《伤寒论》中药煎服法辨证观探析  

Analysis of the Dialectical View in the Method of Decocting and Taking Medicine Recorded in Treatise on Exogenous Febrile Diseases

作　　者：梁鉴 梁伟 薛姗 宋吉美 朱俊霞 郭祺 朱章志[3] LIANG Jian;LIANG Wei;XUE Shan;SONG Jimei;ZHU Junxia;GUO Qi;ZHU Zhangzhi(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Traditional Chinese Medicine,Yangxi General Hospital People's Hospital,Yangjiang 529800 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广东省阳西总医院人民医院中医科,广东阳江529800 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2025年第1期231-236,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82174284)。

摘　　要：中药的煎服法直接影响药物疗效,是临床增效减毒的关键。《伤寒论》作为方书之祖,书中记载了详细且独到的煎服法。该文对《伤寒论》的相同药物不同煎煮法、去滓再煎法、煎煮丸药法及其药物的服药量、服药时机、调护法进行归纳梳理,并探讨其蕴含的中医辨证观。《伤寒论》中方药的特殊煎煮法包含了同药异治、药证合参、峻药缓行的中医辨证观;其服药法则包含了随证施量、因势利导、以知为度的中医辨证观。认为《伤寒论》方药的煎服法随证而设,根据病证特点采取不同的煎煮方式、服药策略及调护方法,更能使方药切中病机,提高临床疗效。The method of decocting and taking medicine can directly influence the efficacy of the Chinese herbal medicine,and is the key to enhancing efficacy and reducing toxicity.As the originator of classic books for traditional Chinese medicine(TCM)prescriptions,Treatise on Exogenous Febrile Diseases has recorded various specific methods of decocting and taking medicine in details.This paper summarized and sorted out various methods of decocting the same Chinese herbal medicine,re-decocting method with the removal of dregs(for concentrating medicinal solution),method of decocting pills,dosage of medicine,time for taking medicine,and notices and healthcare after medication recorded in Treatise on Exogenous Febrile Diseases.Moreover,the dialectical view in the method of decocting medicine recorded in Treatise on Exogenous Febrile Diseases.was explored.The special method of decocting and taking medicine in Treatise on Exogenous Febrile Diseases included the TCM dialectical view of using the same Chinese herbal medicine for the treatment of different diseases,consideration of both Chinese herbal medicine and syndromes,drastic purgatives for chasing long-term efficacy.The method of taking medicine contained the TCM dialectical view of modification of the medicine dosage according to syndrome differentiation,adapting to the general trend,and suspension after medicine starting an effect.It is believed that the method of decocting and taking medicine for the prescriptions in Treatise on Exogenous Febrile Diseases is established according to syndrome differentiation,and the utilization of various methods of decocting and taking medicine as well as notices and healthcare after medication in accordance with the characteristics of diseases and syndromes ensures the prescriptions meeting the pathogenesis,and then enhance the clinical efficacy.

关 键 词：《伤寒论》 中药煎服法 服药量 调护法 同药异治 药证合参 峻药缓行 

分 类 号：R222.13[医药卫生—中医基础理论]