桃核承气汤瘀热互结关系探析  

Study on the relationship of stagnation of stasis and heat in Taohe Chengqi Decoction

作　　者：李冉 钟相根 李明 周冉冉 李志鸣 陶晓华 LI Ran;ZHONG Xianggen;LI Ming;ZHOU Ranran;LI Zhiming;TAO Xiaohua(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《中华中医药杂志》2024年第12期6417-6420,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2019YFC1709200,No.2019YFC1709201);科技部“重大新药创制”(No.2018ZX09721005-007-009);北京中医药大学2022年度基本科研业务费(揭榜挂帅)项目(No.2022-JYB-JBZR-010);北京中医药大学2023年拔尖创新人才培养“后资助”项目(No.90010961020116)。

摘　　要：《伤寒论》桃核承气汤是治疗蓄血证的经典名方,历代医家把桃核承气汤的病机解读为瘀热互结,而关于“瘀”和“热”孰轻孰重的问题现在的主流观点是热重于瘀,但现实中“热重于瘀”的临床病例却并不常见。文章通过对桃核承气汤原文的详细解析,结合症状、字义、方药、中病反应、医案举例等,认为该方病机瘀热互结,但瘀重于热。这一解析或许能对临床精准应用本方及相关研究提供新的思路。Taohe Chengqi Decoction is a classical prescription for the treatment of blood storage syndrome in Shanghan Lun.Doctors of all dynasties interpreted the pathogenesis of Taohe Chengqi Decoction as the stagnation of stasis and heat,and the mainstream view about the importance of‘stasis’and‘heat’is that heat is more important than stasis,but the clinical cases of‘heat is more important than stasis’are not common in reality.Through the detailed analysis of the original text of Taohe Chengqi Decoction,combined with symptom,textual research,prescription,mid disease reaction and medical case examples,this paper believes that the pathogenesis of this prescription is stagnation of stasis and heat,but stasis is more serious than heat.This analysis may provide new ideas for accurate clinical application of this prescription and related research.

关 键 词：桃核承气汤 病机 瘀热互结 瘀重于热 《伤寒论》 张仲景 经方 

分 类 号：R25[医药卫生—中医内科学]