小建中汤健脾机理探究  

Study on the mechanism of Xiaojianzhong Decoction invigorating spleen

作　　者：薛钧[1] XUE Jun(Jiangsu Provincial Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院,210029

出　　处：《中国老年保健医学》2023年第5期88-91,共4页Chinese Journal of Geriatric Care

摘　　要：目的 研究并进一步明确小建中汤发挥健脾功效的机理。方法 采用文献法对历代医家小建中汤相关方论、方解作整理分析,依据中医经典理论体系,结合临床实践,合理推导得出结论。结果 历代医家肯定小建中汤健脾功效,但对组方机理认识不一,以饴糖等甘药的补益功效作解释有22家,成为主流;以芍药抑木以扶土功效作方解有5家;认为该方当用肉桂,健脾是肉桂之功有2家;以数术、运气解释组方有2家;另有9家对此未作详细阐释;《辅行诀》释以虚极脾劳,另建脾土脏气运行秩序之说。结论 简单以药性叠加解释该方功效,说服力不足;《辅行诀》建立的组方规则,从干预措施可推导结果,以结果可逆推干预措施,自洽性高,阐释了虚损状态下以桂枝类方实现健脾功效的机理,当为最优解。Objective To study and further clarify the mechanism of Xiaojianzhong Decoction in strengthening spleen.Methods By literature research method,the related prescriptions and the elaboration on the function of drugs in Xiaojianzhong Decoction were sorted out and analyzed.According to the classical theoretical system of traditional Chinese medicine,combined with clinical practice,reasonable deduction was made to draw a conclusion.Results The physicians of past dynasties affirmed the spleen-invigorating effect of Xiaojianzhong Decoction,but they had different understandings of the mechanism of the prescription.There were 22 doctors who believed the mechanism of tonifying effect was due to caramel and other sweet medicines,which became the mainstream;5 doctors suggested the effect was produced by Paeonia lactiflora,which reinforced the spleen(earth)by inhibiting the hyperactivity of liver(wood);2 doctors considered that cinnamon should be used in this recipe to play a role of strengthening spleen;2 doctors explained the mechanism from the perspective of numerology;another 9 doctors did not explain this in detail.The book of Fuxingjue explained that the spleen was impaired due to overstrain,therefore,the operation order of spleen earth should be reestablished.Conclusion It is not persuasive to explain the efficacy of this prescription simply by superposition of drug properties.The prescription rules established in Fuxingjue can deduce the results from the intervention measures,and the intervention measures can be deduced reversibly with the results,which has high self-consistency.It explains the mechanism of strengthening spleen with cassia twig in the state of deficiency,which should be the optimal solution.

关 键 词：小建中汤 健脾 辅行诀 建中补脾汤 经方 

分 类 号：R289.5[医药卫生—方剂学]