浅议《金匮要略》中“术”药之运用  

Discussion on Application of Atractylodes Rhizome in Synopsis of Golden Chamber

作　　者：刘康宁 杨泽 夏永良[2,3] 陈意 LIU Kangning;YANG Ze;XIA Yongli-ang(First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China;The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Traditional Chinese Medicine);CHEN Yi National Famous TCM Expert Inheritance Office)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学附属第一医院(浙江省中医院) [3]陈意全国名中医传承工作室

出　　处：《浙江中医药大学学报》2025年第3期367-371,共5页Journal of Zhejiang Chinese Medical University

基　　金：陈意全国名中医传承工作室建设项目(国中医药办人教函〔2022〕245号);陈意全国名老中医药专家传承工作室建设项目(国中医药人教发〔2011〕41号);浙江省陈意国医名师传承工作室建设项目(浙中医药〔2020〕12号)。

摘　　要：[目的]探求《金匮要略》中“术”药的应用特点,总结临床辨证用药思路。[方法]从源流考证、剂量探析、配伍特点等方面,综合分析仲景应用“术”的经验。[结果]《金匮要略》条文中提到“术”的共有24条,其功效可归纳为益气健脾、补虚蠲痹、燥湿利水、安胎固本,虽未明确区分“苍术”与“白术”,但白术重于补气健脾、止汗安胎,苍术胜于祛风散寒、燥湿健脾,二者在方剂配伍中各有所长,用量和剂型差异亦与其疗效密切相关。[结论]仲景善于辨证施治,不拘泥于一方一法一途,巧妙利用“术”药的功效特点,灵活选用剂型、调整用量,根据病证调整药物配伍,其所成之方不仅可入中焦以健脾利水,亦擅入肌表以祛风燥湿,又可入冲任以补气安胎,还可补虚除痹,对临床应用具有较大的指导意义。[ObjectiveObjective]To explore the application characteristics of medication“Atractylodes Rhizome”in Synopsis of Golden Chamber and summarize clinical approaches to syndrome differentiation and treatment.[MethodsMethods]ZHANG Zhongjing’s experience in using Atractylodes Rhizome was comprehensively analyzed from source,dosage,compatibility characteristics,etc.[ResultsResults]Synopsis of Golden Chamber mentions a total of 24 applications of Atractylodes Rhizome for treating different diseases.Its main therapeutic effects are to tonify Qi and invigorate the spleen,tonify deficiency and relieve obstruction,dry dampness and diuresis,stabilize the fetus and consolidate the foundation.Although the text does not explicitly differentiate between Atractylodes ovata and Atractylodes sinensis,but it suggests Atractylodes ovata is more important in tonifying Qi,invigorating the spleen,stopping sweat and calming the fetus,while Atractylodes sinensis is better in dispelling wind and cold,drying dampness and invigorating the spleen.Both have their own strengths in formula compatibility,and the differences in dosage and dosage forms are closely related to their therapeutic effects.[ConclusionConclusion]Zhongjing was good at treating diseases according to syndrome differentiation,not limited to one prescription,one method and one path.He cleverly utilized the characteristics of Atractylodes Rhizome,flexibly selected dosage forms and adjusted dosage,and adjusted drug combinations according to disease symptoms.The formula he produced not only can enter the middle-Jiao to strengthen the spleen and promote diuresis,but also can enter the superficial tissues to dispel wind and dampness.It can also enter the Chongren to replenish Qi and prevent miscarriage,as well as tonify deficiency and eliminate painful impediment syndrome,which had great guiding significance for clinical application.

关 键 词：术 白术 苍术 《金匮要略》 历史沿革 处方考证 药物配伍 临床应用 

分 类 号：R282[医药卫生—中药学]