平胃散历史溯源及配伍变化刍议  

Discussion on the Historical Tracing and Compatibility Changes of Pingwei Powder(平胃散)

作　　者：廖俊发 赵雪莹[1] LIAO Junfa;ZHAO Xueying(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《辽宁中医药大学学报》2025年第5期185-190,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：黑龙江教育厅省教改课题(SJGY20210829)。

摘　　要：平胃散收录于宋代《太平惠民和剂局方》,为治疗脾胃不和的经典方剂之一。该文将从方名、病因、病机、脉象、配伍、禁忌、剂型及服法等方面对平胃散进行历史探源,并对历代医家使用平胃散加减治疗不同疾病经验进行分析。结果发现平胃散方名“平胃”之义为“使胃土恢复平和”;平胃散主治病证的病因病机为外感湿邪,或脾虚失运,导致湿邪中阻,脾胃失和,气机不利;其主治病证的脉象包括缓、弦、短涩、沉大、沉缓脉等;禁忌方面,脾胃不足、阴虚及老弱之人不宜轻易使用平胃散;剂型方面,平胃散有汤剂和散剂两种,其服用方式不同,目的不同;另外,历代医家通过对平胃散的加减配伍,丰富了其主治病证,其中包括胃痞、呕吐、宿食不化、泄泻、疟病、瘴病、痢疾以及妇科和外科疾病等,但需把握“湿阻气机,脾胃失和”的基本病机;通过对平胃散的古代文献进行梳理和分析,以期为临床提供参考。Pingwei Powder(平胃散),in Taiping Huimin Hejiju Fang in the Song Dynasty,is one of the classic prescriptions for the treatment of disharmony between spleen and stomach.This article explored the historical origin of Pingwei Powder from the aspects of prescription name,etiologies,pathogenesis,pulse manifestations,synergy,contraindications,dosage forms and taking methods,and analyzed the experience of doctors in the past dynasties using Pingwei Powder to treat different diseases.It is found that the name“Pingwei Powder”means to restore the spleen and stomach to harmony.Pingwei Powder is mainly used to treat diseases caused by external dampness or spleen deficiency with excessive dampness,and its pathogenesis is damp blockage of middle Jiao,spleen and stomach disharmony,and disorder of Qi movement;and the pulse manifestations include moderate pulse,stringy pulse,short and hesitant pulse,deep and large pulse,deep and moderate pulse.In terms of taboos,people with deficiency of spleen and stomach,Yin deficiency,and the elderly or weak,should not use Pingwei Powder.In terms of dosage forms,Pingwei Powder has two types of dosage forms,namely decoction and powder,which are taken in different ways according to different purposes.What's more,through the changes of the compatibility of Pingwei Powder,the doctors of past dynasties enriched its main therapeutic diseases and symptoms,including gastric flatulence,vomit,food retention syndrome,diarrhea,malaria,malignant malaria,dysentery,gynecological and surgical diseases,etc.However,in the treatment of these diseases,it is necessary to grasp the basic pathogenesis of“dampness hampering Qi movement,disharmony of spleen and stomach”.In this paper,the ancient literature of Pingwei Powder was combed and analyzed to provide reference for clinical treatment.

关 键 词：平胃散 经典名方 溯源 配伍变化 

分 类 号：R289.5[医药卫生—方剂学]