【作者】 李晶晶；

【导师】 赵映前；

【作者基本信息】 湖北中医药大学 ， 中医临床基础， 2014， 博士

【摘要】 目的：本课题旨在通过研究经方中各脏腑病证常用药物的功效特点及应用机制，同时搜集整理后世验方、临床报道和病案举隅，归纳出肺系病证、心系病证、脾胃病证、肝胆病证、肾系病证通用药的运用规律，以期为临证用药提供有益借鉴。方法：本文采用文献研究方式，采用归纳总结、比较研究的方法，结合《神农本草经》药物记载，将《伤寒杂病论》中65味常用中药分列为肺系病证、心系病证、脾胃病证、肝胆病证、肾系病证通用药，研究诸病证通用药的功效特点，以及在经方中的具体应用机制，并结合后世验方、临床报道及病案举隅探讨古今医家对药物的运用，总结出诸病证通用药在辨病论证施治下的运用规律。结果：27味肺系病证通用药分别具有发散表邪、宣降肺气、化痰逐饮、收敛阴津、补虚扶正等功效，广泛应用于感冒、哮喘、肺胀等病证；21味心系病证通用药，分别具有补气助阳、滋阴养血、化痰行气、宁心安神、活血化瘀等功效，广泛应用于心悸、胸痹、失眠等病证；23味脾胃病证通用药，分别具有回阳助阳、补气敛阴、燥湿化痰、行气降逆、泻热攻积等功效，广泛应用于胃痛、痞满、泻痢等病证；19味肝胆病证通用药，分别具有行气活血、养血柔肝、散寒温经、清利湿热、化痰软坚等功效，广泛应用于胁痛、黄疸、臌胀等病证；15味肾系病证通用药分别具有补火助阳、滋阴敛阴、宣降肺气、健脾利水、收敛固涩等功效，广泛应用于水肿、小便异常、阳痿等病证。结论：《伤寒论》中常有一药广泛应用于六经不同病证，《金匮要略》中亦可见一药反复在不同脏腑病证中应用，充分体现了仲景病与证相结合，辨病论证，灵活用药的特点。因此病证通用药的实质即在病与证相结合，辨病论证有机统一的辨治体系下，把握药物的功效主治特点，揭示药物的应用规律，了解药物的运用机制，以此为基础，则能更加深刻地认识仲景药物的作用机制，乃至经方的方剂配伍规律，以指导临床用药。更多还原

【Abstract】 Objective: By studying the characteristics and applications of various drugsaccording to syndromes, and collecting modern clinical reports and medicalrecords, to generalize the drug laws for diseases of pulmonary system, heartsystem, spleen-stomach system, liver and Gallbladder system, and kidneysystem.Method: Literature research method was adopted in this paper.65kinds ofTraditional Chinese Medicine were chosen from ‘Shang Han Za Bing Lun’asgeneric drugs for Pdiseases of pulmonary system, heart system,spleen-stomach system, liver and Gallbladder system, and kidney system.Efficacy features and application mechanisms of these drugs were beinghorizontally compared, combined with expanded use of drugs in modern timeto summarize the use law of generic drugs.Result:27drugs which widely used for diseases of pulmonary system havethe efficacy of dispersing superficial exopathogens, disperse and lower the Qiof the lung, sputum and water, convergence of Yin fluid, tonic righting, andgenerally used for cold, ssthma and emphyysema.21drugs which widely usedfor diseases of heart system have the efficacy of reinforcing Qi and Yang,nourishing Yin and Blood, Qi phlegm, tranquilize mind, promoting bloodcirculation and removing blood stasis, and generally widely for Palpitations,Pectoral Stuffiness Pain, Insomnia.23drugs which widely used for diseases of spleen-stomach system have the efficacy of reinforcing Qi and retaining yinwith astringent, restoring Yang, eliminating Dampness and Phlegm, promotingQi, calm the adverse-rising energy, purging Heat attack the plot, and generallyused for Stomach Pain, Fullness, Dysentery.19drugs which widely used fordiseases of liver and Gallbladder system have the efficacy of promoting qi toactivate blood, nourishing Blood and Liver, warming channel for dispellingcold, eliminating dampness and heat,dissipating phlegm and resolving masses,and generally used for Hypochondriac Pain, Icterus and AbdominalTympanites.15drugs which widely used for diseases of kidney system havethe efficacy of tonifying fire and helping Yang, Nourishing Yin, retaining yinwith astringent, dispersing the lung Qi, invigorating spleen for dieresis,astringent, and generally used for dropsy, abnormal urination and impotence.Conclusion:The drugs in Shang han lun were often widely used in the sixmeridians syndromes,and the same situation was appeared inJinkuiyaolue,which embodied that drugs should be used on the base of thecombination of disease and syndrome,so that we could understand the drugsmore profoundly.更多还原