《兰室秘藏》饮食劳倦门方证规律浅析  

Prescription-Pattern Regularity in the Chapter of Improper Dietand Overstrain in Secrets from the Orchid Chamber

作　　者：全荟乔 吴晓丹 QUAN Hui-qiao;WU Xiao-dan(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100101)

机构地区：[1]北京中医药大学中医学院,北京100101

出　　处：《世界中西医结合杂志》2022年第7期1295-1299,共5页World Journal of Integrated Traditional and Western Medicine

摘　　要：文章对《兰室秘藏》饮食劳倦门的方证配伍规律梳理发现,饮食劳倦门包含的十八首方剂共涉及四种病症病机,分别是中焦虚损、寒滞饮食、气机失和、饮食伤胃,治法可归纳为补虚培元、温中化积、理气行滞。配伍用药上,饮食所伤者,分之为二,饮者上下分消,轻用生姜、半夏、枳实、白术,重者芫花、牵牛等;食者,轻则内消,重则除下,伤寒物者,干姜、半夏、神曲、巴豆主之,伤热物者青皮、陈皮、黄连、大黄主之。劳倦所伤者以人参、黄芪配伍升麻、柴胡补气升阳,陈皮、苍术祛湿理气,黄柏、地黄清下元阴火。脾胃虚损者,常以白术甘温补脾胃之元气,除胃中之湿热,利腰脐间血;枳实味苦寒,泄心下之痞闷,化胃中所伤,加荷叶烧饭和药,滋谷养胃。对李东垣治疗饮食劳倦的证、法、方、药进行深入挖掘,有助于提高脾胃病中医临床辨证施治的精准性。This study aims to reveal the prescription-patternregularity in the Chapter of Improper Diet and Overstrain in Secrets from the Orchid Chamber.The 18 prescriptions in this chapter involve four syndromes:deficiency of middle energizer,cold stagnation,disharmony of qi,and impairment of stomach caused by diet.The treatment methods aretonifying deficiency and consolidating original qi,warming middle and resolving accumulation,regulating qi and relieving stagnation,and determining the dosage according to the injury,respectively.In terms of the compatibility,patients with illness caused by improper diet should be treated depending on the causes.Specifically,for the illness caused improper drinking,the pathogens should be respectively expelled from upper and lower(RhizomaZingiberisRecens,PinelliaeRhizoma,FructusAurantiiImmaturus,and AtractylodisMacrocephalaeRhizoma are used for the mild symptoms andGenkwaFlos,Pharbitidis Semen,and other medicinals are applied in the instance of severe symptoms).As to the illness induced by retention of food,the method of eliminating the pathogen in vivoshould be adopted for mild symptoms,and the approach of egesting is used in the case of severe symptoms.Illness caused by food of cold nature should be treated mainly with ZingiberisRhizoma,PinelliaeRhizoma,Massa MedicataFermentata,and CrotonisFructus,and that caused by food of hot naturewith CitriReticulataePericarpiumViride,CitriReticulataePericarpium,CoptidisRhizoma,and Rhei Radix et Rhizoma.Patients with diseases caused by overstrain should be treated according to the principle of tonifying qi and elevating yang(Ginseng Radix et Rhizoma,Astragali Radix,CimicifugaeRhizoma,and BupleuriRadix),removing dampness and regulating qi(CitriReticulataePericarpium and AtractylodisRhizoma),and clearing the yin fire in the kidney(PhellodendriChinensis Cortexand Rehmanniae Radix).For patients with deficiency of spleen and stomach,AtractylodisMacrocephalaeRhizoma is often used to replenish the original qi in spleen and stomach,remove the dampness and

关 键 词：《兰室秘藏》 饮食劳倦 方证规律 

分 类 号：R2-03[医药卫生—中医学]