五脏所苦用药理论临床应用举隅  

Clinical application of the theory of“Sufferings of the Five Organs and Their Remedies”:case studies

作　　者：解宇童 贺娟 XIE Yutong;HE Juan(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《现代中医临床》2025年第1期35-38,48,共5页Modern Chinese Clinical Medicine

基　　金：国家社会科学基金项目(No.21&ZD349)。

摘　　要：《素问·脏气法时论篇》所言五脏苦欲补泻法,是指导脏腑用药的重要理论。本文依据经文对五脏所苦的概念和病证进行理论阐释,并结合临床案例进行阐述,以拓展五脏五味用药思维。“肝苦急,急食甘缓”之甘麦大枣汤合百合地黄汤治疗焦虑症;“心苦缓,急食酸收”之配伍乌梅治疗独语、自笑;“脾苦湿,急食苦燥”之三仁汤治疗抑郁症;“肺苦气上逆,急食苦泄”之桂枝加厚朴杏子汤加减治疗哮喘伴惊恐发作;“肾苦燥,急食辛润”之配伍麻黄治疗便秘。The theory of“Supplementation/Drainage of the Five Organs Based on Their Longings and Sufferings”from the Suwen:Discourse on How the Qi in the Depots Follow the Pattern of the Seasons serves as an important guiding principle for the clinical use of herbal medicine in treating organ disorders.This paper explores the concept of the afflictions of the five Zang organs as described in the book,discussing relevant pathologies and theoretical underpinnings,and demonstrates applications through clinical case studies to expand on the thinking behind flavor-based treatments for each organ.Examples include:using Ganmai Dazao Decoction(Licorice,Wheat and Jujube Decoction)combined with Baihe Dihuang Decoction(Lily Bulb and Rehmannia Decoction)to address anxiety based on the principle that“the liver suffers from tension,thus it craves sweetness to relax”;pairing Wumei(Fructus Mume)with other herbs to treat symptoms like muttering and inappropriate laughter according to the record that“the heart suffers from slackening,thus it craves sourness to contract it again”;applying Sanren Decoction(Three Kernels Decoction)to manage depression as“the spleen suffers from dampness,thus it craves bitterness to dry”;using a modified Guizhi Jia Houpo Xingzi Decoction(Cinnamon Twig,Officinal Magnolia Bark,and Almond Decoction)for asthma with panic attacks based on“the lung suffers from qi rising contrary,thus it craves bitterness to drain it”;and combining Mahuang(Herba Ephedrae)with other herbs to relieve constipation in accordance with“the kidney suffers from desicccation,thus it craves acrid to moisten.”

关 键 词：黄帝内经 五脏苦欲补泻 临床应用 用药拓展 

分 类 号：R221[医药卫生—中医基础理论]