从“汤液经法图”角度探讨《医学心悟》治疗心痛的组方配伍规律  

Formulation Rules in Medical Heart Enlightenment for Treatment of Heart Pain from Perspective of"Tangye Jingfa Tu"

作　　者：刘奕呈 丁砚秋 张宏伟 马晓昌[1] 刘蜜[1] LIU Yicheng;DING Yanqiu;ZHANG Hongwei;MA Xiaochang;LIU Mi(Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学研究生院,北京100029

出　　处：《中国实验方剂学杂志》2023年第20期181-189,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2018YFC1707401)。

摘　　要：目的:从“汤液经法图”角度探讨《医学心悟》治疗心痛的组方配伍规律,为中医药治疗心痛及《医学心悟》的研究提供一种的思路。方法:运用《辅行诀五脏用药法要》所载“汤液经法图”解析清·程国彭所著《医学心悟》卷三论的心痛九方,做成“心痛九方组方配伍分析表”,分别绘制心痛九方的汤液经法分析图,分析药味的配伍结构。结果:治疗气心痛的沉香降气散的配伍结构为“五辛四苦二甘”,治疗血心痛的手拈散的配伍结构为“五苦四辛三甘一咸”,治疗热心痛的清中汤的配伍结构为“六苦三辛二甘”,治疗寒心痛的姜附汤加肉桂的配伍结构为“三辛二甘”,治疗饮心痛的小半夏加茯苓汤的配伍结构为“二辛二甘”,治疗食心痛的保和汤的配伍结构为“五甘四辛四苦一酸”,治疗虚心痛的归脾汤的配伍结构为“八甘四苦三辛一酸”,治疗虫心痛的化虫丸的配伍结构为“七苦六辛四甘”,治疗疰心痛的神术散、葱白酒、生姜汤的配伍结构为“八辛四苦二甘”。结论:从“汤液经法图”角度看,《医学心悟》治疗心痛基本是以“辛-苦-甘”为原则进行组方配伍,心虚治以咸补,或苦甘化咸;心实则治以苦泻,或甘辛化苦,多使用“甘辛化苦”这个五味配伍转化关系,促使作用于脾的辛味药和甘味药入心泻心;多是心肝脾肾同调,注重母子关系及五行相生相克规律的应用,如果疾病进展涉及子母脏,则遵循“子能令母实,母能令子虚”的配伍规律组方。Objective:To explore the formulation rules for the treatment of heart pain in the Medical Heart Enlightenment(《医学心悟》)from the perspective of the"Tangye Jingfa Tu",thereby providing a way of thinking about the treatment of heart pain in traditional Chinese medicine(TCM)and the study of the Medical Heart Enlightenment.Method:The"Tangye Jingfa Tu"contained in the Secrets for Auxiliary Cultivation Life:The Essential Method of Using Herbal Medicine for the Differential Treatment of the Five Zang Organs(《辅行诀五脏用药法要》)was used to analyze the nine prescriptions for heart pain in VolumeⅢof the Medical Heart Enlightenment by CHENG Guopeng in the Qing dynasty.A"table for analyzing the formulation of the nine prescriptions for heart pain"was developed.The analysis diagrams for decoction and meridian rules in nine prescriptions for heart pain were plotted and the compatible structure of the medicinal flavors was analyzed.Result:The composition of Chenxiang Jiangqisan for the treatment of Qi-induced heart pain is"five pungent,four bitter,and two sweet drugs",the composition of Shouniansan for the treatment of blood-induced heart pain is"five bitter,four pungent,three sweet,and one salty drugs",the composition of Qingzhongtang for the treatment of heat-induced heart pain is"six bitter,three pungent,and two sweet drugs",the composition of Jiangfutang with Cinnamomi Cortex for cold-induced heart pain is"three pungent and two sweet drugs",the composition of Xiaobanxia modified with Fuling Tang for treating fluid retention-induced heart pain is"two pungent and two sweet drugs",the composition of Baohetang for treating heart pain due to dietary stagnation is"five sweet,four pungent,four bitter,and one sour drugs",the composition of Guipitang for the treatment of deficiency-induced heart pain is"eight sweet,four bitter,three pungent,and one sour drugs",the combination of Huachongwan for the treatment of worm-induced heart pain is"seven bitter,six pungent,and four sweet drugs",the composition of Shenz

关 键 词：医学心悟 汤液经法图 心痛 组方规律 

分 类 号：R285[医药卫生—中药学] R289[医药卫生—中医学] R287R22R2-031R33R24