枳实芍药散“并主痈脓,以麦粥下之”解析  

Interpretation of Zhi Shi Shao Yao Powder in "Treating Carbuncle Pus by Being Taken with Wheat Porridge"

作　　者：张卫平 封婷 徐爽 郑智礼 钟相根[1] ZHANG Weiping;FENG Ting;XU Shuang;ZHENG Zhili;ZHONG Xianggen(Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]北京中医药大学,北京100029

出　　处：《中医学报》2023年第3期477-481,共5页Acta Chinese Medicine

基　　金：国家重点研发计划项目(2019YFC1709200,2019YFC1709201);北京中医药大学教育科学研究课题项目(XJZX2019)。

摘　　要：《金匮要略》论述枳实芍药散“并主痈脓,以麦粥下之”,鲜有医者对“麦粥”所指、“下之”含义、痈脓之分期及方药功效等作出详细论述。先秦时期《吕氏春秋》中便有“麦”指小麦的说法,结合秦汉时期小麦广泛种植的情况,此处“麦粥”应指小麦粥。经梳理《伤寒杂病论》一书中“下”的含义,发现“下之”即指“送服……”故“以麦粥下之”应指以小麦粥送服枳实芍药散。通过归纳仲景对痈脓的分期辨治,发现仲景常以汤剂治疗前期痈脓,以散剂治疗后期痈脓,故枳实芍药散合小麦粥主治“脓已成”之后期痈脓。Zhishi Shaoyao Powder was illustrated as "treating carbuncle pus and Xia Zhi with Mai porridge" Jin Gui Yao Lue.However, few doctors have made detailed discussions on the meanings of "Mai porridge" and "Xia Zhi",the stages of carbuncle pus as well as the efficacy of prescriptions and drugs.There was a saying that "Mai" refers to wheat in Lü Shi Chun Qiu in the pre-Qin period.In combination with the widespread planting of wheat in the Qin and Han dynasties, "Mai porridge" here should refer to wheat porridge.After sorting out the meaning of "Xia Zhi" in Treatise on Febrile Diseases and Miscellaneous Diseases,it is found that it means "being taken with drugs",so "Yi Mai porridge Xia Zhi" should mean "taking Zhishi Shaoyao Powder with wheat porridge.Through summing up Zhongjing′s treatment of carbuncle and pus by stages, it is found that Zhongjing used to treat carbuncle and pus in the early stage with decoction and in the later stage with Powder, so Zhishi Shaoyao Powder combined with wheat porridge is mainly used to treat carbuncle and pus in the later stage.

关 键 词：枳实芍药散 “并主痈脓 以麦粥下之” 痈脓 小麦粥 《金匮要略》 张仲景 

分 类 号：R222.3[医药卫生—中医基础理论]