从药物组成探四逆汤“强人”之义  

Exploring the Meaning of"Strong Person"of Sini Decoction from the Composition of Medicines

作　　者：刁钰 谷松[1] DIAO Yu;GU Song(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《实用中医内科杂志》2023年第5期17-19,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家重点基础研究发展计划(“973”计划)(2013CB532004)。

摘　　要：《伤寒论》四逆汤方,历代多强调其温阳之性,多云其:“温补下焦之元阳”,普遍认为四逆汤为温补阳气之方。但此认知与方后所注:“强人可大附子一枚,干姜三两”似有所出入。文章从单味药及拆方的角度对四逆汤的功效进行探索研究,认为生附子通行十二经,破表里阴寒,祛寒以回阳;干姜温暖中焦,促进气血的化生;炙甘草补中益气且制约姜、附之毒性,三味药通过为人体创造适合阳气化生的内环境来体现其温补阳气之效。其后所言“强人”者,非言阳气较盛,而是阴津尚未大损者。四逆汤急救回阳,其辛温燥烈之性不可避免会伤及人体正常阴津,仲景在强调“强人”可增加附子、干姜用量的同时,亦暗含“羸人(阴津亦大伤者)”在使用时要注意四逆汤对阴津的耗损之义。In Treatise on Febrile Diseases,the Sini Decoction(四逆汤)has been emphasized to warm the yang in many dynasties.It is said that it"warms and replenishes the yuan yang of the lower energizer".It is generally believed that the Sini Decoction is the prescription to warm and replenish the yang qi.However,this cognition is somewhat different from the"people who are slightly better can use larger aconite and three liang of dried ginger"marked below the prescription.This paper explores and studies the efficacy of Sini Decoction from the perspective of single medicine and from the perspective of disassembling the original formula into smaller ones.It is believed that the raw aconite can pass through the twelve meridians,break the cold evil on the outside and inside,and expel the cold evil to restore yang qi.Dry ginger warms the middle energizer,promotes the production of qi and blood in the human body,and the fire baked licorice can replenish qi and restrict the toxicity of raw aconite and dry ginger,The three herbs can warm and replenish yang qi by creating an internal environment suitable for the transformation of Yang Qi.The"slightly better person"marked below the prescription does not mean that there is more yang,but that the body fluid has not been seriously damaged.Sini Decoction has the function of quickly restoring the yang qi of the human body,and its pungent,warm,dry and intense nature will inevitably hurt the normal body fluid of the human body.Zhongjing emphasizes that"people who are slightly better"can increase the drugs for warming dryness,but also implies that"people who are weak(people whose body fluid is also seriously injured)"should pay attention to the side effect of Sini Decoction when using it,which can consume body fluid.

关 键 词：四逆汤 强人 阳虚阴盛 急救回阳 

分 类 号：R222[医药卫生—中医基础理论]