《金匮要略》桂枝附子汤证与白术附子汤证鉴别之我见

My view on the distinction between Guizhifuzi and Baizhufuzi Decoction’s symptoms in Synopsis of Prescription of Golden Chamber

关键词:  桂枝附子汤证  白术附子汤证  鉴别

Key words:  Guizhifuzi decoction’s symptom  Baizhufuzi decoction’s symptom  distinction

摘要:

对《金匮要略·痉湿暍病》篇桂枝附子汤证与白术附子汤证的鉴别各注家的认识颇不一致,可归纳为风胜与湿胜;风湿胜与寒湿胜;表阳虚与里阳虚。各家认识虽各有所据,但若深推之,均值得商榷。文章从《金匮要略》原文、症状、用药等方面进行分析,提出桂枝附子汤证与白术附子汤证均属风寒湿邪在表而阳气已虚,其鉴别关键在于桂枝附子汤证兼有肾气虚而膀胱气化不行;白术附子汤证则兼有脾气虚而湿邪中阻。

Abstract:

There was a great difference between every annotator's view on the distinction of Guizhifuzi and Baizhufuzi Decoctions symptoms in Synopsis of Golden Chamber,Jing shiyie disease.It sums up to several respects:1.wind exuberance and damPness exuberance,2.wind-damPness exuberance and cold-dampness exuberance,3.exterior-yang deficiency and intetior-yang deficiency.Although every annotator had their own basis on their view,it is worthy of discussing when deeply consideration is needed.This article has carried out an analysis from the original,symptoms and medical herbs in Synopsis of prescription of Golden Chamber.It has put forward that both the two syndromes are all belong to exterior wind-cold-dampness and yang-Qi deficiency.Distinctive keys consist on Guizhifuzi decoction、symptoms are some diseases with kidney-Qi deficiency and the Qi transformation of the urinary bladder is inhihited.Baizhufuzi decoction symPtoms are with deficiency ofspleen-Qi anddampnessin the middle-energizer.