基于气机升降探讨叶天士对旋覆代赭汤的临床应用

Exploration of YE Tianshi's clinical application of Xuanfu Daizhe decoction based on the qi's ascending and descending

关键词:  气机升降  旋覆代赭汤  《伤寒论》

Key words:  qi's ascending and descending  Xuanfu Daizhe decoction  Treatise on Clod Pathogenic Diseases

摘要:

旋覆代赭汤是《伤寒论》中经典方剂，为汗吐下后、表证已解、中气受伤、胃虚气逆所致心下痞硬、噫气不除而设，后世医家抓住其"胃虚气逆"这一主要病机，对此方发挥甚多。文章从气机升降角度，探讨叶天士《临证指南医案》及《未刻本叶天士医案》的医案中对张仲景旋覆代赭汤临床应用，并从气机升降理论、立方新意、脏腑气机三方面对其进行总结分析，以期临床更好地运用此方。

Abstract:

Xuanfu Daizhe decoction is a classic prescription in Treatise on Clod Pathogenic Diseases. After vomiting, sweat and defecation, the exterior syndrome has been solved, the middle qi has been injured, and the stomach becomes weak. This prescription is used to treat the stomach discomfort. Offspring Chinese medicine practitioner grasp the main pathogenesis of "stomach weakness" and have many inheritance and development of Xuanfu Daizhe decoction. From the perspective of qi's ascending and descending, this article discusses the clinical application of ZHANG Zhongjing's Xuanfu Daizhe decoction in Guide to Clinical Practice with Medical Records and Unpublished YE Tianshi's Medical Records. The article also summarizes and analyzes Xuanfu Daizhe decoction from the following three aspects:qi's ascending and descending theory, prescription's innovation, and viscera's qi function. It aims to make better use of this prescription in clinical practice.