浅析《伤寒论》方证的“三易”思想  

Some Notes about “Three Changes” Thinking of Prescriptions and Symptoms from Treatise on Febrile Diseases

作　　者：杨天闯 郭敏[3] 张近远 徐文倩 杨竹青 刘镇亚 王璐 姚翠翠 李合国[3] YANG Tianchuang;GUO Min;ZHANG Jinyuan;XU Wenqian;YANG Zhuqing;LIU Zhenya;WANG Lu;YAO Cuicui;LI Heguo(Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;Huangpu People′s Hospital of Zhongshan,Zhongshan 528403,Guangdong,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]中山市黄圃人民医院,广东中山528403 [3]河南中医药大学第一附属医院,河南郑州450000

出　　处：《辽宁中医杂志》2024年第3期50-54,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81904161);河南省中医药科学研究专项(2018ZYZD06)。

摘　　要：《伤寒论》的核心思想是辨证,辨相似的脉、证,予微调的方、药。变化之道无过于《周易》,其以八经卦演变出天、地、人的变化,《伤寒论》以桂枝汤、麻黄汤、柴胡汤、四逆汤等基础方治疗六经辖下百病。作者本着医易同源的思想,在类方的基础上以《周易》的“简易、变易、不易”核心变化思想,总结先贤关于《伤寒论》113方方证不同变化维度的论述,将方证的简易思想定为保胃气、扶阳气、存津液,“不易思想”定为表传里、上传下、寒化热、热蕴湿、实致虚、微变剧,方的变易思想定为裁、采、穿、化四类,证的“变易思想”定为兼、夹、变、类四种,以期对《伤寒论》方证有个动态的整体定位,临床上以不变的原则,圆活地使用经方治疗多变的疾病。The core thinking of Treatise on Febrile Diseases is to differentiate syndromes,identify similar meridians and syndromes and adjust the prescription and medicine accordingly.There′s no change like The Book of Changes which describes the change of heaven,earth and man through Eight Trigrams.Many diseases are treated by six meridians differentiation from Treatise on Febrile Diseases which contains lots of basic prescriptions like Guizhi Decoction(桂枝汤),Mahuang Decoction(麻黄汤),Chaihu Decoction(柴胡汤)and Sini Decoction(四逆汤).On the basis of homologous between medicine and change,abiding by the similar prescription principle,it summarized different dimensions of change about 113 prescriptions from Treatise on Febrile Diseases with“simple change,constant change,immutable change”idea.The“simple change thinking”for prescription and symptom is about the protection of stomach Qi,the help of Yangqi and the preserve of body fluid.The immutable change thinking is from the surface to the inside,from the top to the bottom,cold turning into heat,heat causing dampness,from the excess to the deficiency and from the mild condition to the severe condition.The change thinking for prescriptions contains regulating,picking,combing and changing.The change of symptoms is accompanying symptoms,mixing symptoms,changing symptoms and similar symptoms.With the grasp of relation between prescriptions and symptoms from Treatise on Febrile Diseases,the relatively constant principle could correspond to more progressive disease in medical practice.

关 键 词：《周易》 《伤寒论》 医易同源 方证相应 方药 症状 

分 类 号：R222.2[医药卫生—中医基础理论]