对大承气汤使用标准的思考  

Thoughts on the Standards of Using Dachengqi Decoction

作　　者：李壮壮 蒋啸 郑旭锐[1] LI Zhuangzhuang;JIANG Xiao;ZHENG Xurui(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《中医学报》2020年第7期1424-1427,共4页Acta Chinese Medicine

基　　金：国家中医药管理局第四批中医基础优秀人才资助项目{国中医人教发[2017]24号}。

摘　　要：痞、满、燥、实四证悉俱方可使用大承气汤的迟下观点与《伤寒论》中急下存阴的记录、后世杂气学说中贵乎早下的观点相左,造成临证上对下法使用的矛盾。造成矛盾的原因有二:一者是对象思维认识深度的偏差,对象思维认识不深刻导致了部分医家执着于象的表征而非象的内涵;二者是对经验继承的一味盲从,一味地强调经验使学术思想趋于"石化"。解决此种困境,需要深刻地理解象思维并加以善用,结合审慎的态度对待经验。The viewpoint that only with four symptoms of distention,fullness,drying and excess can Dachengqi Decoction be used is different from the viewpoint that the record of timely purgation to preserve yin in Shanghan Lun and purgation should be used earlier in the theory of miscellaneous qi,which causes the contradiction in clinical use of purgation method.There are two reasons for the contradiction:One is the deviation of the understanding depth of image thinking,which leads some doctors to cling to the representation of image rather than the connotation of image;the second is blindly following the experience inheritance,emphasizing that the experience makes the academic thought tend to be"petrified".To solve this dilemma,we need to understand image thinking deeply and make good use of it,and treat experience with prudence.

关 键 词：大承气汤 痞 满 燥 实 迟下 急下存阴 下不厌迟 象思维 

分 类 号：R222.2[医药卫生—中医基础理论]