从栀子豉汤探析“火郁发之”  

Analysis on“Dispersing Fire Stagnation”from Zhizichi Decociton(栀子豉汤)

作　　者：张严亓 展照双 ZHANG Yanqi;ZHAN Zhaoshuang(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355

出　　处：《山东中医药大学学报》2021年第2期178-182,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：山东省高校科研计划项目(编号:J18KA289);山东省中医药科技发展计划项目(编号:2019-0041);山东中医药大学科研创新团队项目(编号:2018-10)。

摘　　要："火郁发之"首见于《素问·六元正纪大论》,后世金元及明清温病学家将其拓展应用于内伤杂病及温病治疗之中。"火郁"为火热之邪被郁闭于体内不可往外透发而成的病理改变,病机在于气机壅滞、升降失常;"发之"指发其郁滞,疏泄气机,使怫郁之火得以透达发越而解的治疗原则。栀子豉汤首见于《伤寒论》,由栀子和豆豉构成,共奏清宣郁热之功,用于治疗热郁胸膈,心中懊[忄农]诸证。温病本为郁热,温病学家于临证中多化裁栀子豉汤以治之,并提出本方为"火郁发之"代表方剂之一。结合相关医案,总结以栀子豉汤治疗火郁之病关键在于宣畅气机、疏散郁火。提示火郁之病多可以栀子豉汤治之,且临床对火热证不可一味滥用苦寒,当注意因势利导,避免冰遏病邪。“Dispersing fire stagnation”was first recorded in Plain Questions·Major Discussion on the Progress of the Six Climatic Changes.Later scholars of warm diseases in Jin,Yuan,Ming and Qing Dynasties extended its application to internal damage,miscellaneous diseases and warm diseases.“Fire stagnation”is a pathological change caused by heat and fire pathogen stagnated in the body and can not be transmitted to the outside.The pathogenesis lies in qi stagnation and the disorder of ascending and descending.“Dispersing stagnation”refers to the treatment principle of dispersing stagnation and soothing qi movement,so that the stagnant fire can be thoroughly dispersed and resolved.Zhizichi Decoction(栀子豉汤)was first recorded in Treatise on Cold Pathogenic Diseases.It is composed of Zhizi(Gardeniaae Fructus)and Douchi(Sojae Semen Praeparatum)and has the function of clearing and dispersing stagnant heat,used to treat stagnant heat in the chest and diaphragm and vexation in the heart.Warm diseases are originally stagnant heat.In clinical practice,experts in warm disease modify Zhizichi Decoction to treat warm diseases,and propose that this prescription is one of the representative prescriptions of“dispersing fire stagnation”.Combined with relevant medical records,the key to treat fire stagnation with Zhizichi Decoction is to ventilate qi movement and disperse stagnant fire.It is suggested that the disease of fire stagnation can be treated with Zhizichi Decoction,and the bitter and cold herbs should not be abused blindly in the clinical practice of fire heat syndrome.Attention should be paid to the guidance of the situation to avoid ice suppressing pathogenic factors.

关 键 词：栀子豉汤 《伤寒论》 温病 火郁发之 宣畅气机 疏散郁火 

分 类 号：R222[医药卫生—中医基础理论] R254.2[医药卫生—中医学]