《伤寒论》生姜泻心汤方后注并张仲景理中法探赜  

Exploration of Afternotes of Fresh Ginger Heart-Draining Decoction in Treatise on Cold Damage Diseases and Zhang Zhong-jing's Method of Regulating the Middle

作　　者：张李香 史光伟 张禄璐 芦文娟 梁永林[1,3] ZHANG Li-xiang;SHI Guang-wei;ZHANG Lu-lu;LU Wen-juan;LIANG Yong-lin(Gansu University of Chinese Medicine,Lanzhou,Gansu,China,730000;Jiuquan Hospital of Traditional Chinese Medicine,Jiuquan,Gansu,China,735000;Key Laboratory of Dunhuang Medicine and Transformation,Ministry of Education,Lanzhou,Gansu,China,730000)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]酒泉市中医院,甘肃酒泉735000 [3]敦煌医学与转化教育部重点实验室,甘肃兰州730000

出　　处：《河南中医》2023年第5期656-659,共4页Henan Traditional Chinese Medicine

摘　　要：由生姜泻心汤方后注可知,理中人参黄芩汤的药物组成为生姜、甘草、人参、干姜、黄芩、半夏、大枣、桂枝、白术,为三泻心汤底方。三泻心汤均是治疗寒热错杂心下痞之方,半夏泻心汤以半夏为君,偏于止呕降逆;生姜泻心汤以生姜为君,偏于消中焦水饮;甘草泻心汤以甘草为君,偏于补中止泻。理中人参黄芩汤方中白术健脾益气,生姜发散水气,半夏降逆止呕,集三泻心汤功用为一体。因此,三泻心汤可以看作是由理中人参黄芩汤化裁而来。《伤寒论》中,理中丸体现了仲景的温中思想;三泻心汤体现了仲景温、清并用的理中思想;小建中汤体现了仲景的补中思想;调胃承气汤体现了仲景的泻中思想;小柴胡汤体现了仲景的和中思想;竹叶石膏汤体现了仲景的清中思想。张仲景通过温中、清中、补中、泻中、和中等治疗方法使人体处于中和状态,故而理中也可理解为调和人体之阴阳。张仲景之理中当解读为和中与致中和,而理中人参黄芩汤温、补、清、和兼具,最能体现理中之内涵。According to the afternotes of Fresh Ginger Heart-Draining Decoction,the medicinal composition of Center-Regulating Ginseng and Scutellaria Decoction includes Shengjiang(Rhizoma Zingiveris Recens),Gancao(Radix Glycyrrhizae),Renshen(Radix Ginseng),Ganjiang(Rhizoma Zingiberis),Huangqin(Radix Scutellariae),Banxia(Rhizoma Pinelliae),Dazao(Fructus Jujubae),Guizhi(Ramulus Cinnamomi),Baizhu(Rhizoma Atractylodis Macrocephalae),which is the base formula of Three Heart-Draining Decoctions.Three Heart-Draining Decoctions are all used to treat epigastric stuffiness with cold and heat in complexity:Pinellia Heart-Draining Decoction with Banxia(Rhizoma Pinelliae)as the sovereign medicinal is used to stop vomiting and suppress upward perversion of qi;Fresh Ginger Heart-Draining Decoction with Shengjiang(Rhizoma Zingiveris Recens)as the sovereign medicinal is used to treat fluid retention in the middle energizer;Licorice Heart-Draining Decoction with Gancao(Radix Glycyrrhizae)as the sovereign medicinal is used to tonify the middle energizer and stop diarrhea.In Center-Regulating Ginseng and Scutellaria Decoction,Baizhu(Rhizoma Atractylodis Macrocephalae)can activate the spleen and tonify qi;Shengjiang(Rhizoma Zingiveris Recens)can disperse fluid retention;Banxia(Rhizoma Pinelliae)can suppress upward perversion of qi to stop vomiting.These medicinals integrate the functions of Three Heart-Draining Decoctions.Therefore,Three Heart-Draining Decoctions can be seen as modified versions of Center-Regulating Ginseng and Scutellaria Decoction.In Treatise on Cold Damage Diseases,Center-Regulating Pill reflects Zhang Zhong-jing's middle-warming thought;Three Heart-Draining Decoctions reflect Zhang Zhong-jing's both warming and clearing thought;Minor Center-Fortifying Decoction reflects Zhang Zhong-jing's middle-tonifying thought;Stomach-Regulating and Purgative Decoction reflects Zhang Zhong-jing's middle-purging thought;Minor Bupleurum Decoction reflects Zhang Zhong-jing's middle-harmonizing thought;Lophatherum and Gypsum Decoction refle

关 键 词：理中法 理中人参黄芩汤 半夏泻心汤 甘草泻心汤 生姜泻心汤 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]