【作者】 杨建龙；

【导师】 马健；

【作者基本信息】 南京中医药大学 ， 中医临床基础， 2009， 博士

【摘要】 仲景距今近两千年,所著一度散佚。后书分两部,“以六经论伤寒”部份幸仅隔数十寒暑,赖叔和以存之,原貌如璧。“以脏腑论杂病”部份时时隐现,至林亿等方得重辑,为后学所重,已隔八百余载,研究与实践皆迟滞良多,且脱简、错文恐不能免。是历代研究之难,亦当今研究之艰也。然前赴后继,成果亦日渐丰,范围、深度几已涉及《金匮》方方面面。补法乃《金匮》中重要之法,盖治病无非“攻”、“补”二字。《金匮》补法之研究自亦颇多。然补法大而广,各察一隅,恐难窥其全貌。本论文赖各先学之成就而成之,是欲成其大、成其全,而后得近仲景补法真意。然经学悠远,终不过一尝试而已!亦不失于一尝试也。自古独创惊世之说者鲜矣。仲景学虽浩瀚,仍不得尽离《内》、《难》、《本经》等之源。其自序中亦可见一斑,乃集多本古籍之大成而后发扬之。惜后世所能见者,惟以上三经而已。欲真正学习《金匮》,理解其理、法、方、药,必读以上三经,尤其是《内经》、《本经》。盖《难经》乃《内经》之发扬也。故本文开篇,先溯其源,总结探寻仲景与汉以前医学成就的关系,避免后续研究误入岐途。研究表明,仲景补法确多源承于前人,而在方、药方面应有所发扬增益。补法必有对象,所谓辩证然后施治,有的放矢。一般而言,虚则补之,古今大法也。故补法必用之于虚证,或虚实夹杂之证。查仲景诸方诸药,果然,并不足为奇。然细察之,实证者亦用之。虽居于辅助地位,毕竟对后世预防邪气伤正,及扶正有助祛邪等思想有重要启迪,扩大了后世补法应用的范围,丰富了补法的内容。既知当补,如何补之?气虚者补之以气,血亏者滋养以血,理之当然。此直接补益之法,人皆知之。直补既可,何须舍近以求远?所谓奇正相倚。有正无奇,偶有不逮,诸事皆然。若血虚因于脾失健运,脾失健运又因于脾气之不足,则直补其血,反碍脾胃。即能吸收,亦速为所耗,则补无穷尽矣!是故治病当求其本,直补有不逮时,则间补可为其补充。仲景于此,灵活多变,令人仰止。俗语云,以法统方,方以药成。补已虚之法,终以服药为主法。本论文穷《金匮》全书,观每一味药,察《本经》、《别录》之源,思仲景之意,考当今之用,将补益者,一一摘出。既便己查,亦利于后人深入研究。对于已有之现代研究资料,择其要者,一一罗列,以明取效之理。于补益之方,其补意更浓。亦一一摘出,展示主要之现代研究诸成果,为继续研究之参考。因论文篇幅所限,不能尽数列出,是其憾也。方药既尽览,对仲景补法运用似渐有轮廓,有必要尝试对其运用的关键点作一总结概括,也有与前面补法途径进行回顾、呼应之意。另外,临床病情往往是复杂的,补法经常不能独立于它法之外,而往往要相互配合,视其缓急,互有进退,方能应付自如。仲景深谙于此,堪称典范,足可启迪后学。当然,非药物补法——摄生,也是不可忽视的,仲景也极为注重。若保无病无灾,省去多少补药!此真大补也。然其效难现,贵在持之以恒,故从之者少,“准名利是务,崇饰其末,忽弃其本”者反多。殆至病灾,或以药物奏功,而正气暗馁,天年自见,悔之晚矣。故欲保命全身者,补益方药固知之有益,摄生之法尤在知药之前。是仲景诸言,不可不谨遵也。仲景法先圣之言而发扬之,而后世又法仲景之言发扬之。疾风劲草,烈火真金。仲景自亚圣之名,渐成医圣之尊,后世诸法受其影响必深,补法自不例外。然历时千年,如何渐次演变而来,又岂是寥寥数语所能概括?今概括之,乃冀抛砖引玉而已。更多还原

【Abstract】 Tonifying methods is very important for curing disease means tonification and elimination. There are lots of researches in tonifying of JIN GUI YAO LUE, however, if every one of us could only see from his own angle, we could hardly see it as a whole. We do our search to find its big and full view basing on the ancestors’ study, and try our best to grasp the true meaning of tonification used by Zhang Zhongjing.The subject is essential, that is syndrome differentiation first, then treatment formulation second with aims .Generally speaking, treating deficiency by tonification is the principle through ancient times and nowadays. Hence, tonification has to be used in deficiency or deficiency complicated by excess.Obeserving Zhongjing’s formula and medicine, it is normal indeed.But when we see it carefully, tonification was also used in excess syndrome, although in the place of helpness.In fact, it inspire the prevention of evil qi do harm to healthy qi and supporting healthy qi to eliminate pathogens to later ages, and enlarge the range of tonifying and enrich the contents of tonification.Then how to tonify? It is natural that tonifying qi to the qi deficiency and tonifying blood to the blood deficiency. Almost all people know the direct tonification.Tonifying directly is good, then why seek from far what lies close at hand? That is one coin has two sides. If blood deficiency is due to the spleen dysfunction for deficiency of spleen qi, tonifying the blood could do harm to spleen and stomach. Even it could be absorbed ,it also be reduced that we could hardly tonify it enough! Consequently, we should treat disease from the root because tonifying directly could not always has effects, on the contrary,tonifying indirectly could supplement.Zhonjing’s flexible methods should be adored in this respect.As saying goes, methods guide formula and medicine consist formula. We often tonifying deficiency with medicine. This paper look through the whole JIN GUI YAO LUE book ,observing every drug, chasing for the root of BEN JING and BIE LU, and thinking over ZhongJing’s idea, comparing material nowadays and choosing tonification one by one for checking and further research of posterity .For contemporary material, choosing important contents and list to make the function going clear. Limited by the length, we could not list all tonification which seen as a pity.Having seen through the medicine and formula, it seems that we know the construction of ZhongJing’s tonification little by little. Now we have the necessity to try to grasp the key points, and looking back and echo with preliminary tonifying ways.Moreover, clinical condition is commonly complicated.Tonification often couldn’t be apart from the other methods, and cooperate with each other according to the urgent or not, move on or back. Only in this way, can we deal with the disease smoothly and skillfully. Zhongjing have a very good command of these conditions and set an excellent example for posterity.Zhongjing obeyed the ancients’ words and enhanced them, and the posterity follow Zhongjing and developed them. ZhongJing’s name from Ya-Sheng to a Medical Saint must influence the later generation deeply, including the tonification.Time flies by thousands of years, how to change by and by could not be concluded by some limited words. Now we try to summarize them in order to cast a brick to attract jade.更多还原