首页|炮附子在经方汤剂中的应用规律探析

炮附子在经方汤剂中的应用规律探析

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中医的不传之秘在于药量和煎煮方法。现今医家使用炮附子时通常先煎1~2 h,而仲景则不先煎,而且在用量上也与现今有很大差别。《伤寒论》和《金匮要略》中的炮附子的主要功效为扶阳、逐饮、止痛和恢复沉衰的机能,但在不同剂量与不同煎煮时长下,炮附子所偏重的治疗方向不同,在主治、功效和适应证上也有区别。1枚炮附子主要用于治疗太阳病兼阳虚证;治疗少阴表证需发汗者;温阳利水;治疗四肢疼痛、骨痛、腹部疼痛。2枚炮附子主要用于温中逐饮;治疗身体或骨节痛;治疗消化道出血和子脏开。3枚炮附子主要用于治疗剧烈疼痛和用于祛除较为严重的肌表水湿之邪。不同的煎煮时长亦对炮附子的主治功效有影响。煎煮时间短,则炮附子治疗阳虚恶寒与止痛的功效较强。煎煮时间较长,炮附子的逐饮的功效则更好。若疼痛与水饮的程度皆重,则煎煮时间应当适中,不可过短或更长。虽然大抵按照以上规律使用,但仲景并不拘泥于此,而是根据患者的体质调整用量与煎煮时长。探析炮附子的应用特点,可以为中医治疗各种疾病提供一定的借鉴和启示,帮助医生根据不同的病情和体质,灵活运用药量和煎服方法。
Exploration of Application Rules in Classical Prescription of Processed Fuzi(Aconm Lateralis Radix Praeparata)
The untold secrets of Chinese medicine lie in the dosage and the method of decoction.While present-day practitioners usually first decoct processed Fuzil(Aconm Lateralis Radix Praeparata)for 1 to 2 hours,Zhongjing did not,and the dosage was very different from that of present-day practitioners.The main efficacy of processed Fuzil(Aconm Lateralis Radix Praeparata)in the Treatise on Febrile Diseases and Synopsis of the Golden Chamber are to support Yang,expel drink,relieve pain,and restore the function of sinking and decaying.However,under different dosages and different decoctions,the therapeutic direction favored by processed Fuzil(Aconm Lateralis Radix Praeparata)is different,and there are differences in its main treatment,efficacy,and indications.One cannon processed Fuzil(Aconm Lateralis Radix Praeparata)is mainly used for treating solar diseases with Yang deficiency;treating Shaoyin superficial symptoms requiring sweating;warming Yang and inducing diuresis;and treating pain in the limbs,bone pain,and abdominal pain.Two processed Fuzil(Aconm Lateralis Radix Praeparata)are mainly used for warming the middle Jiao and expelling drinks;treating pain in the body or bone joints;treating gastrointestinal hemorrhage and uterine opening.Three pieces of processed Fuzil(Aconm Lateralis Radix Praeparata)are mainly used for treating severe pain and for removing water-dampness from the more serious muscle surface.Different lengths of decoction also have an effect on the main therapeutic effects of the three processed Fuzil(Aconm Lateralis Radix Praeparata).A shorter decoction time is more effective in treating Yang deficiency with malignant cold and in relieving pain.If the decoction time is longer,the efficacy of processed Fuzil(Aconm Lateralis Radix Praeparata)in removing water retention will be better.If the degree of pain and water-drinking are both severe,the decoction time should be moderate,not too short or too long.Although it was generally used according to the above rules,Zhongjing did not stick to them,but adjusted the dosage and decoction time according to the patients'physical condition.Analyzing the characteristics of the application of processed Fuzil(Aconm Lateralis Radix Praeparata)can provide certain reference and inspiration for Chinese medicine practitioners in the treatment of various diseases,and help them to flexibly use the dosage and decoction according to the different conditions and constitution of the patients.

Treatise on Febrile DiseasesSynopsis of the Golden Chamberprocessed Fuzil(Aconm Lateralis Radix Praeparata)dosedecoction method

曹玉琪、徐亚南、孙佳归、周政署、柳成刚

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黑龙江中医药大学,黑龙江哈尔滨 150040

《伤寒论》 《金匮要略》 炮附子 用量 煎煮方法

2025

辽宁中医药大学学报
辽宁中医药大学

辽宁中医药大学学报

影响因子:0.775
ISSN:1673-842X
年,卷(期):2025.27(1)