《伤寒论》栀子豉汤治湿热证议  

Discussion About Treating Damp Heat Syndrome with Gardenia and Semen Sojae Praeparatum Decoction in Treatise on Cold Damage Diseases

作　　者：滕俊 张永生[1] 唐卓然[1] TENG Jun;ZHANG Yong-sheng;TANG Zhuo-ran(Beijing University of CM,Beijing,China,100029)

机构地区：[1]北京中医药大学,北京100029

出　　处：《河南中医》2020年第3期325-328,共4页Henan Traditional Chinese Medicine

摘　　要：凡《伤寒论》中用栀子豉汤的情况,均是在医家误治之后所作的弥补措施。误治的形式有下法,兼有汗法、吐法。误治后的症状多表现在心中、心下、胸中、胃中,常表现为热、(虚)烦。烦是热的表现,属气,栀子启下焦阴气于上,淡豆豉使气分邪热向上向外透达,两药合用,轻清宣透,“解陈腐郁热”“宣陈腐郁结”,使胸膈郁热从上而解。现代药理学研究证实,栀子豉汤的作用对象以消化器官为主,主要作用为护肝、保胃、抗炎、调整肠道菌群,其治疗机制与中医理论扶正祛邪相似,病位也契合《伤寒论》栀子豉汤的主治,为阳明胃。故栀子豉汤方义重在疏利气机,清透湿热,所治病位在脾胃,兼有心、肺、肝。其疏利清透的方义,符合湿热证中湿浊之邪蒙蔽上焦的治法,故栀子豉汤为治湿热之方。All the cases of Gardenia and Semen Sojae Praeparatum Decoction used in Treatise on Cold Damage Diseases are the remedial measures taken after the doctor's mistreatment.The forms of mistreatment include purging,sweating and vomiting.After mistreatment,symptoms often appear in the heart center,upper heart,chest and stomach,which are often manifested as heat,and(deficiency)annoyance.Annoyance is the manifestation of heat,and belongs to qi.Zhizi(Gardenia)can drive yin qi in lower energizer upward,while Douchi(Semen Sojae Praeparatum)can make pathogenic heat in qifen penetrate outwards.When the two drugs are used together,they can clear away the stagnated heat in chest diaphragm due to their light and clear nature.Modern pharmacology research has confirmed that the main object of Gardenia and Semen Sojae Praeparatum Decoction involves digestive organs,and the main function is to protect the liver and stomach,resist inflammation and adjust the intestinal flora.Its treatment mechanism is similar to the theory of TCM in strengthening the body healthy qi and removing pathogenic factors,and the disease location also conforms to the main treatment of Gardenia and Semen Sojae Praeparatum Decoction in Treatise on Cold Damage Diseases,which is the stomach.Therefore,the prescription is mainly to dredge qi movement and,clear away damp heat;the location focuses on the spleen and stomach,as well as heart,lung and liver.Its meaning is in line with the treatment of dampness and turbidity in damp heat syndrome,so Gardenia and Semen Sojae Praeparatum Decoction is a representative of treating damp heat.

关 键 词：栀子豉汤 《伤寒论》 湿热证 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]