《千金》解肌汤方义及验案举隅  

Formula Connotation and Proven Cases of Qianjin Jieji Decoction

作　　者：连暐暐[1] LIAN Weiwei(Zhejiang Hospital of Traditional Chinese Medicine,Hangzhou(310006),China)

机构地区：[1]浙江省中医院,杭州310006

出　　处：《浙江中医药大学学报》2020年第6期588-590,共3页Journal of Zhejiang Chinese Medical University

基　　金：第六批全国老中医药专家学术经验继承工作(国中医药人教[2017]29号)。

摘　　要：[目的]探析《千金》解肌汤方义,发掘治疗表寒兼里热津亏之外感病的方剂。[方法]通过跟师侍诊,学习中医典籍《伤寒论》《备急千金要方》《千金翼方》,依据理法分析孙思邈《千金》解肌汤的组方特点,据法度辨证运用于临床以证之,并列举验案加以佐证。[结果]《千金》解肌汤出自《备急千金要方·卷九伤寒方上》,配伍得当、方小力宏,既能解表寒,又能清里养津,临证加减运用于外感病之表寒兼里热津亏证,疗效确切。所举验案中,以《千金》解肌汤加减治疗幼儿咳嗽案时,以芦根易黄芩;治疗鼻鼽案时,随证加清肺之药;治疗低热案时,合苇茎汤;治疗成人咳嗽,善后调护加入养阴之药以顾护津液,驱邪不忘扶正。诸案辨证得当,疗效俱佳。[结论]孙思邈发皇古义、融会新知,师古而不泥古,匡仲景之不逮。《千金》解肌汤治疗表寒兼里热津亏之外感病效果显著,应该被临床中医师所重视,以提升治疗外感病的临床疗效。[Objective]To analyze the connotation of Qianjin Jieji decoction and to explore the treatment of external cold and internal heat and fluid deficiency.[Methods]Through learning from the teacher and the classics of traditional Chinese medicine,such as Treatise on Febrile Diseases,Prescriptions Worth a Thousand in Gold for Every Emergency,Supplement to Recipes Worth a Thousand in Gold,the characteristics of the prescriptions of Qianjin Jieji decoction were analyzed according to the theory and method,and the clinical application of syndrome differentiation was presented according to law,and several cases were presented as proof.[Results]After clinical verification,Qianjin Jieji decoction has the advantages of proper compatibility,less medicine taste and good curative effect.It can not only relieve the external cold,but also clear the internal and nourish the body fluid.The effect of modified Qianjin Jieji decoction in treating syndrome of exterior cold and internal heat and fluid deficiency in exogenous diseases is definite.In the treatment of children cough case,hizoma Phragmitis was added,instead of Scutellaria baicalensis.In the treatment of allergic rhinitis,drugs of clearing the lung were added according to the syndrome.While treating case of low fever,Weijing decoction was combined.In treating adult cough,drugs of nourishing Yin were added in aftercare in order to protect body fluid,eliminate evil and restore health.All cases got proper syndrome differentiation and achieved good results.[Conclusion]It can be seen that SUN Simiao made up for Zhongjing's deficiency by developing and extending the ancient meaning,integrating new knowledge,learning from the ancient but not sticking to it.Qianjin Jieji decoction has a remarkable effect on the treatment of external cold and internal heat diseases.Qianjin Jieji decoction should be paid more attention to by the clinical doctors of traditional Chinese medicine in order to improve the clinical effect of treating exogenous diseases.

关 键 词：《千金》解肌汤 方义 验案 外感病 表寒兼里热津亏 孙思邈 方剂 

分 类 号：R331[医药卫生—人体生理学]