《伤寒论》五苓散证的再辨析  

Re-differentiation of Wulingsan Syndrome(五苓散证)in Treatise on Febrile Diseases

作　　者：程锴 杨景锋[1] 陈丽名[1] 李小会[1] 谭颖颖[1] CHENG Kai;YANG Jing-feng;CHEN Li-ming;LI Xiao-hui;TAN Ying-ying(Shaanxi University of Chinese Medicine,Xianyang Shaanxi 712406,China)

机构地区：[1]陕西中医药大学,陕西咸阳712406

出　　处：《中医药导报》2021年第11期158-161,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：陕西中医药大学学科创新团队建设项目(2019-QN04),项目名称:伤寒学与经方辨治疑难病一流学科创新团队项目(2019-QN04)。

摘　　要：历代医家对五苓散证皆有不同程度的诠释,多数医家认同的膀胱气化不利之说有待商榷。首先结合原文与相关注释对具有争议的《伤寒论》五苓散证原文进行分析,认为五苓散证的核心在于水液代谢失调,进而通过对膀胱气化及蓄水理论的辨析,认为五苓散治水非在膀胱。其次根据五苓散药物配伍特点,认为五苓散方证核心病机为脾肺失司,三焦不利,其不为一脏一腑之专方,而为调节人体水液代谢系统的基础方。Doctors of the past dynasties have interpreted the Wulingsan syndrome to varying degrees.When the author sorted out and analyzed the prescriptions of Wulingsan,it was found that most doctors agreed that the bladder gasification is unfavorable,which is open to question.Therefore,this article first analyzes the controversial Wulingsan’s original text in Treatise on Febrile Diseases.According to the original text and related notes,the core of Wulingsan syndrome lies in the disorder of water-liquid metabolism.Through the analysis of the theory of bladder gasification and water storage,it is believed that the location of Wulingsan syndrome is not in the bladder.Secondly,according to the drug compatibility characteristics of Wulingsan,it is believed that the core pathogenesis of Wulingsan syndrome is the dysfunction of the spleen and lungs,and that the triple energizer is unfavorable.It is not a special prescription for one internal organ,but a basic prescription for regulating the human body’s water and fluid metabolism system.

关 键 词：五苓散 《伤寒论》 膀胱气化 水液代谢 肺 脾 三焦 

分 类 号：R222.16[医药卫生—中医基础理论]