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1.北京中医药大学,北京 100105
2.中国中医科学院 西苑医院,北京 100091
袁惠民,在读硕士,从事中医药防治脑病的临床研究,E-mail:yuangaomin1997@foxmail.com
毛丽军,教授,主任医师,从事中西医结合防治脑病与心身医学研究,E-mail:mlj0706@163.com
收稿日期:2022-05-26,
网络出版日期:2022-09-14,
纸质出版日期:2023-04-05
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袁惠民,朱美霖,赵丹等.基于《辅行诀五脏用药法要》探讨乌梅丸论治情志病[J].中国实验方剂学杂志,2023,29(07):230-236.
YUAN Huimin,ZHU Meilin,ZHAO Dan,et al.Mechanism of Wumeiwan in Treatment of Emotional Disorders Based on Secrets for Auxiliary Cultivation Life[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):230-236.
袁惠民,朱美霖,赵丹等.基于《辅行诀五脏用药法要》探讨乌梅丸论治情志病[J].中国实验方剂学杂志,2023,29(07):230-236. DOI: 10.13422/j.cnki.syfjx.20230794.
YUAN Huimin,ZHU Meilin,ZHAO Dan,et al.Mechanism of Wumeiwan in Treatment of Emotional Disorders Based on Secrets for Auxiliary Cultivation Life[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):230-236. DOI: 10.13422/j.cnki.syfjx.20230794.
乌梅丸载于《伤寒杂病论》厥阴篇,历代医家多认为其有温脏安蛔之功,临床应用范围较为局限,自清代医家柯琴提出其为厥阴病之主方后乌梅丸才被医家重视,其临床应用亦得以拓展。乌梅丸证之成因,实则归于厥阴风木气运失常,阴阳不相顺接,而非仅为蛔虫内扰所致。以《黄帝内经》“开阖枢”理论分析六经之功能,并结合《伤寒杂病论》原文可证“阴枢”实为厥阴,乌梅丸为厥阴病之主方,有顺接阴阳之功,故其可治疗厥阴枢机不利,寒热错杂之证。《辅行诀五脏用药法要》与《伤寒杂病论》二者同源,均参考了《汤液经法》所载内容,《辅行诀五脏用药法要》中补泻诸方及救逆方之组成有规律可寻,均依文中所载“汤液经法图”而成,与五行理论密切相关。该文通过探索“汤液经法图”组方规律及药物五行归属,以“汤液经法图”组方规律剖析乌梅丸,可证乌梅丸主要作用于肝、脾、心三脏,依黄帝内经五脏藏神理论,此三脏与情志调节密切相关,故以乌梅丸论治厥阴枢机不利、寒热错杂所致之情志病有据可循,文末亦列举概述近年乌梅丸治疗情志病的报道。该文为临床应用乌梅丸治疗情志病提供了思路及依据,扩展了其应用范围,古方亦能为今用。
Wumeiwan are recorded in the Jueyin chapter of
Treatise on Cold Damage and Miscellaneous Diseases
(《伤寒杂病论》), and many doctors in the past dynasties believed that they had the effects of calming intestinal ascarid by warming Zang organs. The clinical application was limited. Since KE Qin, a doctor in the Qing dynasty, proposed that Wumeiwan were the primary prescription against Jueyin diseases, Wumeiwan have been valued by doctors, and their clinical application has also been expanded. The syndrome indicated for Wumeiwan is attributed, not only to the ascarid internal harassment, but to the abnormal Qi movement of wind and wood in Jueyin and the dysfunction of Yin and Yang. According to the functions of six meridians based on the theory of "open-close axis" in
Huangdi's Internal Classic
(《黄帝内经》) and the original texts of
Treatise on Cold Damage and Miscellaneous Diseases
, Yinshu refers to Jueyin. Wumeiwan, the primary prescription against Jueyin diseases, have the function of connecting Yin and Yang, and they can treat diseases caused by Qi disturbance of Jueyin and cold and heat in complexity. Sharing the same resource, the
Secrets for Auxiliary Cultivation Life
:
The Essential Method of Using Herbal Medicine for the Differential Treatment of the Five Zang Organs
(《辅行诀五脏用药法要》) and
Treatise on Cold Damage and Miscellaneous Diseases
both consult
Models of the Classic of Decoction
(《汤液经方》). The formulation rules of tonic/purgative and collapse-saving prescriptions in
Secrets for Auxiliary Cultivation Life
follow the recorded "Tang Ye Jing Fa Tu" (an image revealing the compatibility principles of Chinese herbal drugs) and are closely related to the five elements theory. By exploring the formulation rules in "Tang Ye Jing Fa Tu" and the five elements of drugs, this study analyzed Wumeiwan and proved that Wumeiwan mainly acted on the liver, spleen, and heart. According to the Five Zang-organs Storing Spirit theory from
Huangdi's Internal Classic
, the above three organs are closely related to emotional adjustment. Therefore, the treatment of emotional disorders caused by qi disturbance of Jueyin and cold and heat in complexity with Wumeiwan is supported by evidence. At the end of this article, the reports on the treatment of emotional disorders with Wumeiwan in recent years were listed and reviewed. This article provides new ideas for the clinical application of Wumeiwan in the treatment of emotional disorders and expands the application range.
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