附子汤组方思路与证治要点  

The Thought of Aconite Decoction Formulation and Key Points of Syndrome and Treatment

作　　者：王家豪 陈仁寿 WANG Jiahao;CHEN Renshou(Institute of Literature in Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210023;Jiangsu Classic Famous Formulas Engineering Research Center,Nanjing,Jiangsu,China,210023)

机构地区：[1]南京中医药大学中医药文献研究所,江苏南京210023 [2]江苏省经典名方工程研究中心,江苏南京210023

出　　处：《河南中医》2023年第10期1474-1477,共4页Henan Traditional Chinese Medicine

基　　金：国家社会科学基金冷门绝学专项研究项目(21VJXG038)。

摘　　要：附子汤为张仲景创制的“伤寒温补第一方”,主治阳虚阴盛兼寒湿证,组方思路以益气回阳为本,兼以补土、益阴,方中附子大辛大热,具有回阳救逆、补火助阳、散寒止痛之功,重用附子两枚,意在以附子之辛热驱散肾间之阴寒;人参大补元气、复脉固脱,二者共为君药;白术、茯苓为臣,补土化湿;芍药为使,益阴固本。五药配伍,扶阳不忘益阴,救寒必兼固本。临床辨证以“虚”“寒”“湿”为要点,主治病证可分为虚寒证与寒湿证,古代常用于治疗痹证、妊娠腹痛、心腹痛、泄泻、多寐等证,现代亦用于治疗痛风、风湿性关节炎、类风湿性关节炎、强直性脊柱炎以及心功能不全、肠胃炎等疾病。Aconite Decoction as"the first formula for warming and tonifying cold damaged diseases"was created by Zhang Zhongjing,which was used to treat yang deficiency and yin excess combined with cold dampness syndrome.The formulation thought is to replenish qi and restore yang as the foundation,complicated with tonifying earth and nourishing yin.Fuzi(Radix Aconiti Lateralis Preparata)and Renshen(Radix Ginseng)are the chief ingredients.Fuzi has strong pungent and hot nature,can restore yang from the collapse,tonify fire and reinforce yang,dispel cold and relieve pain.This formula uses two pieces of Fuzi to disperse yin cold between the kidneys with the hot and pungent nature.Renshen can greatly tonify original qi,reactivate the pulse and prevent collapse.Baizhu(Rhizoma Atractylo-dis Macrocephalae)and Fuling(Poria)are minister ingredients,can tonify earth and resolve dampness.Shaoyao(Radix Paeoniae Alba seu Rubra)is a courier ingredient which can replenish yin and consolidate the root.The combination of five medicines can reinforce yang without ignoring replenishing yin,warm cold and strengthen the root.Clinical syndrome diferentiation is based on"deficiency,"cold"and"dampness"as the key points,and the main treatment can target deficiency cold syndrome and cold dampness syndrome.In ancient times,the formula was often used to treat impediment disease,pregnancy abdominal pain,heart and abdominal pain,diarrhea,in-somnia and other syndromes.In modern times,it can also be used to treat gout,rheumatic arthritis,rheumatoid arthritis,compulsory spondylitis and heart dysfunction,gastroenteritis and other diseases.

关 键 词：附子汤 虚寒证 寒湿证 《伤寒杂病论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]