从“药类法象”探讨妇科疾病诊治思路  

Discussion on Thoughts for Differentiation and Treatment of Gynecological Disease Following Pharmacological Theory Based on Natural Phenomena

作　　者：郑玮琳 刘浩 曹立幸[2] ZHENG Weilin;LIU Hao;CAO Lixing(Guangdong Second Provincial General Hospital,Guangzhou 510315 Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广东省第二人民医院,广东广州510315 [2]广州中医药大学第二附属医院,广东省中医院,广东广州510120

出　　处：《广州中医药大学学报》2025年第3期768-773,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金-青年科学基金项目(编号:82305295);广东省自然科学基金项目(编号:2023A1515011109);广东省自然科学基金-粤穗联合青年基金项目(编号:2022A1515110697);广东省中医药局科研项目(编号:20231018);国家中医药管理局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]1号)。

摘　　要：“药类法象”为中药传统理论之一。“药类法象”发端于《黄帝内经》,元代的张元素将药物的四气五味与运气相结合,提出“风升生、热浮长、湿化成、燥降收、寒沉藏”的“药物顺应天地四时”的理论,创立了“药类法象”之说;李东垣发展了“药类法象”观,临证时顺应四时与机体的气机之升降浮沉而用药。该文通过分析张元素与李东垣有关“药类法象”的观点,探讨了“风升生、热浮长、湿化成、燥降收、寒沉藏”等“药类法象”理论在妇科疾病辨识与治疗中的应用。“药类法象”以其独特的思维方式将药物进行分类,体现天人相合观;基于“药类法象”用药是传统中医思维的表现,顺应“四时升降”,体现了人体的生物节律。从气机升降失常认识妇科疾病,运用“药类法象”指导中医妇科疾病用药,可为中医妇科异病同治提供新思路。Pharmacological theory based on natural phenomena(abbreviated as natural-phenomena-based pharmacology)belongs to the traditional theory of Chinese herbal medicine,and is originated from Huang Di Nei Jing(The Yellow Emperor s Inner Classic).By analyzing the correlation of four properties and five flavors of medicines with the seasonal changes of nature,Zhang Yuansu,a famous physician of Yuan Dynasty,put forward the view that medicines properties accord with the features of climatic factors of nature,showing that wind has the properties of ascending and generating,heat has the properties of going up and growing,dampness has the properties of transforming and developing,dryness has the properties of descending and reaping,and cold has the properties of sinking and storing,and then established the theory of natural-phenomena-based pharmacology.As a promotion of the theory,Li Dongyuan advocated that the medication should adapt to the seasonal changes and to the ascending,descending,floating and sinking of qi movement of human body.By reviewing the viewpoints of Zhang Yuansu and Li Dongyuan on natural-phenomena-based pharmacology,this paper discussed the application of natural-phenomena-based pharmacological theory,such as wind-medicine having the properties of ascending and generating,heat-medicine having the properties of going up and growing,damp-medicine having the properties of transforming and developing,dry-medicine having the properties of descending and reaping,and cold-medicine having the properties of sinking and storing,in the identification and treatment of gynecological diseases.The unique way of classification of Chinese herbal medicines according to the theory of natural-phenomena-based pharmacology reflects the view of correspondence between human being and nature.And medication following the theory of natural-phenomena-based pharmacology accords with the thinking of traditional Chinese medicine(TCM),and is in line with the seasonal changes,which reflects the biological rhythm of the human body.Identif

关 键 词：药类法象 四气五味 四时 气机 升降浮沉 中医妇科疾病 诊治思路 

分 类 号：R271.1[医药卫生—中医妇科学]