《河南中医》2018年第4期489-494,共6页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药传承工作室建设项目{编号:国中医药人教发[2013]47号};2018年广东省中医药立项课题(编号:20182137);广东省首批名中医师承项目{编号:粤中医函[2015]20号};广东省省级中医药建设专项资金名中医工作室建设项目{编号:粤中医函[2017]17号}

摘　　要：作为少阳病主方的小柴胡汤,在《伤寒论》少阳病篇中却只有两条条文,而在太阳病中条文最多,阳明病篇中次之。从条文解析可以看出,小柴胡汤证常表现为里证或外证,易与其他方证相混淆;仲景使用小柴胡汤并非为和解少阳而设;小柴胡汤在太阳病篇可用于解外发汗,主要解除伤寒证或中风证;外证(伤寒证或中风证)与太阳表证不是同等概念,不可混淆;小柴胡汤脉象不典型,并非传统认识的脉弦细,可见浮、沉、细、紧、实、涩等脉象;小柴胡汤证的发作有时是因为"热入血室,其血必结";"血结"表现为半在里半在外,故而导致小柴胡汤证常可表现为外证,让世人误以为小柴胡汤可解表,小柴胡汤证亦可表现为里证,让世人不识柴胡证而下之。In the content of treating shaoyang disease of Treatise on Cold Damage Diseases,there are only two articles on Minor Bupleurum Decoction as the main prescription for treating Shaoyang disease,but there are most articles in the content of treating Taiyang disease,followed by the content of treating Yangming disease.From the analysis of the articles,it can be seen that syndrome of Minor Bupleurum Decoction is often manifested as interior or exterior syndrome,easily confused with other prescriptions.ZHANG Zhong-jing＇s use of Minor Bupleurum Decoction is not designed for relieving syndrome of Shaoyang,in the content of treating Taiyang disease,it can be used to relieve exterior syndrome by sweating,mainly to remove syndrome of exogenous febrile disease or wind-stroke disease syndrome of Taiyang.External syndrome（exogenous febrile disease or wind-stroke disease syndrome） is not the same concept as Taiyang exterior syndrome,and should not to be confused.The pulse condition of Minor Bupleurum Decoction is not typical,which is not manifested as wiry and thin pulse,but floating,sinking,thin,tense,forceful,uneven,etc.The attack of syndrome of Minor Bupleurum Decoction is sometimes because of hot invasion into Chong Meridian leading to blood stasis manifested as half exterior and half interior syndrome.Therefore,syndrome of Minor Bupleurum Decoction is often manifested as exterior syndrome and makes people wrongly think that it can only relieve exterior syndrome.In fact,it is also manifested as exterior syndrome,and can relieve exterior syndrome.

关 键 词：小柴胡汤 小柴胡汤证 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]