基于寒热虚实轻重缓急探析张仲景活血化瘀方药的运用  

An Analysis of the Application of Zhang Zhong-jing′s Formulas for Activating Blood Circulation and Removing Blood Stasis Based on the"Order of Priorities of Cold and Heat and Deficiency and Excess"

作　　者：陈志强 张意林 CHEN Zhi-qiang;ZHANG Yi-lin(Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210023;Anhui University of Chinese Medicine,Hefei,Anhui,China,230012)

机构地区：[1]南京中医药大学,江苏南京210023 [2]安徽中医药大学,安徽合肥230012

出　　处：《河南中医》2022年第9期1301-1304,共4页Henan Traditional Chinese Medicine

摘　　要：张仲景辨治瘀血病证时,常根据病性的寒、热、虚、实,选择合适的祛瘀药物;根据病证的轻、重、缓、急,采取适宜的剂型和服药方法。若瘀属虚寒,则选用温补药物;若瘀属虚热,则选用寒补药物;若瘀属实热,则选用寒凉药物;若瘀属实寒,则选用温热药物;若瘀属寒热错杂,则寒温并用;若瘀属虚实兼夹,则攻补兼施。在剂型与服药方法上,若病重势急,多用峻药取汤,服用方法多用顿服、更服;若病重势缓,多用峻药作丸,服药方法多为定时服;若病轻势急且病位趋下,多以缓药取汤,服用方法多为先食服;若病轻势缓,多用缓药作丸,服药方法多为日三服;若因瘀血而致腹中急痛者,多取散剂以酒和服。In the differentiation and treatment of blood stasis syndrome,Zhang Zhong-jing chooses the appropriate drugs for remo-ving blood stasis according to the cold,heat,deficiency and excess of the disease nature.He adopts appropriate dosage forms and medication methods based on the order of priorities of symptoms.If blood stasis belongs to deficiency and cold type,he chooses warm and tonic drugs to remove blood stasis;If the blood stasis belongs to deficiency and heat type,he chooses cold and tonifying drugs to remove blood stasis.If blood stasis belongs to excess and heat type,he chooses,he chooses cold and cool drugs.If blood stasis belongs to excess and cold type,he chooses,he chooses warm-heat drugs.If blood stasis is cold and heat in complexity,he chooses cold and heat drugs together.If blood stasis is deficiency and excess in complexity,he chooses,he uses simultaneous elimi-nation and reinforcement.In terms of dosage form and medication method,if the patient is seriously ill and in an urgent situation,he uses drastic drugs for decoction,taken in one single dose or taken again.If the illness is serious and slow,he uses drastic drugs for pills taken regularly.If the disease is mild and acute,and the disease position is in lower part of body,he chooses slow-acting drugs for decoction taken after meals.If the disease is mild and slow,he often uses slow-acting drugs for pills taken three times one day.For those with acute abdominal pain caused by blood stasis,he often takes powder taken with wine.Zhang Zhong-jing has pio-neered the syndrome differentiation and treatment of blood stasis,and the key lies in flexibility.

关 键 词：瘀血证 活血化瘀方药 《伤寒论》 《金匮要略》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]