1.中国中医科学院 广安门医院,北京 100053
2.北京中医药大学,北京 100029
3.北京中医药大学 东直门医院,北京 100070
4.中国人民解放军 火箭军特色医学中心,北京 100088
安俊桥,在读硕士,从事中医药防治心血管疾病临床与基础研究,E-mail:2933919340@qq.com
李东梅,在读硕士,主治医师,从事中医药防治心血管疾病临床与基础研究,E-mail:254329584@qq.com
何庆勇,博士,教授,主任医师,博士生导师,从事中医药防治心血管疾病临床与基础研究,E-mail:heqingyongg@163.com; *
收稿:2025-06-18,
录用:2025-08-06,
网络出版:2025-08-08,
纸质出版:2026-02-05
移动端阅览
安俊桥,马伊昕,李东梅等.基于《辅行诀》释理中类方[J].中国实验方剂学杂志,2026,32(03):265-272.
AN Junqiao,MA Yixin,Li Dongmei,et al.Interpretation of Middle-regulating Formulas Based on Fuxing Jue[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(03):265-272.
安俊桥,马伊昕,李东梅等.基于《辅行诀》释理中类方[J].中国实验方剂学杂志,2026,32(03):265-272. DOI: 10.13422/j.cnki.syfjx.20252493.
AN Junqiao,MA Yixin,Li Dongmei,et al.Interpretation of Middle-regulating Formulas Based on Fuxing Jue[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(03):265-272. DOI: 10.13422/j.cnki.syfjx.20252493.
敦煌遗书《辅行诀》以“汤液经法图”为组方配伍理论核心,其用药理论主要包括“五行体用补泻原则”及“五行本位除化原则”,在五脏虚实辨证基础上,灵活运用体、用、化味进行补泻治疗,为其独特的遣方用药方式。太阴病中“痞证”常与“下利”同见,此二者亦为理中类方之主证:其中理中丸(汤)主太阴之虚,三泻心汤(半夏泻心汤、甘草泻心汤、生姜泻心汤)主太阴之虚而兼有邪实,四逆汤及通脉四逆汤主肝脾肾失用、开阖枢失司之下利。理中类方的组成药味皆不离辛、甘、苦而直接作用于太阴脾土。辛味泻脾、甘味补脾,辛苦除痞。将理中类方的组成药物单位统一后,其辛甘药味比值便可反映方剂的补泻强度。此外,理中类方中的“短煎取气”及“长煎取味”2种不同的煎煮法也影响着其补泻功效的发挥。本文基于药味组成及特殊煎法,论述了理中类方治疗“痞证”与“下利”的不同之处。脾土功能异常则诸病皆生,因而理中类方不仅限于治疗“虚、寒、湿”类病证,后世医家更以理中汤加减治疗“实、热、燥”类病证,为临床实践中更加灵活和有效地运用理中类方打下坚实的基础。
The Dunhuang manuscript
Fuxing Jue
takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgativ
e strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
衣之镖 , 衣玉品 , 赵怀舟 . 《辅行诀五藏用药法要》研究 [M]. 北京 : 学苑出版社 , 2009 : 496 .
YI Z B , YI Y P , ZHAO H Z . Study of Fuxingjue Wuzang Yongyao Fayao [M]. Beijing : Academy Press , 2009 : 496 .
秦楠 , 金锐 . 《黄帝内经》与《辅行诀》五味补泻关系的对比分析 [J]. 中国实验方剂学杂志 , 2025 , 31 ( 12 ): 234 - 238 .
QIN N , JIN R . Comparative analysis of relationship between five medicinal tastes and reinforcing-reducing effect in Huangdi Neijing and Fuxingjue [J]. Chin J Exp Tradit Med Form , 2025 , 31 ( 12 ): 234 - 238 .
罗强 , 杨晓轶 , 马骏 , 等 . 《辅行诀脏腑用药法要》“四神兽汤”意象思维探微 [J]. 中医杂志 , 2022 , 63 ( 24 ): 2301 - 2305 .
LUO Q , YANG X T , MA J , et al . Exploration of the image thinking of "four gods and beasts soup" in "auxiliary movement pithy viscera medication method" [J]. J Tradit Chin Med , 2022 , 63 ( 24 ): 2301 - 2305 .
邓中甲 . 方剂学 [M]. 北京 : 中国中医药出版社 , 2003 : 381 .
DENG Z J . Formulas of Traditional Chinese Medicine [M]. Beijing : China Press of Chinese Medicine , 2003 : 381 .
仝小林 , 穆兰澄 , 姬航宇 , 等 . 《伤寒论》药物剂量考 [J]. 中医杂志 , 2009 , 50 ( 4 ): 368 - 372 .
TONG X L , MU L C , JI H Y , et al . Study on drug dosage in Treatise on Febrile Diseases [J]. J Tradit Chin Med , 2009 , 50 ( 4 ): 368 - 372 .
张林 , 唐若水 , 宋佳 , 等 . 古代经典名方中方药剂量折算原则考证 [J]. 中国实验方剂学杂志 , 2024 , 30 ( 10 ): 196 - 202 .
ZHANG L , TANG R S , SONG J , et al . Textual research on principle of dose conversion in ancient famous classical formulas [J]. Chin J Exp Tradit Med Form , 2024 , 30 ( 10 ): 196 - 202 .
姜侠 , 闫方杰 . HPLC比较去滓再煎法对半夏泻心汤中3种主要成分含量的影响 [J]. 中国中医药现代远程教育 , 2022 , 20 ( 21 ): 143 - 146 .
JIANG X , YAN F J . Comparison on the effect of deslagging redecocting on the contents of threemain components in Banxia Xiexin decoction by HPLC [J]. Chin Med Mod Dis Educ China , 2022 , 20 ( 21 ): 143 - 146 .
柯雪帆 . 现代中医药应用与研究大系:第4卷·伤寒及金匮 [M]. 上海 : 上海中医药大学出版社 , 1995 : 233 .
KE X F . Application and research of modern traditional Chinese medicine: Volume 4: Typhoid Fever and Golden Chamber [M]. Shanghai : Shanghai University of Traditional Chinese Medicine Press , 1995 : 233 .
渠敬文 . 《伤寒论》方药剂量古今折算考 [J]. 南京中医药大学学报 , 1999 ( 2 ): 42 - 44 .
QU J W . Research on the ancient and modern conversion of prescription dose in Treatise on Febrile Diseases [J]. J NanjingUniv Tradit Chin Med , 1999 ( 2 ): 42 - 44 .
陶汉华 . 经方药量换算与考证 [J]. 山东中医药大学学报 , 1997 ( 4 ): 68 - 69 .
TAO H H . Conversion and textual research of classical prescriptions [J]. J Shandong Univ Tradit Chin Med , 1997 ( 4 ): 68 - 69 .
张仲景 . 金匮要略 [M]. 广州 : 广东科学技术出版社 , 2022 : 160 .
ZHANG Z J . JINGUI YAOLUE [M]. Guangzhou : Guangdong Science and Technology Press , 2022 : 160 .
方有执 . 伤寒论条辨 [M]. 太原 : 山西出版传媒集团 , 2009 : 243 .
FANG Y Z . Shanghanlun Tiaobian [M]. Taiyuan : Shanxi Publishing Media Group , 2009 : 243 .
佚名 . 神农本草经 [M].吴普, 叙 . 孙星衍,孙冯翼,辑 . 北京 : 科学技术文献出版社 , 1996 : 133 .
Anonymous . Shennong Bencaojing [M]. WU P,Account.SUN X Y,SUN F Y,Edit.Beijing : Scientific and Technical Documentation Press , 1996 : 133 .
陶弘景 . 名医别录 [M]. 北京 : 人民卫生出版社 , 1986 : 342 .
TAO H J . Mingyi Bielu [M]. Beijing : People's Medical Publishing House , 1986 : 342 .
张机 . 伤寒论 [M]. 上海 : 上海科学技术出版社 , 1983 : 115 .
ZHANG J . Shanghanlun [M]. Shanghai : Shanghai Scientific Technical Publishers , 1983 : 115 .
毛盛芳 , 张洁 . 不同煎煮方法对半夏泻心汤中有效成分的影响分析 [J]. 中草药 , 2019 , 50 ( 15 ): 3654 - 3659 .
MAO S F , ZHANG J . Effect of different decocting methods on active ingredients in Banxia Xiexin decoction [J]. Chin Tradit Herb Drug , 2019 , 50 ( 15 ): 3654 - 3659 .
吉益东洞 . 药征及药征续编 [M]. 北京 : 人民卫生出版社 , 1955 : 110 .
Yoshimasu T . Drug sign and its continuation [M]. Beijing : People's Medical Publishing House , 1955 : 110 .
吴谦 . 医宗金鉴 [M]. 北京 : 中国中医药出版社 , 1994 : 1036 .
WU Q . Yizong Jinjian [M]. Beijing : China Press of Chinese Medicine , 1994 : 1036 .
邹澍 . 本经疏证 [M]. 海口 : 海南出版社 , 2009 : 596 .
ZOU S . Benjing Shuzheng [M]. HAIKOU : Hainan Publishing House , 2009 : 596 .
柯琴 . 伤寒来苏集 [M]. 太原 : 山西科学技术出版社 , 2010 : 302 .
KE Q . Shanghan Laisuji [M]. Taiyuan : Shanxi Science and Technology Press , 2010 : 302 .
王露瑶 , 宁晚玲 , 唐汉庆 , 等 . 从水通道蛋白4探讨附子理中汤温阳健脾祛湿的作用 [J]. 中国中医基础医学杂志 , 2020 , 26 ( 9 ): 1265 - 1268 .
WANG L Y , NING W L , TANG H Q , et al . Discussion on the effect of Fuzi Lizhong Decoction on Warming Yang,strengthening spleen and eliminating dampness from aquaporin 4 [J]. China J Basic Med Tradit Chin Med , 2020 , 26 ( 9 ): 1265 - 1268 .
王沐晨 , 单思 , 刘红宁 . 水通道蛋白与“肾主水”理论的关系探析 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 18 ): 205 - 212 .
WANG M C , SHAN S , LIU H N . 水通道蛋白与“肾主水”理论的关系探析 [J]. Chin J Exp Tradit Med Form , 2022 , 28 ( 18 ): 205 - 212 .
张丽丽 , 马跃海 , 南明花 , 等 . 基于气、血、水探讨经方治疗慢性胃炎思路 [J]. 河南中医 , 2024 , 44 ( 10 ): 1475 - 1479 .
ZHANG L L , MA Y H , NAN M H , et al . Study on treating chronic gastritis with classical formulas based on Qi and blood and water aspects [J]. Henan Tradit Chin Med , 2024 , 44 ( 10 ): 1475 - 1479 .
王龙华 , 李柏 , 李萍 , 等 . 慢性萎缩性胃炎的中医辨治思路与对策 [J]. 世界中医药 , 2024 , 19 ( 15 ): 2334 - 2338 .
WANG L H , LI B , LI P , et al . TCM syndrome differentiation and countermeasures for chronic atrophic gastritis [J]. World Chin Med , 2024 , 19 ( 15 ): 2334 - 2338 .
冉思邈 , 黄珍 , 黎仲援 , 等 . 叶天士对《伤寒论》泻心法的临床运用 [J]. 亚太传统医药 , 2018 , 14 ( 1 ): 37 - 39 .
RANG S M , HUANG Z , LI Z Y , et al . Discussion the clinical application of Xiexin method on Treatiseon Febrile Diseases by YE Tianshi [J]. Asia-Pac Trad Med , 2018 , 14 ( 1 ): 37 - 39 .
张奕 , 郑文 , 杜旭辉 , 等 . 基于中药七情配伍探讨半夏及其药对研究进展 [J]. 中华中医药学刊 , 2025 , 43 ( 11 ): 234 - 238 .
ZHANG Y , ZHENG W , DU X H , ET AL . Research progress of Banxia(Pinelliae Rhizoma) and drug pairs based on seven relations of medicinal compatibilit [J]. Chin Arch Tradit Chin Med , 2025 , 43 ( 11 ): 234 - 238 .
于小伏 , 刘宏宇 , 宋俊生 . 论《伤寒论》理中汤“以热治热”治口疮 [J]. 中医药学报 , 2019 , 47 ( 2 ): 42 - 45 .
YU X F , LIU H Y , SONG J S . On Lizhong decoction in Treatise on Febrile Diseases for the treatment of aphthous ulcer [J]. Acta Chin Med Pharmacol , 2019 , 47 ( 2 ): 42 - 45 .
巢元方 . 诸病源候论 [M]. 北京 : 人民卫生出版社 , 1955 : 268 .
CHAO Y F . Zhubing Yuanhoulun [M]. Beijing : People's Medical Publishing House , 1955 : 268 .
王肯堂 . 证治准绳 [M]. 北京 : 中国中医药出版社 , 1997 : 2053 .
WANG K T . Zhengzhi Zhunsheng [M]. Beijing : China Press of Chinese Medicine , 1997 : 2053 .
卞慧 , 林江 , 李振华 . 复发性口腔溃疡中医诊疗专家共识意见(2023) [J]. 中国中西医结合消化杂志 , 2024 , 32 ( 3 ): 181 - 188,194 .
BIAN H , LIN J , LI Z H . Expert consensus on traditional Chinese medicine diagnosis and treatment of recurrent oral ulcer(2023) [J]. Chin J Integr Tradit West Med Dig , 2024 , 32 ( 3 ): 181 - 188,194 .
高艳 , 肖蕾 , 车飙 , 等 . 人参皂苷Rb 1 促进小鼠口腔溃疡愈合的作用机制研究 [J]. 中国医院药学杂志 , 2023 , 43 ( 11 ): 1225 - 1231 .
GAO Y , XIAO L , CHE B , et al . Mechanism of ginsenoside Rb 1 promoting oral ulcer healing in mice [J]. Chin J Hosp Pharm , 2023 , 43 ( 11 ): 1225 - 1231 .
张明发 , 沈雅琴 . 甘草酸及其苷元甘草次酸的糖皮质激素样作用 [J]. 现代药物与临床 , 2011 , 26 ( 1 ): 33 - 35 .
ZHANG M F , SHEN Y Q . Glucocorticoid-like effect of glycyrrhizic acid and its aglycone glycyrrhetic acid [J]. Drug Clin , 2011 , 26 ( 1 ): 33 - 35 .
王佳佳 , 杨志军 , 杨秀娟 , 等 . 基于TRPV通道的辛味中药药理作用研究进展 [J]. 药学学报 , 2025 , 60 ( 3 ): 679 - 692 .
WANG J J , YANG Z J , YANG X J , et al . Research progress in the pharmacological effects of pungent Chinese medicine based on TRPV channels [J]. Acta Pharm Sin , 2025 , 60 ( 3 ): 679 - 692 .
谢锋 , 李敏 , 兰卫 . 附子-干姜含药血清对缺氧复氧损伤的H9C2细胞保护作用研究 [J]. 时珍国医国药 , 2024 , 35 ( 13 ): 2926 - 2931 .
XIE F , LI M , LAN W . Study on the protective effect of aconite-ginger containing serum on H9C2 cells injured by hypoxia-reoxygenation [J]. Lishizhen Med Mater Med Res , 2024 , 35 ( 13 ): 2926 - 2931 .
舒宇航 , 简祈盼 , 郑宇锟 , 等 . 基于灰色关联度与正交偏最小二乘法分析的黄连抗菌谱效关系研究 [J]. 时珍国医国药 , 2023 , 34 ( 9 ): 2298 - 2302 .
SHU Y H , JIAN Q P , ZHENG Y K , et al . Study on antibacterial spectrum eff ect relationship of Coptis chinensis based on grey correlation degree and orthogonal partial least squares analysis [J].. Lishizhen Med Mater Med Res , 2023 , 34 ( 9 ): 2298 - 2302 .
韩曼 , 姜泉 , 唐晓颇 , 等 . 基于国医大师路志正“燥湿互济”学术思想论干燥综合征中医辨治 [J]. 中华中医药杂志 , 2024 , 39 ( 2 ): 770 - 774 .
HAN M , JIANG Q , TANG X P , et al . Discussion on syndrome differentiation and treatment of Sjogren's syndrome based on the academic thought of "dryness and dampness mutual aid" of national medical master LU Zhizheng [J]. China J Tradit Chin Med Pharm , 2024 , 39 ( 2 ): 770 - 774 .
刘完素 . 素问玄机原病式 [M]. 北京 : 中国中医药出版社 , 2007 : 51 .
LIU W S . Suwen Xuanji Yuanbingshi [M]. Beijing : China Press of Chinese Medicine , 2007 : 51 .
周新尧 , 姜泉 , 唐晓颇 , 等 . 干燥综合征中医证候专家共识 [J]. 北京中医药大学学报 , 2023 , 46 ( 3 ): 310 - 314 .
ZHOU X Y , JIANG Q , TANG X P , et al . Expert consensus for patterns of traditional Chinese medicine of Sjögren syndrome [J]. J Beijing Univ Tradit Chin Med , 2023 , 46 ( 3 ): 310 - 314 .
何廉臣 . 重订广温热论 [M]. 北京 : 人民卫生出版社 , 1960 .
HE L C . Chongding Guangwenrelun [M]. Beijing : People's Medical Publishing House , 1960 .
吴鞠通 . 温病条辨 [M]. 广州 : 广东科技出版社 , 2022 .
WU J T . Wenbing Tiaobian [M]. Guangzhou : Guangdong science and Technology Press , 2022 .
李东垣 . 脾胃论 [M]. 北京 : 中国中医药出版社 , 2007 .
LI D Y . Piweilun [M]. Beijing : China Press of Chinese Medicine , 2007 .
范珉珏 , 贾育新 , 柴瑞婷 . 基于网络药理学分析甘味药治疗肾实证的作用机制 [J]. 河南中医 , 2020 , 40 ( 11 ): 1756 - 1762 .
FAN M J , JIA Y X , CHAI R T . Analysis of the mechanism of sweet drugs in the treatment of kidney syndrome based on network pharmacology [J]. Henan Tradit Chin Med , 2020 , 40 ( 11 ): 1756 - 1762 .
党琳 , 秦松林 , 晁旭 . 从脾阴虚辨治干燥综合征 [J]. 山东中医杂志 , 2019 , 38 ( 3 ): 225 - 228 .
DANG L , QIN S L , CHAO X . Treatment of Sjogren's syndrome based on spleen Yin deficiency [J]. Shandong J Tradit Chin Med , 2019 , 38 ( 3 ): 225 - 228 .
秦源 , 林崇泽 , 孙晗 , 等 . 益气养阴祛瘀方对干燥综合征颌下腺细胞AQP5及M3R表达的影响 [J]. 中国中医急症 , 2017 , 26 ( 1 ): 5 - 8 .
QIN Y , LIN C Z , SUN H , et al . Study on influence of Yiqiyangyin Quyu formulae on AQP5 and M3R expression of Sjogren's syndrome submandibular gland cells [J]. JETCM , 2017 , 26 ( 1 ): 5 - 8 .
0
浏览量
22
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
