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赵开美本《伤寒论》桂枝加附子汤剂量疑考

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《伤寒论》中桂枝加附子汤为太阳中风误汗亡阳而设。赵开美本《伤寒论》中桂枝加附子汤剂量并非桂枝汤加附子一枚,而是于桂枝汤基础上又增加了甘草一两,对此,争议颇多。本文综合运用文献学研究方法,通过分析《伤寒论》现存主要版本、宋以前医籍记载、黑水城出土的《伤寒论》抄本残页等文献,认为北宋校正医书局刊行的《伤寒论》中桂枝加附子汤原剂量应为桂枝汤加附子一枚,甘草为二两。赵开美本中甘草三两的剂量,并非因发汗太过,在桂枝汤基础上刻意增加一两,补气滋阴以祛邪,应为刻印过程中失误所致,当予以校正。
Study on Dosage of Guizhi Jia Fuzi Decoction in Zhao Kaimei's Version of Shang Han Lun(Treatise on Febrile Diseases)
Guizhi Jia Fuzi Decoction,which was proposed in Shang Han Lun,was designed for the Yang Qi depletion syndrome when the sweating method was used by mistake in treatment of Taiyang Zhongfeng Disease.The dose of Guizhi Jia Fuzi Decoction in Zhao Kaimei's version of Shang Han Lun is not the case of Guizhi Decoction plus one piece of Fuzi(Aconitum carmichaelii),but one or two pieces of Gancao(Licorice)is added to Guizhi Decoction.However,this is a controversial issue.In this paper,by comprehensively applying the bibliographic research method,through analyzing the existing major versions of Shang Han Lun,the medical records before Song Dynas-ty,and the remnants of the copy of Shang Han Lun unearthed in Heishuicheng City,etc.,it is believed that the original dosage of Guizhi Decoction Jia Fuzi Decoction in Shang Han Lun published by the Bureau of Correcting and Medicine of the Northern Song Dynasty was one piece of Fuzi being added in Guizhi Decoction with two Liang of Gancao(licorice).The dosage of three Liang of Gancao in Zhao Kaimei's version of Shang Han Lun is not the deliberate dose increasing by one or two Liang based on Guizhi Decoction,for the purpose of replenishing Qi and nourishing Yin to get rid of the Evil Factors with too much sweating.Actually,the dose of three Liang of Gancao in the formula is just a mistaken dose in process of engraving and printing,which should be corrected.

Shang Han LunZhao Kaimei's versionGuizhi Jia Fuzi DecoctionGancao(Licorice)classical prescriptionsversionsmodified Guizhi Decoction

李志鸣、陶晓华

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北京中医药大学中医学院,北京 100029

北京中医药大学中医文献研究院,北京 100029

《伤寒论》 赵开美本 桂枝加附子汤 甘草 经方 版本 桂枝汤类方

2025

中医学报
河南中医药大学,中华中医药学会

中医学报

影响因子:1.264
ISSN:1674-8999
年,卷(期):2025.40(1)