从“但见一证便是,不必悉具”谈郑启仲教授经方应用经验  

On professor ZHENG Qizhong’s application experience in classic prescriptions from“Only one of Chaihu Tang syndromes is evident for the disease”

作　　者：张建奎[1] 郑宏[1] 冯刚[1] 郑启仲(指导) ZHANG Jiankui;ZHENG Hong;FENG Gang;ZHENG Qizhong(Directed)(Department of Pediatrics,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,450000,China;不详)

机构地区：[1]河南中医药大学第一附属医院儿科,河南郑州450000 [2]不详

出　　处：《中医儿科杂志》2020年第4期23-25,共3页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教发[2011]41号);河南省中医药科学研究专项课题(2014ZY02036);河南省科技厅科技攻关课题(162102310099)。

摘　　要："但见一证便是,不必悉具"出自《伤寒论·辨太阳病脉证并治》,郑启仲教授认为,对此条文的理解,其核心应该是强调临床要坚持辨证论治原则,抓主症,不要"头痛医头,脚痛医脚";并且要"知常达变",对于"一证",不必界定在《伤寒论》中所提及的适应小柴胡汤的某症某脉上,而是应该依据临证复杂多变的实际情况去灵活把握。只要能真实反映少阳病的病机和本质的任何脉症,都应列入"一证"的范畴内,而不必所有当见症悉具。相反,如果病机不符,即使有相同的症状,也不可使用小柴胡汤。不仅小柴胡汤,《伤寒论》中其他经方,抑或后世时方的运用亦皆如此。附案例2则,以资验证。"Only one of Chaihu Tang syndromes is evident for the disease"(shortened for one of the symptoms)is excerpted from Treatise on Exogenous Febrile Diseases:Syndrome Differentiation and Treatment of Taiyang Disease.Professor ZHENG holds that for understanding this provision,the core thereof should focus on the clinical adherence to the principle of treatment based on syndrome differentiation,and grasps the main symptoms,it should not"treat the head when the head aches,treat the foot when the foot hurts".Besides,a doctor should"distinguish the changing symptoms by mastering the commonly encountered diseases",for"one of the symptoms",it should not be defined on a pulse or on a symptom belonging to Xiaochaihu Tang(小柴胡汤)syndromes mentioned in Treatise on Exogenous Febrile Diseases.Instead,it requires us to flexibly grasp the complex and varied actual situation in clinic practice.Any pulse and symptom,as long as it corresponds to the pathogenesis and nature of Shaoyang disease,should be included in the"one of the symptoms",without having to see all the symptoms.On the contrary,if the pathogenesis does not correspond to,even if there are the same symptoms,it is not allowed to use Xiaochaihu Tang.Not only Xiaochaihu Tang,but also other classical prescriptions in Treatise on Exogenous Febrile Diseases,as well as the non-classical prescriptions in the later generations.Two cases ane attaehed for verification.

关 键 词：但见一证便是 不必悉具 小柴胡汤 辨证论治 临床经验 郑启仲 

分 类 号：R289.1[医药卫生—方剂学]