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张锡纯附子用药解析

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张锡纯是清末民初的代表性医家,研究其使用附子的习惯与规律对于指导临证有现实意义.在张锡纯著作《医学衷中参西录》中,含附子方剂共计 30首,其中 29首为复方汤剂,21首方剂指明使用经过炮制的附子(原文称"乌附子"),无使用生附子的实际案例,均未对煎煮法作特殊要求,其用量为 0.6~24 g,总体使用剂量较小.人参、甘草、干姜、山药、白术是常与附子配伍的药味,旨在发挥益火扶阳(温里寒)、温阳通痹、回阳固脱、引火归元等功效.张锡纯使用附子的用法较为谨慎保守,其用药经验可以为现代中医临床提供思路与启示.
Analysis of ZHANG Xichun's use of Fuzi(Aconiti Lateralis Radix Praeparata)in medication
ZHANG Xichun was an representative Chinese medicine specialist in the late Qing Dynasty and early Republic of China.Studying his habits and rules in using Fuzi(Aconiti Lateralis Radix Praeparata)is of practical significance for guiding clinical practice.In ZHANG Xichun's work Yi Xue Zhong Zhong Can Xi Lu(Records of Chinese Medicine with Reference to Western Medicine),there are a total of 30 formulas containing Fuzi(Aconiti Lateralis Radix Praeparata),among which 29 are compound decoctions,and 21 formulas specify the use of processed Fuzi(Aconiti Lateralis Radix Praeparata)(originally referred to as"black Fuzi"),with no actual cases of using raw Fuzi(Aconiti Lateralis Radix Praeparata).There are no special requirements for the decoction method,and the dosage is approximately 0.6 g to 24 g,with a generally low overall dosage.Renshen(Ginseng Radix et Rhizoma),Gancao(Glycyrrhizae Radix et rhizoma),Ganjiang(Zingiberis Rhizoma),Huaishan(Dioscoreae Rhizoma),and Baizhu(Atractylodis Macrocephalae Rhizoma)were frequently used in combination with Fuzi(Aconiti Lateralis Radix Praeparata),aiming to exert its effects of benefiting fire and supporting yang(warming interior cold),warming yang and unblocking impediment,resuscitating yang and preventing collapse,and guiding fire to its origin.Generally speaking,ZHANG was relatively discreet and conservative in using Fuzi(Aconiti Lateralis Radix Praeparata),and his experience in medication can provide ideas and insights for modern clinical practice of TCM.

ZHANG XichunYi Xue Zhong Zhong Can Xi Lu(Records of Chinese Medicine with Reference to Western Medicine),Fuzi(Aconiti Lateralis Radix Praeparata)Supporting-Yang SchoolSchool of Integrated Chinese and Western Medicine

湛韬、李杰

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长沙市第一医院中西医结合科,湖南 长沙 410005

湖南中医药大学,湖南 长沙 410208

张锡纯 医学衷中参西录 附子 火神派 中西汇通学派

湖南省中医药科研项目湖南省中医药科研重点项目

E2022036C2023002

2024

湖南中医药大学学报
湖南中医药大学

湖南中医药大学学报

CSTPCD
影响因子:1.098
ISSN:1674-070X
年,卷(期):2024.44(7)