《辅行诀》与《脏腑标本虚实寒热用药式》中肝木疾病临床表现及治疗用药的异同点分析  

Clinical manifestations and therapeutic use of Chinese medicine for liver diseases in Fuxingjue and Medication Patterns for Treating Deficiency-excess and Cold-heat of Five Viscera

作　　者：齐明月 吕旭潇 金锐 QI Ming-yue;LYU Xu-xiao;JIN Rui(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091)

机构地区：[1]山东中医药大学附属医院,济南250014 [2]中国中医科学院西苑医院,北京100091

出　　处：《中南药学》2024年第8期2084-2089,共6页Central South Pharmacy

基　　金：中国中医科学院科技创新工程重大攻关项目(No.CI2021A03805,No.CI2021A00101);中国中医科学院西苑医院能力提升项目(No.XYZX0202-07)。

摘　　要：目的《辅行诀》与《脏腑标本虚实寒热用药式》均采用五脏虚实辨证作为理论架构,本文比较两者关于肝木疾病辨证用药的异同点,为“汤液经法图”的现代应用和理论融入提供依据。方法收集《辅行诀》与《脏腑标本虚实寒热用药式》关于肝木疾病辨证论治章节的临床症状表现和治疗药物信息,数据标准化后拆分成独立的语义概念进行比较,计算相符度。最终拆分成24个独立症状与《辅行诀》比较并计算相符度,用药药味依据“汤液经法图”五味补泻五脏规律进行定味和标记,并计算与补肝泻肝缓肝的“辛酸甘”味相符度。结果《脏腑标本虚实寒热用药式》肝木疾病包含24个症状,其中17个症状与《辅行诀》相符,相符度为70.8%,共有症状包括头痛、多怒、两胁肿痛等,《脏腑标本虚实寒热用药式》独有症状如卵缩、寒热虐等。同时,《脏腑标本虚实寒热用药式》包含76个肝木病治疗中药,其中辛味、酸味和甘味药总和占比为71.05%。结论《脏腑标本虚实寒热用药式》与《辅行诀》关于肝木疾病临床症状和治疗药物的认识有许多相同之处,相似度高达70%,两者可能具有相同的起源。五脏虚实+五味补泻辨证论治体系具有真实历史背景和临床实践价值。Objective To compare the similarities and differences between the two books on the syndrome differentiation of liver diseases to provide the basis for the modern application and theoretical integration of“Tang-ye-jing-fa map”,while both Fuxingjue and Medication Patterns for Deficiency-excess and Cold-heat of Five Viscera use syndrome differentiation of deficiency and excess of five viscera as the theoretical framework.Methods The clinical symptoms and medication information of the chapters on syndrome differentiation and treatment of liver diseases in Fuxingjue and Medication Patterns for Deficiency-excess and Cold-heat of Five Viscera were collected.After the data standardization,the symptoms were divided into independent semantic concepts for comparison and calculation of the coincidence.The flavors of medication herbs were determined and labeled according to the principle of tonifying and purging characteristics of five flavor in“Tang-ye-jingfa map”,and the coincidence degree was calculated.Results Medication Patterns for Deficiencyexcess and Cold-heat of Five Viscera included 24 symptoms of liver diseases,17 of which were also recorded in Fuxingjue,with a coincidence of 70.8%.The common symptoms included headache,irritability,swelling and pain in both flanks,etc.The unique symptoms of Medication Patterns for Deficiency-excess and Cold-heat of Five Viscera included testicular atrophy,alternate cold and heat,etc.This book also described 76 Chinese herbs for liver diseases.Those with pungent,sour and sweet flavors accounted for 71.05%out of the 76 herbs.Conclusion There are many similarities in the clinical symptoms and therapeutic herbs of liver diseases in both Medication Patterns for Deficiencyexcess and Cold-heat of Five Viscera and Fuxingjue,with similarity over 70%.The two books might share the same origin.Syndrome differentiation and treatment of deficiency and excess of five viscera and tonifying and purging of five flavors,may have real historical background and clinical value.

关 键 词：汤液经法图 脏腑标本虚实寒热用药式 辅行诀 肝木疾病 辨证论治 

分 类 号：R283[医药卫生—中药学]