唐容川与张锡纯辨治脾阴虚证比较分析

Comparative analysis between TANG Rongchuan and ZHANG Xichun in distinguishing and treating syndrome of spleen yin deficiency

关键词:  唐容川  张锡纯  脾阴虚  用药特色

Key words:  TANG Rongchuan  ZHANG Xichun  spleen yin deficiency  prescription medication features

摘要:

通过阅读相关著作及文献，归纳唐容川和张锡纯在脾阴虚证理法方药上的异同。病机方面，唐容川重脾阴亏虚、脾不统血、脾失健运间的相互影响，张锡纯重肝木克乘脾土。治法方面，两人均重津液存亡，唐容川创“开胃补脾阴法”，且关注营血存亡，遣滋阴、降火、生津于活血养血诸法中，张锡纯倡“汁浆荣津法”和“佐金平木扶土法”，且常气阴双补。药性理论方面，二家均遵“欲令脾实……宜甘宜淡”之则，但唐容川重甘味而张锡纯重淡味。性味配伍上，二家均崇“甲己合化”，但唐容川扬“酸甘化阴”之法，而张锡纯倡“甘苦合化”之道。具体用药方面，唐容川善用经方，以人参和天花粉为要药，且善用血肉之品，张锡纯以山药、甘草为要药，且喜用食疗剂型。唐容川和张锡纯之脾阴虚辨治思想相得益彰，对临床实践具有一定指导意义。

Abstract:

Consulted related works and research literature to summarize the similarities and differences between TANG Rongchuan and ZHANG Xichun in the treatment of spleen yin deficiency. In terms of pathogenesis，TANG Rongchuan emphasized the interaction effect of spleen yin deficiency，failure of the spleen to control blood，and dysfunction of the spleen in transportation，and ZHANG Xichun focused on examining the mechanism of wood over-restricting earth. For therapeutic methods，both of them attached great importance to the fluid. TANG，who created the “appetizing and invigorating spleen yin” was concerned about the loss of blood and put forward the methods of nourishing yin，lowering fire，and generating fluid to promote blood circulation and nourish the blood. ZHNAG Xichun，who advocated the therapy of “juice nourishing fluid” and “assisting metal to harmonize liver and spleen” usually tonified both spleen yin and qi. In the medicinal theory，they both followed the principle of tonifying the spleen with herbs with the flavor of sweet and bland. TANG Rongchuan emphasized sweet，while ZHANG Xichun stressed bland. In medicinal flavor synthesis，they advocated “Jiaji transforming earth” in which TANG Rongchuan carried forward the idea of “sweetening yin with sour and sweet medicine” while ZHANG Xichun stuck to a “sweet-bitter combination”. In terms of specific usage of herbs，TANG Rongchuan，who stressed classical prescriptions，took Renshen and Tianhuafen as vital medicine and was skilled in using flesh and blood products. ZHANG Xichun prioritized Shanyao and Gancao，and ZHANG Xichun was good at using diet therapy. Thoughts on the therapy of spleen yin deficiency by TANG Rongchuan and ZHANG Xichun complement each other，which was significant for clinical practice guidance.