研习中医经典《伤寒论》,用活经方  

A study on flexibly using classical prescriptions in Shanghan Lun

作　　者：姬令山[1] 刘洪峰 王松龄[1] JI Lingshan

机构地区：[1]河南省中医院,河南郑州450002 [2]郑州市金水区总医院,河南郑州450000

出　　处：《中医临床研究》2024年第26期9-12,共4页Clinical Journal Of Chinese Medicine

基　　金：王松龄全国名老中医药专家工作室(国中医药人教发【2018】134号)。

摘　　要：经典著作是中医理论的源泉,是传承与创新的基础。《伤寒论》是融医经和经方于一炉,其中的三阴三阳是病理概念,体现了病位、病性、病势和预后。由此确立了理、法、方、药相结合的辨证论治体系,体现了个体化的诊疗方案,并作为中医特色之一沿用至今。由于体质差异,感邪轻重,失治、误治及病症兼杂,使疾病的主证、病机多变,证候之间颇多疑似。如何掌握辨证要点,区分异同,本研究立足《伤寒论》原文,分别从归类“煮后去滓再煎”方证,区别经方;运用对偶统一观,比较方证,活用经方;用恒动观,理解方证,巧用经方;同一方证,前后条文对比,解释医理,重认经方;抓病机,妙用经方;鉴别方证,用准经方6个方面入手,从文字论述、先后联系、语境分析、医理推断和逻辑分析方法中,运用归类对比法,在细微之处,区别要领,抓主症和病机,便于掌握及更深层次理解条文,分析方义,培养感悟,活用经方,有效临证。当前中医药事业拥有历史发展过程中最好的外部环境,中医人应抓住机遇,钻经典,勤临证,得奇恒,辨精微,在临证中动态观察脉证,调整方药,加减药味,增减药量,权衡利害,以期达到最佳效果,实现中医药的伟大振兴。Classics are the source of TCM theories and the foundation for inheritance and innovation.Shanghan Lun(《伤寒论》)is a fusion of medical scriptures and prescriptions in one furnace,in which San Yin(三阴)and San Yang(三阳)are pathological concepts,reflecting the location,nature,condition and prognosis of the disease.As a result,a syndrome differentiation and treatment system combining theory,law,prescription and medicine was established,which embodied the individualized diagnosis and treatment plan,and has been used as one of the characteristics of traditional Chinese medicine.Due to the difference in physical constitution,the severity of the susceptibility,the failure of treatment,mistreatment and the combination of symptoms,the main syndrome and pathogenesis of the disease are changeable,and there are many suspicions between the syndromes.How to grasp the key points of syndrome differentiation and distinguish similarities and differences,this article classifies the formulas of"boiling and then decoction"from the original text of Shanghan Lun,and distinguishes the prescriptions.The concept of duality unity was applied to compare the evidence,and make full use of the scriptures.The concept of perpetual motion was applied to understand the evidence,and skillfully use the scriptures.The same prescription,comparing the provisions before and after,explaining the medical theory,and recognizing the scriptures,grasp the disease mechanism,and use the prescription wisely.Identification of prescriptions can start from the 6 aspects of the quasi-scripture formula,from the textual discussion,successive contact,context analysis,medical inference,logical analysis methods,the use of classification and comparison method,in the subtleties,distinguish the essentials,grasp the main symptoms and pathogenesis,easy to grasp and deeper understanding of the provisions,analysis of the meaning,cultivation of perception,make full use of the scriptures,effective clinical evidence.The current Chinese medicine industry has the best ex

关 键 词：《伤寒论》 归类 对比 经方 

分 类 号：R289.1[医药卫生—方剂学]