以《辨证录》疏肝健脾方逍遥散加减为例探析陈士铎用药特点  

Analysis on the medication characteristics of Chen Shiduo exemplified by the prescriptions of Xiaoyao powder documented in Syndrome Differentiation Record

作　　者：李蓝 李然[1] 刘立萍[1] LI Lan;LI Ran;LIU Liping(College of Traditional Chinese Medicine,Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学中医学院,沈阳110032

出　　处：《吉林中医药》2025年第2期224-228,共5页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金面上项目(81673876);第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕239号)。

摘　　要：目的以陈士铎《辨证录》中所用逍遥散方的组成药物以及主要加减药味为切入点探析陈士铎的用药特点。方法对《辨证录》中明确提及的逍遥散加减的方剂进行整理,对结果进行分析,通过用药频次佐证所用方的构成药物,并对构成药物在加减方中剂量情况进行统计,绘制剂量分布图。结果陈士铎所用逍遥散的药物组成为白芍、柴胡、甘草、陈皮、当归、白术、茯苓(茯神);主要加减药味为栀子、半夏、牡丹皮等;君臣佐药的常用量分别为5钱、3钱、1钱。结论陈士铎所用逍遥散与《医贯》古方逍遥散组成相近;陈士铎临证主要围绕散表里邪、解郁清火、疏肝健脾三个功效对逍遥散进行运用,主要加减药味药用以增强清火消痰之效;其组方药物的剂量分布体现陈氏组方中君臣佐药逐渐减量的特点。Objective To explore the medication characteristics of Chen Shiduo by analyzing the composition of Xiaoyao powder documented in his Syndrome Differentiation Record and the principal drugs added to or subtracted from the formula.Methods The prescriptions explicitly identified as Xiaoyao powder with modifications were extracted from the Syndrome Differentiation Record,and a statistical analysis was performed on them.The constituent drugs in the prescriptions were substantiated by their frequency,and their dosages in the modified prescriptions were subjected to a statistical analysis.A graphical representation of dosage distribution was also generated.Results Chen Shiduo's Xiaoyao powder was mainly made up of debark peony root,Chinese thorowax root,liquorice root,dried tangerine peel,Chinese angelica,largehead atractylodes rhizome,Indian bread.The major added drugs featured cape jasmine fruit,pinellia tuber,tree peony root bark.The standard drug dosages were 5 qian for the sovereign drugs,3 qian for the minister drugs,and 1 qian for the assistant drugs.Conclusion The composition of Xiaoyao powder utilized by Chen Shiduo closely resembles that of the ancient formula Xiaoyao powder in the Key Link of Medicine.Chen Shiduo primarily employs Xiaoyao powder to achieve the effects of harmonizing and releasing the exterior and interior,resolving qi stagnation and clearing heat,and dispersing stagnated liver qi and strengthening the spleen.The additive drugs are frequently used to enhance the efficacy of clearing internal fire and eliminating phlegm.The dosage distribution of the drugs in the prescriptions reflects the characteristics of gradual reduction in terms of sovereign,minister,and assistant drugs.

关 键 词：辨证录 疏肝健脾 逍遥散 用药特点 陈士铎 

分 类 号：R289.1[医药卫生—方剂学]