基于文献梳理的备化汤中地黄使用之解析  

Study on the Use of Rehmanniae Radix in Beihua Decoction Based on Literature Review

作　　者：周敬文 老膺荣 周薇 刘琴 ZHOU Jing-Wen;LAO Ying-Rong;ZHOU Wei;LIU Qin(State Key Laboratory of Dampness Syndrome of Chinese Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]省部共建中医湿证国家重点实验室(广州中医药大学第二附属医院),广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405

出　　处：《广州中医药大学学报》2023年第2期488-493,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：省部共建中医湿证国家重点实验室专项(编号:SZ2021ZZ01);国家中医药管理局龙砂医学流派传承基地建设项目(国中医药人教函[2012]228号);广东省中医院顾植山学术经验传承工作室建设项目(中医二院[2014]089号)。

摘　　要：备化汤首载于宋代名医陈无择的《三因极一病证方论》,为十六首运气方之一。作为治疗“湿寒合德”所致病症的运气方(基于五运六气理论而拟定的方剂),备化汤主要由木瓜、茯神、牛膝、附子、地黄、覆盆子、甘草、生姜等组成,在湿证与湿病的治疗上应用广泛。有关备化汤中地黄的使用,宋代的陈无择及其之后的缪问与王旭高对其记述有所不同。陈无择根据丑未之岁运气常位状态下的疾病表现,本“功能气味,合其性用”的治法,宗“甘温治其下”的原则使用熟地黄;缪问在龙砂医家临证实践的基础上,考虑到太阴湿土主岁之年可能出现的火郁情况而使用生地黄;王旭高则主张辨证使用生地黄或熟地黄。现代医家在应用备化汤时,可以结合理论解读与临证实践,酌情选用生地黄或熟地黄。备化汤组方用药具有坚实的理论基础,如能系统掌握和大胆应用其配伍规律,备化汤可在湿证与湿病的治疗上发挥更大的作用。As one of the sixteen circuit qi formulae,Beihua Decoction was firstly recorded in Treatise on Three Categories of Pathogenic Factors and Prescriptions(San Yin Ji Yi Bing Zheng Fang Lun)written by the practitioner CHEN Wu-Ze in the Song Dynasty. Beihua Decoction is mainly composed of Chaenomelis Fructus,Sclerotium Poriae Circum Radicem Pini,Achyranthis Bidentatae Radix,Aconiti Lateralis Radix Praeparata,Rehmanniae Radix,Rubi Fructus,Glycyrrhizae Radix et Rhizoma,and Zingiberis Recens Rhizoma. The decoction has been widely used as one of the circuit qi formulae(the formulae based on the theory of the five circuit phases and six climatic factors)indicated for the syndrome due to“the predominance of cold-damp after the Limit of Heat(14th solar term)”,and is widely used for the treatment of damp syndrome and damp diseases. The use of Rehmanniae Radix in Beihua Decoction was recorded differently by CHEN Wu-Ze in the Song dynasty and later by MIAO Wen and WANG Xu-Gao. Based on therapeutic principle of“use of the herb by considering its property and action”for the diseases in regular yearly evolutive phase of the Chou and Wei year(the 2ndand 8thof the twelve Earthly Branches),CHEN Wu-Ze used Rehmanniae Radix Preparata to“treat the cold-water of zaiquan(the second half of the alterable yearly circuit qi)with sweet-warm property”. On the basis of the clinical practice of the Longsha School,MIAO Wen used Rehmanniae Radix Recens in consideration of the fire-stagnation that may occur in the regular yearly evolutive phase of the year when taiyin damp-earth is predominated. WANG Xu-Gao advocated the use of either Rehmanniae Radix Recens or Rehmanniae Radix Praeparata according to syndrome differentiation.Modern practitioners can select either Rehmanniae Radix Recens or Rehmanniae Radix Praeparata during the application of Beihua Decoction based on the theoretical interpretation and clinical practice. The compatibility of Beihua Decoction has a solid theoretical basis,and the prescription will play an important role

关 键 词：备化汤 五运六气 运气方 地黄 湿证 陈无择 《三因极一病证方论》 

分 类 号：R289.5[医药卫生—方剂学]