栀子在《伤寒杂病论》中配伍应用规律探讨  

Analysis on the Application Law of Zhizi(Gardeniae Fructus)in Treatise on Febrile Diseases

作　　者：李天骄 张沁园[1] LI Tianjiao;ZHANG Qinyuan(Shandong University of Traditional Chinese Medicine,Jinan 250300,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250300

出　　处：《辽宁中医药大学学报》2024年第8期178-182,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中医药管理局齐鲁医派中医药特色技术整理推广项目(鲁卫函[2021]45号)。

摘　　要：栀子在《伤寒杂病论》中共涉及经方10首,根据对其相关原文以及文献资料的整理分析,对其配伍规律得出以下结论:(1)仲景对栀子的用量较为稳定,为14~15枚不等,约12.6~19.5 g,皆取生品入汤剂。(2)所伍经方主治症状多以烦、热为主,病位多在上焦,涉及中下二焦,原文提示六经多在太阳、阳明及厥阴,病机皆突出郁热内结的特点。(3)栀子的配伍甚为灵活,基于中医治疗八法分析,其配伍组方规律体现在:①以清法为主,如代表方栀子豉汤,栀子配豆豉而成清宣里热基本药对;②清中兼下-栀子配厚朴、枳实或大黄以清热通腑,利湿退黄,有栀子大黄汤、枳实栀子豉汤等;③清中兼消——栀子配茵陈、黄柏以清消湿热,解毒退黄,有茵陈蒿汤、栀子柏皮汤等;④清中兼温——即栀子干姜汤中配入干姜,寒温并用,清热温中;⑤清中兼补——即栀子甘草豉汤中配入甘草,补益中气,标本兼顾;⑥清中兼和——即栀子生姜豉汤中配入生姜以调理气机,降逆和中。仲景运用栀子灵活巧妙,药简力宏,探析其配伍规律对现代用药组方思路颇具指导性及启发性。Zhizi(Gardeniae Fructus)involves 10 prescriptions in Treatise on Febrile Diseases.According to the collation and analysis of relevant original texts and literature materials,the following conclusions are drawn on the compatibility rules:(1)Zhongjing's dosage of Zhizi(Gardeniae Fructus)is relatively stable,ranging from 14 to 15 pieces,about 12.6-19.5 g,all of which use raw products into decoction.(2)The main symptoms of the prescriptions are mainly vexation and heat.The location of the disease is mostly in the upper Jiao,involving the middle Jiao and the lower Jiao.The original text suggests that the six meridians are mostly in Taiyang,Yangming and Jueyin.The pathogenesis is characterized by heat stagnation.(3)The compatibility of Zhizi(Gardeniae Fructus)is very flexible.Based on the analysis of the eight methods of traditional Chinese medicine,the rules of its compatibility are as follows:①Mainly based on the heat-clearing method,such as the representative prescription Zhizichi Decoction(栀子豉汤),Zhizi(Gardeniae Fructus)with Douchi(Sojae Semen Praeparatum)to form a basic drug pair for clearing heat;②Heat-clearing combined leading down Zhizi(Gardeniae Fructus)with Houpo(Magnoliae Officinalis Cortex),Zhishi(Aurantii Fructus)or Dahuang(Rhei Radix Et Rhizoma)to clear heat and dredge Fu-organs,dampness and jaundice,Zhizi Dahuang Decoction(栀子大黄汤),Zhishi Zhizichi Decoction(枳实栀子豉汤),etc.;③Heat-clearing combined with eliminating Zhizi(Gardeniae Fructus)with Yinchen(Artemisiae Scopariae Herba),Huangbai(Phellodendri Chinensis Cortex)to clear damp heat,detoxification and jaundice,Yinchenhao Decoction(茵陈蒿汤),Zhizi Baipi Decoction(栀子柏皮汤);④Heat-clearing combined with warming the interior-that is,Ganjiang(Zingiberis Rhizoma)is added to Zhizi Ganjiang Decoction(栀子干姜汤),combined with cold and warm,clearing heat and warming the interior;⑤Heat-clearing and tonifying-that is,Gancao(Glycyrrhizae Radix Et Rhizoma)is added to Zhizi Gancaochi Decoction(栀子甘草豉汤)to to

关 键 词：栀子 《伤寒杂病论》 《伤寒论》 配伍规律 经方 

分 类 号：R282.71[医药卫生—中药学]