《经方实验录》葛根汤证寒温探析  

Exploration and Analysis of Cold and Warm Cases in Using Gegen Decoction in Jing Fang Shi Yan Lu

作　　者：邵文雪 许二平[1] SHAO Wenxue;XU Erping(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2022年第12期2487-2491,共5页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(81973739);河南省中医药科学研究专项课题项目(2019ZY1019)。

摘　　要：一般认为《伤寒论》葛根汤所治病证为太阳伤寒表实经输不利证,以及津液不足而外感风寒之刚痉等病证。曹颖甫《经方实验录》中葛根汤为治疗太阳温病而设,葛根汤证即先日伤津,续得太阳病,此处太阳温病亦可理解为太阳伤寒兼阴津不足或素有蕴热。伤寒与温病作为外感病的不同体系,其发展过程各有特点,不可混称,而病有阴阳变化,证有寒热兼夹或转化,因此治温与治寒之法可渗透交互。若疾病初期或发展过程中兼见津伤蕴热而未脱离伤寒本质,在治疗伤寒的基础上可灵活结合治疗温病思想,予葛根汤从寒从热治之;若疾病脱离太阳伤寒而传变,则应不泥初始之寒温,观其脉证,随证治之。It is generally believed that the syndromes treated by Gegen Decoction are the exterior excessiveness and unfavorable transfusion of superficies meridians in fever of Taiyang typhoid syndrome as well as the syndrome of rigid spasm caused by insufficient body Fluid and exogenous Wind and Cold Evil factors.In Cao Yingfu′s Jing Fang Shi Yan Lu,Gegen Decoction was created for treatment of Taiyang disease with Heat character.Gegen Decoction syndrome is used to treat disease that the body Fluid is injured first,which followed by Taiyang disease.Therefore,Taiyang Heat disease can also be understood as the Taiyang typhoid fever and the lack of Yin Fluid or the accumulation of Heat in normal times.Typhoid and Heat disease,which are different system of exogenous diseases,have their own characteristics in development process and should not be confused.However,the disease may be with Yin or Yang syndrome,and the syndromes Cold and Heat may be combined with each or both may be transformed from each other.Therefore,the methods of treating Hot and treating Cold one can penetrate and interact with each other.In the early stage or in the course of development of the disease,if the both Fluid injury and Heat accumulation can be seen with the essence of typhoid fever,based on the idea of treating typhoid fever,the thinking of treating Heat disease can also be flexibly combined.Gegen Decoction can be used to treat both the cases.If the disease breaks away from Taiyang typhoid fever and transmission takes place,the initial Cold or Heat characteristic of the disease should not be sticked to anylonger,but by observing the pulse and syndrome,treatment is carried out accordingly.

关 键 词：葛根汤 葛根汤证 太阳伤寒 太阳温病 《经方实验录》 曹颖甫 姜佐景 

分 类 号：R254[医药卫生—中医内科学]