本文目錄
1 【四逆散(san)組成】2 【四逆散(san)方(fang)歌】3 【四逆散(san)方(fang)解】4 【四逆散(san)主(zhu)治】5 【四逆散(san)醫案】6 【醫案分析】7 《鄧中(zhong)甲方(fang)劑學講稿》中(zhong)關于(yu)四逆散(san)的論述7.1 主(zhu)治證候(hou)7.2 四逆散(san)主(zhu)治證候(hou)分析7.3 功用7.4 運(yun)用7.4.1 辨證要點
【四逆散(san)組成】炙甘草 枳實 柴胡 生白芍各 6g
【四逆散(san)方歌(ge)】陽郁厥(jue)逆四逆散(san)， 等分柴(chai)芍枳(zhi)實甘(gan)， 透(tou)邪解郁理肝(gan)脾， 肝(gan)郁脾滯力(li)能堪。
【四(si)(si)逆(ni)散(san)(san)方解(jie)(jie)】本方出自(zi)《傷寒論》，治(zhi)“少(shao)陰(yin)(yin)病，四(si)(si)逆(ni)”。四(si)(si)逆(ni)者，乃(nai)(nai)手足不(bu)(bu)溫(wen)也。其證(zheng)緣于(yu)外邪傳經入里，氣(qi)(qi)機為(wei)(wei)之(zhi)(zhi)(zhi)郁(yu)遏(e)，不(bu)(bu)得(de)疏(shu)(shu)泄，導致陽(yang)(yang)(yang)氣(qi)(qi)內郁(yu)，不(bu)(bu)能達于(yu)四(si)(si)末(mo)，而見手足不(bu)(bu)溫(wen)。此(ci)種(zhong)“四(si)(si)逆(ni)”與(yu)(yu)陽(yang)(yang)(yang)衰陰(yin)(yin)盛的四(si)(si)肢厥逆(ni)有本質區別。正如李中(zhong)梓云：“此(ci)證(zheng)雖云四(si)(si)逆(ni)，必不(bu)(bu)甚冷(leng)，或(huo)(huo)指頭微(wei)溫(wen)，或(huo)(huo)脈不(bu)(bu)沉微(wei)，乃(nai)(nai)陰(yin)(yin)中(zhong)涵陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)證(zheng)，唯(wei)氣(qi)(qi)不(bu)(bu)宣通，是為(wei)(wei)逆(ni)冷(leng)”。故治(zhi)宜透邪解(jie)(jie)郁(yu)，調(diao)暢氣(qi)(qi)機為(wei)(wei)法。方中(zhong)取(qu)柴(chai)(chai)胡(hu)入肝(gan)(gan)膽經，升(sheng)發陽(yang)(yang)(yang)氣(qi)(qi)，疏(shu)(shu)肝(gan)(gan)解(jie)(jie)郁(yu)，透邪外出，為(wei)(wei)君(jun)藥(yao)。白芍(shao)斂(lian)陰(yin)(yin)養(yang)血(xue)柔肝(gan)(gan)為(wei)(wei)臣，與(yu)(yu)柴(chai)(chai)胡(hu)合用(yong)(yong)，以(yi)補養(yang)肝(gan)(gan)血(xue)，條達肝(gan)(gan)氣(qi)(qi)，可使柴(chai)(chai)胡(hu)升(sheng)散(san)(san)而無(wu)耗傷陰(yin)(yin)血(xue)之(zhi)(zhi)(zhi)弊。佐以(yi)枳(zhi)實理氣(qi)(qi)解(jie)(jie)郁(yu)，泄熱破結，與(yu)(yu)柴(chai)(chai)胡(hu)為(wei)(wei)伍，一(yi)升(sheng)一(yi)降，加(jia)強(qiang)舒暢氣(qi)(qi)機之(zhi)(zhi)(zhi)功(gong)，并(bing)奏(zou)升(sheng)清降濁(zhuo)之(zhi)(zhi)(zhi)效;與(yu)(yu)白芍(shao)相(xiang)配，又能理氣(qi)(qi)和(he)血(xue)，使氣(qi)(qi)血(xue)調(diao)和(he)。使以(yi)甘草，調(diao)和(he)諸藥(yao)，益脾和(he)中(zhong)。綜合四(si)(si)藥(yao)，共奏(zou)透邪解(jie)(jie)郁(yu)，疏(shu)(shu)肝(gan)(gan)理脾之(zhi)(zhi)(zhi)效，使邪去郁(yu)解(jie)(jie)，氣(qi)(qi)血(xue)調(diao)暢，清陽(yang)(yang)(yang)得(de)伸，四(si)(si)逆(ni)自(zi)愈。原方用(yong)(yong)白飲(米湯)和(he)服，亦取(qu)中(zhong)氣(qi)(qi)和(he)則陰(yin)(yin)陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)氣(qi)(qi)自(zi)相(xiang)順接(jie)之(zhi)(zhi)(zhi)意。由于(yu)本方有疏(shu)(shu)肝(gan)(gan)理脾之(zhi)(zhi)(zhi)功(gong)，所(suo)以(yi)后世常(chang)以(yi)本方加(jia)減治(zhi)療肝(gan)(gan)脾不(bu)(bu)和(he)諸證(zheng)。
【四逆散主治(zhi)】（1）陽郁(yu)厥(jue)逆證。手足不(bu)溫，或(huo)(huo)(huo)(huo)身微熱，或(huo)(huo)(huo)(huo)咳，或(huo)(huo)(huo)(huo)悸，或(huo)(huo)(huo)(huo)小便不(bu)利，或(huo)(huo)(huo)(huo)腹痛(tong)，或(huo)(huo)(huo)(huo)泄(xie)利下重，脈弦。
（2）肝(gan)脾不和(he)證。脅肋脹悶(men)，脘腹疼痛，脈弦。
【四(si)逆散(san)醫(yi)(yi)案】患者(zhe)(zhe)，男，48歲，2005年11月(yue)(yue)12日初診。患者(zhe)(zhe)近(jin)兩月(yue)(yue)來感右脅(xie)脹(zhang)滿隱痛不適。B超(chao)示中度脂(zhi)(zhi)肪肝(gan)(gan)。血脂(zhi)(zhi)：總(zong)膽固醇5.9mmol/L，三(san)酞(tai)甘油2.6mmol/L。現證：右脅(xie)憋脹(zhang)、隱痛，納(na)差，乏力，口干苦。舌(she)(she)紅(hong)(hong)，苔黃(huang)厚，脈弦(xian)滑。證屬肝(gan)(gan)郁氣滯(zhi)，濕(shi)濁阻滯(zhi)。治以(yi)疏肝(gan)(gan)理氣、祛濕(shi)化痰。方(fang)以(yi)加(jia)(jia)味(wei)四(si)逆湯治療：柴胡10 g，枳實15g，白芍30g，甘草6克，丹參(can)30g，澤瀉(xie)15g，雞內金12g，何首烏10g，生山楂30 g，川楝(lian)子15g，郁金15g。1個月(yue)(yue)后，右脅(xie)隱痛消失，惟覺(jue)脹(zhang)滿不適，納(na)食增，口中和(he)，乏力不減，舌(she)(she)淡紅(hong)(hong)，苔薄黃(huang)，脈弦(xian)滑。原方(fang)稍作(zuo)加(jia)(jia)減，繼(ji)續(xu)服藥2個月(yue)(yue)，患者(zhe)(zhe)精神好(hao)轉(zhuan)，無(wu)不適癥狀。復(fu)查血脂(zhi)(zhi)：三(san)酞(tai)甘油1.6mmol/L；B超(chao)示脂(zhi)(zhi)肪肝(gan)(gan)消失、肝(gan)(gan)臟恢復(fu)正常(chang)。 （摘自《陜西中醫(yi)(yi)學院學報》）
【醫(yi)(yi)案分(fen)析(xi)】甘油三(san)酯（以前叫三(san)酞甘油）的(de)(de)(de)(de)正常值是(shi)(shi)(shi)低于1.7 mmol/L，總(zong)膽(dan)固(gu)醇應低于5.20 mmol/I，看來該(gai)患者是(shi)(shi)(shi)血脂高日久所(suo)致的(de)(de)(de)(de)脂肪肝(gan)(gan)。中醫(yi)(yi)是(shi)(shi)(shi)辨證治療(liao)為主，知道(dao)這(zhe)個(ge)診斷(duan)結(jie)果幫助不大(da)(da)，只是(shi)(shi)(shi)有(you)(you)利于檢(jian)查藥后(hou)(hou)(hou)效果而已。“右脅(xie)憋脹、隱痛”，這(zhe)是(shi)(shi)(shi)脹而及痛，肝(gan)(gan)氣(qi)(qi)郁結(jie)表現。“納(na)差，乏(fa)力(li)(li)”，肝(gan)(gan)病(bing)中見(jian)(jian)這(zhe)種癥狀，要看病(bing)情新久，還(huan)要結(jie)合舌脈(mo)(mo)，才(cai)能(neng)知道(dao)到底是(shi)(shi)(shi)否(fou)真有(you)(you)脾(pi)(pi)氣(qi)(qi)虛(xu)，還(huan)是(shi)(shi)(shi)肝(gan)(gan)氣(qi)(qi)暫(zan)時壓(ya)制(zhi)脾(pi)(pi)氣(qi)(qi)造成的(de)(de)(de)(de)。后(hou)(hou)(hou)一種情況相(xiang)當常見(jian)(jian)，肝(gan)(gan)氣(qi)(qi)舒暢后(hou)(hou)(hou)立愈(yu)。“口干苦，舌紅，苔黃厚”，應是(shi)(shi)(shi)肝(gan)(gan)郁化火。“脈(mo)(mo)弦滑”，示肝(gan)(gan)膽(dan)病(bing)？或痰(tan)飲病(bing)？或二者兼有(you)(you)？有(you)(you)的(de)(de)(de)(de)醫(yi)(yi)生凡(fan)是(shi)(shi)(shi)肝(gan)(gan)膽(dan)病(bing)，自動在病(bing)歷(li)上寫“脈(mo)(mo)弦”，這(zhe)種情況還(huan)真不少。看病(bing)案時，有(you)(you)些(xie)脈(mo)(mo)象(xiang)不容易(yi)搞(gao)錯(cuo)(cuo)，如遲、數、浮(fu)、沉(chen)、大(da)(da)、洪、芤、細、有(you)(you)力(li)(li)、無力(li)(li)、促、結(jie)、代(dai)，可(ke)(ke)以完(wan)全采信(xin)。小兒脈(mo)(mo)易(yi)誤(wu)判(pan)(pan)為脈(mo)(mo)數，女性(xing)和緩脈(mo)(mo)易(yi)誤(wu)判(pan)(pan)為無力(li)(li)脈(mo)(mo)，瘦人脈(mo)(mo)易(yi)誤(wu)判(pan)(pan)為浮(fu)脈(mo)(mo)，伏脈(mo)(mo)易(yi)誤(wu)判(pan)(pan)為微脈(mo)(mo)。很多其他(ta)脈(mo)(mo)象(xiang)的(de)(de)(de)(de)記述都只能(neng)作為參考(kao)。尤其是(shi)(shi)(shi)現代(dai)醫(yi)(yi)生，摸脈(mo)(mo)是(shi)(shi)(shi)薄弱環節。本案雖暫(zan)不考(kao)慮脈(mo)(mo)弦滑，但由此可(ke)(ke)肯(ken)定脈(mo)(mo)非無力(li)(li)，這(zhe)是(shi)(shi)(shi)不易(yi)搞(gao)錯(cuo)(cuo)的(de)(de)(de)(de)。舌亦無齒(chi)痕，故前面氣(qi)(qi)虛(xu)的(de)(de)(de)(de)懷疑要打個(ge)大(da)(da)大(da)(da)的(de)(de)(de)(de)問(wen)號，肝(gan)(gan)暫(zan)時壓(ya)制(zhi)脾(pi)(pi)的(de)(de)(de)(de)可(ke)(ke)能(neng)性(xing)就(jiu)更(geng)大(da)(da)了。苔并不膩(ni)，“弦滑”脈(mo)(mo)為痰(tan)濕的(de)(de)(de)(de)結(jie)論很難(nan)站住(zhu)腳。所(suo)以，應該(gai)就(jiu)是(shi)(shi)(shi)個(ge)單純的(de)(de)(de)(de)肝(gan)(gan)郁化火，可(ke)(ke)以用金鈴子(zi)散(san)。若從“見(jian)(jian)肝(gan)(gan)之病(bing)，知肝(gan)(gan)傳(chuan)脾(pi)(pi)，當先實脾(pi)(pi)”而言，可(ke)(ke)用丹梔逍遙散(san)肝(gan)(gan)脾(pi)(pi)兼顧又清郁火。
肥(fei)人多痰，血脂(zhi)(zhi)高、脂(zhi)(zhi)肪(fang)肝(gan)(gan)的(de)人是(shi)(shi)否也肯定(ding)有(you)(you)(you)痰濕呢？作(zuo)者(zhe)(zhe)估計是(shi)(shi)從脈弦滑、苔(tai)厚(hou)，又結(jie)合血脂(zhi)(zhi)高，判斷(duan)是(shi)(shi)兼(jian)有(you)(you)(you)痰濕。未明說肝(gan)(gan)郁(yu)(yu)(yu)化火，但用(yong)(yong)藥有(you)(you)(you)川(chuan)楝(lian)子(zi)、郁(yu)(yu)(yu)金均既(ji)疏(shu)(shu)肝(gan)(gan)又清火。治療(liao)思(si)路(lu)是(shi)(shi)四逆散疏(shu)(shu)肝(gan)(gan)柔肝(gan)(gan)，加(jia)川(chuan)楝(lian)子(zi)、郁(yu)(yu)(yu)金加(jia)強疏(shu)(shu)肝(gan)(gan)、清肝(gan)(gan)。郁(yu)(yu)(yu)金又并(bing)澤瀉祛肝(gan)(gan)經(jing)濕熱。丹參確有(you)(you)(you)醫家喜(xi)用(yong)(yong)大劑量來療(liao)肝(gan)(gan)區痛的(de)。雞內金、山楂緩解納差，前者(zhe)(zhe)并(bing)健脾，后者(zhe)(zhe)已被證明有(you)(you)(you)較(jiao)好降脂(zhi)(zhi)作(zuo)用(yong)(yong)，都(dou)是(shi)(shi)身兼(jian)兩職。何首烏加(jia)強白(bai)芍補(bu)陰柔肝(gan)(gan)之(zhi)力。總體感覺是(shi)(shi)，作(zuo)者(zhe)(zhe)雖(sui)然自述“祛濕化痰”，對濕的(de)重視并(bing)不十分明顯，主體仍在(zai)疏(shu)(shu)肝(gan)(gan)、柔肝(gan)(gan)，兼(jian)清肝(gan)(gan)、開胃(wei)，類似丹梔逍遙(yao)散的(de)思(si)路(lu)，又結(jie)合了(le)一點龍膽瀉肝(gan)(gan)湯(tang)的(de)思(si)路(lu)。筆者(zhe)(zhe)覺得，方子(zi)是(shi)(shi)比較(jiao)精當的(de)。
服了一個月，還(huan)有(you)(you)脹滿不(bu)(bu)(bu)適(shi)，但疏肝(gan)(gan)的(de)(de)力度已經不(bu)(bu)(bu)小了，并(bing)不(bu)(bu)(bu)宜再加(jia)大。可(ke)(ke)(ke)(ke)能因與常(chang)見的(de)(de)功能性(xing)的(de)(de)肝(gan)(gan)膽病(bing)不(bu)(bu)(bu)同，這次是(shi)(shi)有(you)(you)器質(zhi)性(xing)改變，檢查(cha)明確看出脂肪肝(gan)(gan)了，所以效(xiao)果慢一些(xie)。看來(lai)器質(zhi)性(xing)變要(yao)早早給(gei)病(bing)人講清楚，效(xiao)果會(hui)有(you)(you)，但要(yao)慢一些(xie)，要(yao)有(you)(you)思想準備。免得(de)后(hou)面(mian)有(you)(you)埋怨情(qing)緒，不(bu)(bu)(bu)能堅持(chi)，再解(jie)釋就顯得(de)是(shi)(shi)推脫責任了。脅痛消失(shi)，川(chuan)楝(lian)子又有(you)(you)毒，筆者覺得(de)丹參、川(chuan)楝(lian)子可(ke)(ke)(ke)(ke)以去掉。乏力不(bu)(bu)(bu)減(jian)，加(jia)點黨參或炒白術應(ying)是(shi)(shi)可(ke)(ke)(ke)(ke)以的(de)(de)。再堅持(chi)治療，主方不(bu)(bu)(bu)變。作者也(ye)提倡主方不(bu)(bu)(bu)變，稍作加(jia)減(jian)，又療兩(liang)個月，血(xue)脂已正(zheng)常(chang)，更重(zhong)要(yao)的(de)(de)是(shi)(shi)脂肪肝(gan)(gan)也(ye)逆轉了，著實(shi)不(bu)(bu)(bu)易(yi)。值得(de)注意(yi)的(de)(de)是(shi)(shi)，疏肝(gan)(gan)的(de)(de)方用這么長時(shi)間，養陰柔(rou)肝(gan)(gan)藥(yao)絕對少不(bu)(bu)(bu)得(de)。不(bu)(bu)(bu)然的(de)(de)話，很可(ke)(ke)(ke)(ke)能前面(mian)幾包藥(yao)病(bing)情(qing)似乎在減(jian)輕，后(hou)來(lai)繼續(xu)吃不(bu)(bu)(bu)但可(ke)(ke)(ke)(ke)能沒效(xiao)果，還(huan)可(ke)(ke)(ke)(ke)能惡化加(jia)重(zhong)。肝(gan)(gan)為(wei)剛(gang)臟(zang)，忌燥，不(bu)(bu)(bu)可(ke)(ke)(ke)(ke)不(bu)(bu)(bu)慎。肺(fei)為(wei)嬌臟(zang)，亦忌燥，燥痰藥(yao)宜慎。胃喜潤惡燥，理氣除滿藥(yao)不(bu)(bu)(bu)宜過用。不(bu)(bu)(bu)宜暢快淋漓地(di)追擊鞏固，后(hou)期要(yao)側重(zhong)扶正(zheng)，這都(dou)是(shi)(shi)題外話了。
——本段摘自《方劑(ji)學案例分析》
《鄧中甲方劑學講稿》中關于四逆散的論述四逆散?《傷寒論》
在(zai)調(diao)和(he)肝脾(pi)這(zhe)一(yi)節里(li)(li)，第一(yi)個(ge)(ge)方，四(si)逆散(san)(san)。說到(dao)四(si)逆散(san)(san)的(de)歸(gui)類(lei)。過去四(si)逆散(san)(san)，就把它放在(zai)這(zhe)一(yi)節里(li)(li)，但是(shi)總(zong)要聲明一(yi)下，它主要治療的(de)陽(yang)郁(yu)四(si)逆。因為從(cong)《傷寒(han)(han)論(lun)(lun)》的(de)角度，寒(han)(han)邪侵犯人體，郁(yu)而(er)陽(yang)氣不(bu)得輸布，陽(yang)氣郁(yu)結，引(yin)起(qi)了(le)(le)(le)不(bu)能布散(san)(san)而(er)四(si)肢逆冷(leng)，陽(yang)郁(yu)四(si)逆。五版(ban)里(li)(li)談到(dao)，至于(yu)后世用(yong)四(si)逆散(san)(san)治療，由于(yu)肝脾(pi)氣郁(yu)，造成了(le)(le)(le)脘腹脅肋諸(zhu)痛(tong)，是(shi)司其法(fa)而(er)不(bu)易其方，也就是(shi)說靈活(huo)運(yun)用(yong)，不(bu)在(zai)本方討(tao)論(lun)(lun)范圍之(zhi)(zhi)內，那不(bu)在(zai)本方討(tao)論(lun)(lun)范圍之(zhi)(zhi)內，怎么放在(zai)調(diao)和(he)肝脾(pi)里(li)(li)頭呢？所以又是(shi)一(yi)個(ge)(ge)矛(mao)盾。現在(zai)六版(ban)七版(ban)的(de)，都把調(diao)和(he)肝脾(pi)，這(zhe)個(ge)(ge)做為主治里(li)(li)單獨(du)一(yi)項，所以這(zhe)個(ge)(ge)主治證候，就變成了(le)(le)(le)兩個(ge)(ge)方面。
(肝脾氣郁(yu))肝氣郁(yu)滯
↑?↓
脾氣郁滯(zhi)從現代運(yun)用(yong)(yong)的(de)實際情況，包(bao)括宋代以后的(de)運(yun)用(yong)(yong)實際情況，肝脾不和，肝脾氣郁是四逆散的(de)運(yun)用(yong)(yong)。針對(dui)的(de)最基本病機(ji)。
因(yin)為原有(you)《傷寒論》那個四(si)(si)(si)逆，它(ta)強調(diao)陽(yang)(yang)氣(qi)閉(bi)郁了(le)，外邪入里閉(bi)郁了(le)陽(yang)(yang)氣(qi)，那就(jiu)是(shi)氣(qi)機不(bu)(bu)暢(chang)了(le)。陽(yang)(yang)氣(qi)不(bu)(bu)能(neng)輸布到四(si)(si)(si)肢，造成四(si)(si)(si)逆。但是(shi)它(ta)要區別于(yu)這種心腎(shen)(shen)陽(yang)(yang)虛(xu)，或者(zhe)中(zhong)焦虛(xu)寒，這種陽(yang)(yang)氣(qi)不(bu)(bu)達四(si)(si)(si)肢，這種四(si)(si)(si)逆，中(zhong)焦虛(xu)寒說(shuo)(shuo)，手(shou)足(zu)不(bu)(bu)溫，手(shou)足(zu)清冷(leng)，甚至于(yu)嚴重的(de)叫(jiao)逆冷(leng)。但叫(jiao)厥(jue)逆呢(ni)，一般(ban)心腎(shen)(shen)陽(yang)(yang)虛(xu)，腎(shen)(shen)陽(yang)(yang)虛(xu)衰，那都要用(yong)溫中(zhong)藥，或者(zhe)溫腎(shen)(shen)藥，用(yong)溫陽(yang)(yang)藥，這方里沒(mei)有(you)。所以這個四(si)(si)(si)逆，后來解釋陽(yang)(yang)郁四(si)(si)(si)逆，四(si)(si)(si)逆的(de)范圍很小(xiao)。就(jiu)是(shi)遠程，但是(shi)指(zhi)頭還是(shi)微溫的(de)。有(you)的(de)又說(shuo)(shuo)摸久了(le)，指(zhi)頭也透出熱氣(qi)，陽(yang)(yang)氣(qi)郁厥(jue)了(le)，這個四(si)(si)(si)逆。
主(zhu)(zhu)治(zhi)(zhi)，我們把(ba)肝(gan)脾氣(qi)(qi)(qi)(qi)(qi)郁(yu)做主(zhu)(zhu)要的(de)。傷寒論上(shang)寫(xie)的(de)四(si)逆(ni)(ni)散(san)主(zhu)(zhu)治(zhi)(zhi)，“少(shao)(shao)陰病，四(si)逆(ni)(ni)，或(huo)咳(ke)、或(huo)悸，或(huo)小便(bian)(bian)不(bu)利，或(huo)腹中痛，泄利下重者，四(si)逆(ni)(ni)散(san)主(zhu)(zhu)之。”實際(ji)上(shang)指的(de)陽(yang)氣(qi)(qi)(qi)(qi)(qi)郁(yu)結(jie)以(yi)后，氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)阻滯能(neng)(neng)引起五(wu)(wu)臟(zang)(zang)病變，能(neng)(neng)引起各樣病變。泛指氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)被郁(yu)了，不(bu)管是(shi)肝(gan)脾氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)郁(yu)結(jie)了，或(huo)外來的(de)邪入里，郁(yu)遏陽(yang)氣(qi)(qi)(qi)(qi)(qi)，總之，形(xing)成氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)郁(yu)滯。五(wu)(wu)臟(zang)(zang)，如果氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)郁(yu)滯了，都會影響功能(neng)(neng)，所以(yi)在每一臟(zang)(zang)就選一個證(zheng)，來做代表。或(huo)者咳(ke)嗽，肺(fei)，肺(fei)氣(qi)(qi)(qi)(qi)(qi)不(bu)利，宣降失(shi)常(chang)(chang)，所以(yi)咳(ke)嗽。心悸，那是(shi)胸部陽(yang)氣(qi)(qi)(qi)(qi)(qi)被郁(yu)，不(bu)能(neng)(neng)正常(chang)(chang)舒展。小便(bian)(bian)不(bu)利，涉及到腎。腹中痛，肝(gan)。泄利下重，脾。猛一看，心肝(gan)脾肺(fei)腎都有(you)問(wen)題了，實際(ji)上(shang)講的(de)是(shi)一種(zhong)基本(ben)病機(ji)(ji)，氣(qi)(qi)(qi)(qi)(qi)機(ji)(ji)郁(yu)滯。你也很少(shao)(shao)就拿這四(si)個藥，去治(zhi)(zhi)療某一個具體的(de)病。
所以四(si)逆散是一個治(zhi)療肝脾(pi)氣郁的基礎方。
肝脾不和
(肝(gan)脾(pi)氣郁)肝(gan)氣郁滯
↑???↓
脾(pi)氣郁(yu)(yu)滯(zhi)剛才(cai)講到(dao)調和(he)肝脾(pi)法(fa)，這(zhe)(zhe)(zhe)法(fa)針對(dui)肝脾(pi)不和(he)的(de)病機(ji)，它(ta)建立(li)在肝脾(pi)兩(liang)個(ge)系統生(sheng)理(li)上(shang)密(mi)切聯系基礎上(shang)的(de)。臨床上(shang)主要反映出一種肝脾(pi)不和(he)，惡(e)性循環這(zhe)(zhe)(zhe)種特點(dian)。在四(si)逆(ni)散這(zhe)(zhe)(zhe)個(ge)方來講，現在側重點(dian)，剛才(cai)提到(dao)了陽郁(yu)(yu)四(si)逆(ni)一個(ge)基理(li)，從(cong)陽郁(yu)(yu)四(si)逆(ni)的(de)角度來講，這(zhe)(zhe)(zhe)個(ge)方里的(de)柴胡(hu)，它(ta)可以透邪外達，解(jie)除這(zhe)(zhe)(zhe)陽郁(yu)(yu)四(si)逆(ni)造成的(de)原因。陽氣不被郁(yu)(yu)了，氣機(ji)通暢，清陽能實四(si)肢，也就這(zhe)(zhe)(zhe)四(si)逆(ni)解(jie)除了。
當(dang)然(ran)從四(si)逆(ni)(ni)(ni)(ni)散(san)自(zi)身這(zhe)(zhe)(zhe)(zhe)個方(fang)(fang)(fang)來(lai)講，我自(zi)己有(you)(you)(you)(you)(you)個不(bu)(bu)(bu)一定成熟的(de)(de)(de)(de)看法(fa)，它(ta)(ta)(ta)是(shi)仲(zhong)(zhong)景用來(lai)做為鑒別診(zhen)斷的(de)(de)(de)(de)。在少(shao)(shao)陰(yin)(yin)篇(pian)(pian)(pian)里(li)(li)(li)(li)邊，他(ta)(ta)并不(bu)(bu)(bu)是(shi)典型的(de)(de)(de)(de)治療少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)(de)(de)，仲(zhong)(zhong)景《傷(shang)(shang)寒論(lun)》里(li)(li)(li)(li)，每一類病(bing)(bing)(bing)(bing)(bing)(bing)它(ta)(ta)(ta)都有(you)(you)(you)(you)(you)提(ti)綱(gang)(gang)，少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)提(ti)綱(gang)(gang)，少(shao)(shao)陰(yin)(yin)之(zhi)為病(bing)(bing)(bing)(bing)(bing)(bing)，脈微(wei)(wei)細，但(dan)(dan)欲(yu)寐，那(nei)就是(shi)說，心(xin)(xin)腎陽(yang)(yang)虛(xu)的(de)(de)(de)(de)情(qing)況(kuang)下，脈來(lai)微(wei)(wei)細，陽(yang)(yang)氣不(bu)(bu)(bu)能推動血液運行，不(bu)(bu)(bu)能溫通，不(bu)(bu)(bu)能養神，神衰欲(yu)寐，這(zhe)(zhe)(zhe)(zhe)是(shi)主要反(fan)應心(xin)(xin)陽(yang)(yang)了(le)(le)。同時(shi)腎陽(yang)(yang)來(lai)說，基(ji)(ji)本的(de)(de)(de)(de)熱力來(lai)源差了(le)(le)，四(si)肢厥(jue)(jue)逆(ni)(ni)(ni)(ni)，惡寒蜷臥，這(zhe)(zhe)(zhe)(zhe)類基(ji)(ji)本表現(xian)，是(shi)心(xin)(xin)腎陽(yang)(yang)虛(xu)的(de)(de)(de)(de)一些共同特(te)點(dian)，但(dan)(dan)是(shi)四(si)肢厥(jue)(jue)逆(ni)(ni)(ni)(ni)，和(he)這(zhe)(zhe)(zhe)(zhe)個在同樣逆(ni)(ni)(ni)(ni)冷方(fang)(fang)(fang)面(mian)(mian)(mian)，有(you)(you)(you)(you)(you)相似的(de)(de)(de)(de)病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)，還有(you)(you)(you)(you)(you)譬(pi)如當(dang)歸四(si)逆(ni)(ni)(ni)(ni)，吳茱萸湯也有(you)(you)(you)(you)(you)四(si)肢厥(jue)(jue)冷，那(nei)這(zhe)(zhe)(zhe)(zhe)種情(qing)況(kuang)，怎么鑒別？張仲(zhong)(zhong)景他(ta)(ta)在四(si)逆(ni)(ni)(ni)(ni)，少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)這(zhe)(zhe)(zhe)(zhe)一部(bu)份里(li)(li)(li)(li)邊，是(shi)以(yi)(yi)四(si)逆(ni)(ni)(ni)(ni)湯為代(dai)表，基(ji)(ji)礎方(fang)(fang)(fang)，它(ta)(ta)(ta)同時(shi)把有(you)(you)(you)(you)(you)四(si)逆(ni)(ni)(ni)(ni)表現(xian)的(de)(de)(de)(de)方(fang)(fang)(fang)都附在里(li)(li)(li)(li)邊。所以(yi)(yi)在《傷(shang)(shang)寒論(lun)》里(li)(li)(li)(li)有(you)(you)(you)(you)(you)一些條(tiao)(tiao)文前(qian)面(mian)(mian)(mian)的(de)(de)(de)(de)少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)，太陽(yang)(yang)病(bing)(bing)(bing)(bing)(bing)(bing)，有(you)(you)(you)(you)(you)一些包(bao)括吳茱萸湯前(qian)面(mian)(mian)(mian)也有(you)(you)(you)(you)(you)一條(tiao)(tiao)少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)，也有(you)(you)(you)(you)(you)陽(yang)(yang)明病(bing)(bing)(bing)(bing)(bing)(bing)，有(you)(you)(you)(you)(you)厥(jue)(jue)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)。由四(si)逆(ni)(ni)(ni)(ni)這(zhe)(zhe)(zhe)(zhe)幾條(tiao)(tiao)，都反(fan)映在少(shao)(shao)陰(yin)(yin)篇(pian)(pian)(pian)里(li)(li)(li)(li)，它(ta)(ta)(ta)是(shi)用來(lai)跟四(si)逆(ni)(ni)(ni)(ni)湯做鑒別診(zhen)斷的(de)(de)(de)(de)。過(guo)去的(de)(de)(de)(de)人(ren)刻那(nei)竹板不(bu)(bu)(bu)像現(xian)在，你(ni)(ni)計算機(ji)一打(da)，它(ta)(ta)(ta)是(shi)第(di)幾頁，他(ta)(ta)自(zi)動自(zi)己就上面(mian)(mian)(mian)寫(xie)清楚了(le)(le)。又(you)不(bu)(bu)(bu)像紙一個個很薄，可以(yi)(yi)落(luo)在一起，一寫(xie)第(di)幾頁，頁碼就很清楚了(le)(le)。竹片片，擺(bai)了(le)(le)一地，對吧？最后串成冊(ce)，你(ni)(ni)要有(you)(you)(you)(you)(you)個標志呀。那(nei)它(ta)(ta)(ta)前(qian)面(mian)(mian)(mian)這(zhe)(zhe)(zhe)(zhe)個是(shi)整(zheng)個這(zhe)(zhe)(zhe)(zhe)一堆，放在少(shao)(shao)陰(yin)(yin)篇(pian)(pian)(pian)里(li)(li)(li)(li)，那(nei)一堆放在太陽(yang)(yang)篇(pian)(pian)(pian)，分(fen)類，前(qian)面(mian)(mian)(mian)有(you)(you)(you)(you)(you)小字少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)，少(shao)(shao)陰(yin)(yin)篇(pian)(pian)(pian)的(de)(de)(de)(de)。到后來(lai)王(wang)叔和(he)他(ta)(ta)們不(bu)(bu)(bu)見得(de)知道(dao)，散(san)在篇(pian)(pian)(pian)章找(zhao)來(lai)以(yi)(yi)后，那(nei)少(shao)(shao)陰(yin)(yin)這(zhe)(zhe)(zhe)(zhe)個誤入(ru)正文。你(ni)(ni)否(fou)則從少(shao)(shao)陰(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)(de)(de)基(ji)(ji)本特(te)征，和(he)四(si)逆(ni)(ni)(ni)(ni)散(san)的(de)(de)(de)(de)用藥，你(ni)(ni)說符合不(bu)(bu)(bu)符合。所以(yi)(yi)鬧得(de)這(zhe)(zhe)(zhe)(zhe)個四(si)逆(ni)(ni)(ni)(ni)散(san)轉(zhuan)個大圈(quan)圈(quan)來(lai)解釋。我是(shi)這(zhe)(zhe)(zhe)(zhe)樣看。
因為(wei)你(ni)(ni)實踐是(shi)(shi)檢驗真理的(de)標準，你(ni)(ni)現(xian)在(zai)這(zhe)個方(fang)用在(zai)四(si)逆(ni)(ni)(ni)上(shang)，用多少(shao)呢？也就告(gao)訴你(ni)(ni)，心腎(shen)陽(yang)虛(xu)出(chu)(chu)(chu)現(xian)四(si)逆(ni)(ni)(ni)，肝(gan)(gan)胃虛(xu)寒(han)(han)，濁陰上(shang)逆(ni)(ni)(ni)，像(xiang)吳(wu)茱萸湯證(zheng)可以(yi)(yi)(yi)出(chu)(chu)(chu)現(xian)四(si)逆(ni)(ni)(ni)。陽(yang)氣不足(zu)，陰血(xue)不足(zu)，又感(gan)受寒(han)(han)邪，可以(yi)(yi)(yi)出(chu)(chu)(chu)現(xian)四(si)肢厥寒(han)(han)，當歸四(si)逆(ni)(ni)(ni)湯證(zheng)。同(tong)時(shi)，氣機(ji)阻滯也可以(yi)(yi)(yi)出(chu)(chu)(chu)現(xian)四(si)逆(ni)(ni)(ni)，程度不同(tong)，都屬于(四(si)逆(ni)(ni)(ni))范圍。要鑒別診斷。而這(zhe)些(xie)相應的(de)方(fang)，四(si)逆(ni)(ni)(ni)散之類，它不是(shi)(shi)治療少(shao)陰病的(de)。所(suo)以(yi)(yi)(yi)到了宋以(yi)(yi)(yi)后(hou)，這(zhe)個方(fang)的(de)方(fang)向，主要轉向了調(diao)和肝(gan)(gan)脾氣郁。肝(gan)(gan)脾氣機(ji)郁滯出(chu)(chu)(chu)現(xian)的(de)，以(yi)(yi)(yi)脘腹(fu)、脅肋諸(zhu)痛為(wei)特點的(de)證(zheng)。所(suo)以(yi)(yi)(yi)后(hou)來(lai)四(si)逆(ni)(ni)(ni)散產(chan)生的(de)那(nei)個系列方(fang)劑(ji)來(lai)講，也都是(shi)(shi)從肝(gan)(gan)脾氣郁入(ru)手。這(zhe)成為(wei)一個主要了。
所以(yi)方劑學應(ying)當是(shi)從這(zhe)個(ge)(ge)原(yuan)始出來(lai)以(yi)后，后世發展(zhan)當中，多用的(de)(de)方面這(zhe)個(ge)(ge)為基(ji)礎(chu)(chu)，而不是(shi)元素為基(ji)礎(chu)(chu)。元素為基(ji)礎(chu)(chu)，那就和(he)《傷寒論》沒有(you)區別(bie)了。所以(yi)這(zhe)個(ge)(ge)方的(de)(de)一個(ge)(ge)，現代(dai)設(she)定它(ta)的(de)(de)功用、主(zhu)治、病(bing)機(ji)，是(shi)建立在這(zhe)個(ge)(ge)基(ji)礎(chu)(chu)上的(de)(de)。所以(yi)在研究四逆散的(de)(de)基(ji)本病(bing)機(ji)，應(ying)該(gai)是(shi)肝脾(pi)不和(he)、肝脾(pi)氣郁，為它(ta)主(zhu)要(yao)特點。
肝脾(pi)(pi)氣郁(yu)(yu)又(you)互(hu)(hu)相(xiang)影(ying)響(xiang)的(de)(de)，這(zhe)個表反應出(chu)一種相(xiang)互(hu)(hu)影(ying)響(xiang)，惡(e)性循(xun)環(huan)的(de)(de)。肝氣郁(yu)(yu)滯(zhi)，不能幫助脾(pi)(pi)胃(wei)運(yun)化，運(yun)化障礙，那(nei)脾(pi)(pi)氣也會郁(yu)(yu)滯(zhi)；脾(pi)(pi)氣郁(yu)(yu)滯(zhi)了，脾(pi)(pi)是人體(ti)升降的(de)(de)樞紐，是中(zhong)軸(zhou)，中(zhong)樞，也會影(ying)響(xiang)到肝氣的(de)(de)郁(yu)(yu)滯(zhi)。肝脾(pi)(pi)都彼此相(xiang)互(hu)(hu)影(ying)響(xiang)。造(zao)成氣機郁(yu)(yu)滯(zhi)上的(de)(de)一種，氣機郁(yu)(yu)滯(zhi)偏實，這(zhe)上面的(de)(de)一個惡(e)性循(xun)環(huan)了。
肝脾氣郁脅肋脹滿，脘腹疼痛，脈弦。肝脾氣機(ji)郁滯，那就是(shi)(shi)(shi)(shi)肝脾所主(zhu)(zhu)的部位，脅肋(lei)，脘(wan)腹，脹(zhang)悶疼痛為(wei)主(zhu)(zhu)。由于是(shi)(shi)(shi)(shi)氣機(ji)郁滯，也是(shi)(shi)(shi)(shi)反應出主(zhu)(zhu)要是(shi)(shi)(shi)(shi)弦脈。這個是(shi)(shi)(shi)(shi)證(zheng)候(hou)分析。它(ta)主(zhu)(zhu)治兩個。
君柴胡透邪外達，疏肝解郁臣白芍斂陰養血柔肝，和柴胡為調肝常用的組合，又可制柴胡耗傷陰血之弊佐枳實理氣解郁，泄熱破結，和柴胡一升一降，舒暢調達肝脾氣機，和白芍則調暢氣血而止腹痛。使甘草(cao)調和(he)諸藥，益脾和(he)中。這(zhe)方(fang)(fang)是(shi)個基礎方(fang)(fang)，基礎方(fang)(fang)就是(shi)利用它做為基本(ben)的一些組合。根(gen)據證候具體不同來加減，產生具體方(fang)(fang)劑的。功用也(ye)是(shi)從兩個方(fang)(fang)面歸納的。透(tou)邪解郁，剛才講了這(zhe)個方(fang)(fang)里，柴(chai)胡有透(tou)邪解郁，通過(guo)透(tou)邪解除陽氣被郁。疏(shu)肝理脾是(shi)指的主治(zhi)第(di)二個，肝脾氣郁，要疏(shu)肝理脾，疏(shu)理肝脾氣機。
君藥(yao)是柴(chai)胡(hu)，柴(chai)胡(hu)在這方(fang)透邪(xie)力量不(bu)必太大(da)，為什(shen)么？透邪(xie)解(jie)(jie)(jie)郁(yu)，外邪(xie)入里郁(yu)遏(e)陽氣，它不(bu)是需(xu)要很大(da)的發散，所(suo)以逐漸透邪(xie)外達。同(tong)時有(you)疏(shu)肝解(jie)(jie)(jie)郁(yu)作用(yong)(yong)。肝脾氣郁(yu)，柴(chai)胡(hu)有(you)疏(shu)肝解(jie)(jie)(jie)郁(yu)作用(yong)(yong)。疏(shu)肝解(jie)(jie)(jie)郁(yu)一(yi)般柴(chai)胡(hu)也(ye)不(bu)用(yong)(yong)大(da)量。
芍(shao)(shao)藥(yao)呢，可(ke)以益(yi)陰(yin)(yin)養血(xue)柔肝(gan)(gan)(gan)(gan)，酸收，收斂(lian)，所(suo)以說斂(lian)陰(yin)(yin)養血(xue)柔肝(gan)(gan)(gan)(gan)。和柴(chai)(chai)胡結(jie)合，就(jiu)成為調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)的常用(yong)(yong)組(zu)合。四逆散里(li)的柴(chai)(chai)胡、芍(shao)(shao)藥(yao)這個(ge)(ge)結(jie)構，在仲景時(shi)代，并不是(shi)做為調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)的基(ji)本(ben)(ben)(ben)結(jie)構。而是(shi)說你(ni)在外邪入里(li)，郁遏陽(yang)(yang)氣，芍(shao)(shao)藥(yao)偏寒，有(you)清泄(xie)(xie)郁熱(re)作用(yong)(yong)，同時(shi)又(you)能(neng)制(zhi)約柴(chai)(chai)胡的辛散，耗傷陰(yin)(yin)血(xue)，避免柴(chai)(chai)胡容易耗傷陰(yin)(yin)血(xue)。到了宋以后(hou)(hou)，用(yong)(yong)四逆散，這時(shi)侯柴(chai)(chai)胡芍(shao)(shao)藥(yao)，實際上成為了一(yi)(yi)種調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)的基(ji)本(ben)(ben)(ben)結(jie)構，調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)是(shi)針(zhen)對肝(gan)(gan)(gan)(gan)為剛臟(zang)，體(ti)陰(yin)(yin)用(yong)(yong)陽(yang)(yang)，肝(gan)(gan)(gan)(gan)主(zhu)疏泄(xie)(xie)，體(ti)現用(yong)(yong)陽(yang)(yang)的方(fang)(fang)面(mian)，肝(gan)(gan)(gan)(gan)主(zhu)藏血(xue)，體(ti)現了體(ti)陰(yin)(yin)的方(fang)(fang)面(mian)。那柴(chai)(chai)胡協(xie)助疏泄(xie)(xie)，芍(shao)(shao)藥(yao)益(yi)陰(yin)(yin)養血(xue)，柴(chai)(chai)、芍(shao)(shao)并用(yong)(yong)就(jiu)是(shi)條肝(gan)(gan)(gan)(gan)的陰(yin)(yin)陽(yang)(yang)，調(diao)(diao)(diao)(diao)整它疏泄(xie)(xie)藏血(xue)的平衡。這本(ben)(ben)(ben)種基(ji)本(ben)(ben)(ben)結(jie)構，后(hou)(hou)世(shi)大量的調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)方(fang)(fang)，出(chu)(chu)現這兩個(ge)(ge)很多都是(shi)調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)。你(ni)從(cong)《方(fang)(fang)劑大辭典》里(li)邊(bian)，有(you)柴(chai)(chai)胡、芍(shao)(shao)藥(yao)出(chu)(chu)現，大多數都用(yong)(yong)于這個(ge)(ge)方(fang)(fang)面(mian)。所(suo)以成為一(yi)(yi)個(ge)(ge)調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)常用(yong)(yong)的一(yi)(yi)種基(ji)本(ben)(ben)(ben)組(zu)合。所(suo)以你(ni)光(guang)開一(yi)(yi)個(ge)(ge)柴(chai)(chai)胡，你(ni)說叫他(ta)疏肝(gan)(gan)(gan)(gan)去，那往往得配(pei)一(yi)(yi)些芍(shao)(shao)藥(yao)。聯合起來既好調(diao)(diao)(diao)(diao)肝(gan)(gan)(gan)(gan)，又(you)能(neng)夠(gou)避免耗傷陰(yin)(yin)血(xue)的副作用(yong)(yong)。
方(fang)里的(de)枳(zhi)實(shi)，它(ta)能夠(gou)理(li)氣(qi)(qi)解郁(yu)，主要是作(zuo)用(yong)(yong)于脾(pi)(pi)(pi)氣(qi)(qi)，通降脾(pi)(pi)(pi)氣(qi)(qi)。當(dang)然(ran)枳(zhi)實(shi)本(ben)身還可以(yi)(yi)(yi)導(dao)滯，當(dang)然(ran)這個出(chu)在(zai)(zai)原書《傷寒論》時代，枳(zhi)實(shi)、枳(zhi)殼是沒有(you)分的(de)。所以(yi)(yi)(yi)不(bu)需(xu)要它(ta)導(dao)滯的(de)時候，現在(zai)(zai)很(hen)多(duo)方(fang)改(gai)為(wei)枳(zhi)殼，像后(hou)世(shi)柴胡(hu)(hu)疏(shu)肝(gan)(gan)散這一(yi)(yi)(yi)類，以(yi)(yi)(yi)調(diao)氣(qi)(qi)為(wei)主的(de)都(dou)用(yong)(yong)枳(zhi)殼了。枳(zhi)實(shi)通過它(ta)的(de)一(yi)(yi)(yi)種導(dao)治滯的(de)作(zuo)用(yong)(yong)，又偏寒，所以(yi)(yi)(yi)在(zai)(zai)理(li)氣(qi)(qi)的(de)基礎(chu)上，它(ta)可以(yi)(yi)(yi)有(you)一(yi)(yi)(yi)定(ding)的(de)清熱作(zuo)用(yong)(yong)，有(you)散節作(zuo)用(yong)(yong)。而枳(zhi)實(shi)和(he)柴胡(hu)(hu)相配，后(hou)來就成(cheng)為(wei)一(yi)(yi)(yi)升(sheng)一(yi)(yi)(yi)降，也是調(diao)理(li)肝(gan)(gan)脾(pi)(pi)(pi)氣(qi)(qi)機(ji)的(de)常用(yong)(yong)組(zu)合。柴胡(hu)(hu)疏(shu)肝(gan)(gan)還主升(sheng)，作(zuo)用(yong)(yong)在(zai)(zai)肝(gan)(gan)，枳(zhi)實(shi)理(li)脾(pi)(pi)(pi)主降，所以(yi)(yi)(yi)肝(gan)(gan)脾(pi)(pi)(pi)同(tong)治，肝(gan)(gan)脾(pi)(pi)(pi)氣(qi)(qi)機(ji)同(tong)時調(diao)理(li)，同(tong)時一(yi)(yi)(yi)升(sheng)一(yi)(yi)(yi)降，暢(chang)通內(nei)在(zai)(zai)的(de)一(yi)(yi)(yi)身氣(qi)(qi)機(ji)，這是一(yi)(yi)(yi)個常用(yong)(yong)調(diao)氣(qi)(qi)的(de)一(yi)(yi)(yi)個組(zu)合。
枳實和芍藥呢，又是一個常用組合。枳實是調氣為主的，行氣，有時候可以通過行氣導滯，可以解決氣血郁滯，特別是氣滯這種疼痛，特別是腹痛。芍藥可以調血，作用于血分，芍藥既有于益陰養血作用，也有一定活血作用。因為在《神農本草(cao)經》時(shi)代，赤(chi)、白芍(shao)(shao)不(bu)分的(de)(de)。到唐代還不(bu)分的(de)(de)，唐以后(hou)才分的(de)(de)。現代你(ni)真正說這個芍(shao)(shao)藥，家種的(de)(de)，個兒大的(de)(de)，根大了，切了是白芍(shao)(shao)了，野生的(de)(de)都是赤(chi)芍(shao)(shao)，你(ni)就家種的(de)(de)，跟(gen)須(xu)須(xu)小的(de)(de)就出來，把它(ta)和到赤(chi)芍(shao)(shao)堆里去(qu)，也(ye)不(bu)是非常嚴(yan)格(ge)的(de)(de)。所以自身(shen)以益(yi)陰養血(xue)(xue)為主，芍(shao)(shao)藥也(ye)有(you)調血(xue)(xue)的(de)(de)作用。加上它(ta)擅(shan)長于緩急止痛，所以芍(shao)(shao)藥和枳實相配，又成(cheng)為調暢氣血(xue)(xue)治腹痛的(de)(de)常用組(zu)合(he)。
所(suo)以(yi)每一(yi)個方劑(ji)里(li)突(tu)出的(de)，特別基礎方，一(yi)些常用組合，對(dui)后世影(ying)響很大。所(suo)以(yi)學習一(yi)個方劑(ji)，不僅僅掌握它功用、主(zhu)治，和(he)(he)(he)臨床運用一(yi)般情況，要保障療效，它的(de)常用組和(he)(he)(he)非常重要。了(le)解了(le)常用組和(he)(he)(he)配(pei)伍上這(zhe)些技巧，可以(yi)直接使這(zhe)個方劑(ji)保證臨床的(de)療效。這(zhe)是方義分析(xi)這(zhe)三味主(zhu)要的(de)方面了(le)。
甘草(cao)是調和(he)藥性，同(tong)時有一定(ding)的補脾作(zuo)用。補脾補氣這個作(zuo)用。嚴格(ge)講(jiang)，甘草(cao)和(he)芍藥，能夠(gou)增加芍藥的止痛作(zuo)用。
四(si)(si)逆(ni)散主要(yao)的現在是用于(yu)脅肋、脘腹疼痛，而且(qie)使氣郁(yu)、氣滯造成(cheng)為主。考慮(lv)到陽郁(yu)四(si)(si)逆(ni)，也有手足不(bu)溫，出現陽郁(yu)四(si)(si)逆(ni)，也可以以四(si)(si)逆(ni)散做(zuo)基礎方(fang)。
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方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)教(jiao)學(xue)(xue)(xue)(xue)(xue)法(fa) 1 背(bei)(bei)(bei)誦(song)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)，重(zhong)(zhong)點(dian)(dian)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 現(xian)(xian)今方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)學(xue)(xue)(xue)(xue)(xue)教(jiao)材(cai)(cai)所(suo)(suo)選的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)正(zheng)、附方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)近四(si)(si)(si)(si)(si)(si)百(bai)首，每首方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)由(you)哪(na)些(xie)(xie)藥(yao)(yao)(yao)(yao)物(wu)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)，具(ju)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)什么(me)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)哪(na)些(xie)(xie)病(bing)(bing)(bing)(bing)(bing)(bing)證(zheng)(zheng)等(deng)(deng)(deng)基(ji)(ji)本(ben)(ben)內(nei)(nei)(nei)容(rong)，都(dou)(dou)應該要(yao)(yao)(yao)(yao)(yao)(yao)(yao)求(qiu)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)熟(shu)(shu)悉或(huo)(huo)(huo)掌(zhang)握，這(zhe)(zhe)(zhe)是(shi)(shi)在(zai)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)學(xue)(xue)(xue)(xue)(xue)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)學(xue)(xue)(xue)(xue)(xue)習(xi)過(guo)(guo)(guo)程中(zhong)(zhong)最令人(ren)頭痛(tong)(tong)(tong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)問題。的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)確(que)，如(ru)(ru)(ru)果(guo)孤(gu)立地(di)(di)(di)去(qu)(qu)(qu)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)并(bing)掌(zhang)握這(zhe)(zhe)(zhe)些(xie)(xie)內(nei)(nei)(nei)容(rong)確(que)實(shi)(shi)比較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)困難(nan)。因(yin)(yin)此(ci)，前輩醫家們(men)為(wei)(wei)了方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)便(bian)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)，將(jiang)(jiang)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)重(zhong)(zhong)點(dian)(dian)內(nei)(nei)(nei)容(rong)提煉壓縮，并(bing)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)歌(ge)(ge)(ge)訣(jue)(jue)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)形式編寫成(cheng)(cheng)(cheng)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)，如(ru)(ru)(ru)麻黃(huang)(huang)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)是(shi)(shi)：“麻黃(huang)(huang)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)中(zhong)(zhong)臣桂(gui)枝(zhi)，杏仁(ren)甘(gan)草(cao)(cao)四(si)(si)(si)(si)(si)(si)般施，發汗解(jie)表宣肺氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)，傷寒(han)(han)(han)(han)表實(shi)(shi)無汗宜”。該方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)只(zhi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)四(si)(si)(si)(si)(si)(si)句話(hua)，就(jiu)(jiu)囊(nang)括了方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)名(ming)、組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)配伍、功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)及主(zhu)(zhu)(zhu)(zhu)癥(zheng)等(deng)(deng)(deng)主(zhu)(zhu)(zhu)(zhu)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)內(nei)(nei)(nei)容(rong)。方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)是(shi)(shi)中(zhong)(zhong)醫傳(chuan)統(tong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)法(fa)，其(qi)(qi)特點(dian)(dian)是(shi)(shi)音(yin)韻和(he)(he)(he)(he)諧(xie)，讀起(qi)來(lai)朗(lang)朗(lang)上(shang)(shang)(shang)口(kou)，便(bian)于(yu)(yu)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)誦(song)。方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)學(xue)(xue)(xue)(xue)(xue)教(jiao)學(xue)(xue)(xue)(xue)(xue)大(da)綱(gang)對(dui)(dui)教(jiao)材(cai)(cai)中(zhong)(zhong)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)求(qiu)掌(zhang)握或(huo)(huo)(huo)熟(shu)(shu)悉的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)一(yi)(yi)百(bai)五(wu)十多首方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)，明(ming)(ming)確(que)規定(ding)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)背(bei)(bei)(bei)誦(song)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)。為(wei)(wei)此(ci)，筆(bi)(bi)(bi)者(zhe)第一(yi)(yi)次上(shang)(shang)(shang)課(ke)(ke)(ke)就(jiu)(jiu)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)求(qiu)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)自備一(yi)(yi)個袖珍小(xiao)(xiao)本(ben)(ben)子(zi)(zi)(zi)，將(jiang)(jiang)已(yi)學(xue)(xue)(xue)(xue)(xue)過(guo)(guo)(guo)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)歌(ge)(ge)(ge)訣(jue)(jue)抄(chao)(chao)在(zai)上(shang)(shang)(shang)面(mian)，晨起(qi)或(huo)(huo)(huo)利(li)(li)(li)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)零碎時(shi)(shi)間背(bei)(bei)(bei)上(shang)(shang)(shang)幾(ji)首，在(zai)背(bei)(bei)(bei)誦(song)新方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)前，必須先背(bei)(bei)(bei)舊方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)，這(zhe)(zhe)(zhe)樣(yang)才能(neng)“溫(wen)故而(er)(er)(er)(er)知(zhi)新”，背(bei)(bei)(bei)訣(jue)(jue)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)做(zuo)到(dao)(dao)一(yi)(yi)章(zhang)一(yi)(yi)節(jie)地(di)(di)(di)背(bei)(bei)(bei)，學(xue)(xue)(xue)(xue)(xue)到(dao)(dao)哪(na)里抄(chao)(chao)到(dao)(dao)哪(na)里背(bei)(bei)(bei)到(dao)(dao)哪(na)里，有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)些(xie)(xie)同(tong)(tong)(tong)(tong)(tong)(tong)學(xue)(xue)(xue)(xue)(xue)嘗試了一(yi)(yi)段時(shi)(shi)間后(hou)(hou)深(shen)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)體會，覺得(de)(de)盡(jin)(jin)管書后(hou)(hou)附有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)或(huo)(huo)(huo)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)專門(men)(men)印刷的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)小(xiao)(xiao)冊子(zi)(zi)(zi)，但“手抄(chao)(chao)本(ben)(ben)”更親切，印象(xiang)深(shen)。我(wo)經(jing)常告(gao)誡學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)：年輕(qing)時(shi)(shi)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)力(li)(li)強(qiang)(qiang)(qiang)，背(bei)(bei)(bei)熟(shu)(shu)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)東(dong)西不(bu)易(yi)遺(yi)忘，因(yin)(yin)此(ci)，要(yao)(yao)(yao)(yao)(yao)(yao)(yao)求(qiu)他們(men)趁年輕(qing)時(shi)(shi)多背(bei)(bei)(bei)誦(song)，反復(fu)背(bei)(bei)(bei)誦(song)，每次上(shang)(shang)(shang)課(ke)(ke)(ke)前都(dou)(dou)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)檢查督促(cu)，并(bing)定(ding)期在(zai)課(ke)(ke)(ke)堂(tang)上(shang)(shang)(shang)默寫方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)。好(hao)(hao)多經(jing)過(guo)(guo)(guo)見、實(shi)(shi)習(xi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)同(tong)(tong)(tong)(tong)(tong)(tong)學(xue)(xue)(xue)(xue)(xue)都(dou)(dou)感受到(dao)(dao)了當(dang)時(shi)(shi)上(shang)(shang)(shang)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)課(ke)(ke)(ke)時(shi)(shi)為(wei)(wei)什么(me)老(lao)師(shi)一(yi)(yi)再(zai)(zai)強(qiang)(qiang)(qiang)調(diao)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)背(bei)(bei)(bei)熟(shu)(shu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)重(zhong)(zhong)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)性(xing)(xing)，因(yin)(yin)為(wei)(wei)只(zhi)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)熟(shu)(shu)練而(er)(er)(er)(er)準確(que)地(di)(di)(di)背(bei)(bei)(bei)誦(song)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)歌(ge)(ge)(ge)，臨(lin)(lin)床(chuang)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)才可(ke)(ke)能(neng)得(de)(de)心應手。 2 衍化(hua)(hua)(hua)(hua)(hua)延伸(shen)，擴展記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 這(zhe)(zhe)(zhe)種方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)法(fa)是(shi)(shi)將(jiang)(jiang)部分(fen)(fen)(fen)基(ji)(ji)礎(chu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)衍化(hua)(hua)(hua)(hua)(hua)出(chu)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)系(xi)(xi)列方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)或(huo)(huo)(huo)通過(guo)(guo)(guo)適當(dang)加(jia)(jia)減而(er)(er)(er)(er)變(bian)成(cheng)(cheng)(cheng)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)類(lei)(lei)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)進(jin)行(xing)縱橫梳理(li)(li)(li)(li)、總結(jie)(jie)(jie)延伸(shen)，有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)機(ji)地(di)(di)(di)聯(lian)系(xi)(xi)，觸類(lei)(lei)旁通，以(yi)(yi)(yi)擴展記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)。例(li)如(ru)(ru)(ru)四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)是(shi)(shi)補(bu)(bu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)基(ji)(ji)礎(chu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)，其(qi)(qi)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)為(wei)(wei)人(ren)參、白(bai)術、茯苓(ling)(ling)(ling)(ling)(ling)、炙甘(gan)草(cao)(cao)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)是(shi)(shi)益(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)健(jian)(jian)脾(pi)(pi)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)脾(pi)(pi)胃(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)證(zheng)(zheng)。若加(jia)(jia)陳皮(pi)(pi)名(ming)異(yi)(yi)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)散(san)(san)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)兼(jian)(jian)行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)化(hua)(hua)(hua)(hua)(hua)滯，適用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)于(yu)(yu)脾(pi)(pi)胃(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)兼(jian)(jian)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)滯證(zheng)(zheng)；加(jia)(jia)陳皮(pi)(pi)、半(ban)夏名(ming)六(liu)(liu)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)兼(jian)(jian)燥(zao)(zao)濕(shi)化(hua)(hua)(hua)(hua)(hua)痰(tan)，適用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)于(yu)(yu)脾(pi)(pi)胃(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)兼(jian)(jian)痰(tan)濕(shi)證(zheng)(zheng)；加(jia)(jia)陳皮(pi)(pi)、半(ban)夏、木香(xiang)、砂(sha)仁(ren)名(ming)香(xiang)砂(sha)六(liu)(liu)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)兼(jian)(jian)行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)化(hua)(hua)(hua)(hua)(hua)痰(tan)，適用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)于(yu)(yu)脾(pi)(pi)胃(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)，痰(tan)阻(zu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)滯證(zheng)(zheng)；四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)除(chu)(chu)可(ke)(ke)衍化(hua)(hua)(hua)(hua)(hua)出(chu)如(ru)(ru)(ru)上(shang)(shang)(shang)所(suo)(suo)述異(yi)(yi)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)散(san)(san)、六(liu)(liu)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、香(xiang)砂(sha)六(liu)(liu)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)等(deng)(deng)(deng)附方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)外(wai)(wai)，還(huan)(huan)可(ke)(ke)衍化(hua)(hua)(hua)(hua)(hua)為(wei)(wei)參苓(ling)(ling)(ling)(ling)(ling)白(bai)術散(san)(san)、補(bu)(bu)中(zhong)(zhong)益(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、歸(gui)(gui)(gui)(gui)脾(pi)(pi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)等(deng)(deng)(deng)正(zheng)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)。有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)時(shi)(shi)其(qi)(qi)藥(yao)(yao)(yao)(yao)味(wei)(wei)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)僅(jin)相(xiang)差一(yi)(yi)味(wei)(wei)而(er)(er)(er)(er)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)就(jiu)(jiu)大(da)不(bu)相(xiang)同(tong)(tong)(tong)(tong)(tong)(tong)，歸(gui)(gui)(gui)(gui)類(lei)(lei)也不(bu)一(yi)(yi)樣(yang)，如(ru)(ru)(ru)四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)去(qu)(qu)(qu)佐藥(yao)(yao)(yao)(yao)茯苓(ling)(ling)(ling)(ling)(ling)加(jia)(jia)干姜(jiang)為(wei)(wei)君(jun)(jun)名(ming)理(li)(li)(li)(li)中(zhong)(zhong)丸(wan)，歸(gui)(gui)(gui)(gui)在(zai)溫(wen)里劑(ji)(ji)(ji)(ji)(ji)(ji)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)以(yi)(yi)(yi)溫(wen)中(zhong)(zhong)祛(qu)(qu)寒(han)(han)(han)(han)為(wei)(wei)主(zhu)(zhu)(zhu)(zhu)，適用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)于(yu)(yu)中(zhong)(zhong)焦(jiao)虛(xu)寒(han)(han)(han)(han)證(zheng)(zheng)；四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)去(qu)(qu)(qu)君(jun)(jun)藥(yao)(yao)(yao)(yao)人(ren)參加(jia)(jia)桂(gui)枝(zhi)為(wei)(wei)臣名(ming)苓(ling)(ling)(ling)(ling)(ling)桂(gui)術甘(gan)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)為(wei)(wei)溫(wen)陽(yang)(yang)(yang)化(hua)(hua)(hua)(hua)(hua)飲(yin)(yin)，健(jian)(jian)脾(pi)(pi)利(li)(li)(li)濕(shi)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)中(zhong)(zhong)陽(yang)(yang)(yang)不(bu)足(zu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)痰(tan)飲(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)，此(ci)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)屬(shu)于(yu)(yu)祛(qu)(qu)濕(shi)劑(ji)(ji)(ji)(ji)(ji)(ji)中(zhong)(zhong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)溫(wen)化(hua)(hua)(hua)(hua)(hua)寒(han)(han)(han)(han)濕(shi)劑(ji)(ji)(ji)(ji)(ji)(ji)。其(qi)(qi)它如(ru)(ru)(ru)健(jian)(jian)脾(pi)(pi)丸(wan)、枳實(shi)(shi)消痞(pi)丸(wan)、布袋丸(wan)、八珍湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)等(deng)(deng)(deng)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)都(dou)(dou)可(ke)(ke)以(yi)(yi)(yi)說是(shi)(shi)四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)衍化(hua)(hua)(hua)(hua)(hua)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)。筆(bi)(bi)(bi)者(zhe)體會到(dao)(dao)重(zhong)(zhong)點(dian)(dian)掌(zhang)握這(zhe)(zhe)(zhe)類(lei)(lei)基(ji)(ji)礎(chu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)、功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)以(yi)(yi)(yi)后(hou)(hou)，通過(guo)(guo)(guo)擴展，就(jiu)(jiu)容(rong)易(yi)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)住(zhu)更多相(xiang)關聯(lian)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)。 3 理(li)(li)(li)(li)解(jie)貫(guan)通，加(jia)(jia)深(shen)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 理(li)(li)(li)(li)解(jie)是(shi)(shi)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)基(ji)(ji)礎(chu)，方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)、方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)義(yi)、用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)法(fa)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)、功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)（治(zhi)(zhi)(zhi)(zhi)法(fa)）、主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)等(deng)(deng)(deng)內(nei)(nei)(nei)容(rong)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)間有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)著內(nei)(nei)(nei)在(zai)聯(lian)系(xi)(xi)，只(zhi)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)深(shen)刻理(li)(li)(li)(li)解(jie)，融會貫(guan)通，在(zai)理(li)(li)(li)(li)解(jie)貫(guan)通的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)基(ji)(ji)礎(chu)上(shang)(shang)(shang)，才能(neng)加(jia)(jia)深(shen)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)。例(li)如(ru)(ru)(ru)寒(han)(han)(han)(han)下(xia)(xia)(xia)(xia)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)大(da)承(cheng)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)中(zhong)(zhong)大(da)黃(huang)(huang)瀉(xie)(xie)熱通便(bian)，蕩滌胃(wei)腸實(shi)(shi)熱積滯；芒(mang)(mang)硝(xiao)軟堅潤(run)燥(zao)(zao)，以(yi)(yi)(yi)除(chu)(chu)燥(zao)(zao)堅；厚(hou)(hou)樸(pu)下(xia)(xia)(xia)(xia)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)除(chu)(chu)滿(man)；枳實(shi)(shi)行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)消痞(pi)；其(qi)(qi)煎服方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)法(fa)為(wei)(wei)先煎枳實(shi)(shi)、厚(hou)(hou)樸(pu)，后(hou)(hou)下(xia)(xia)(xia)(xia)大(da)黃(huang)(huang)，芒(mang)(mang)硝(xiao)溶服，且厚(hou)(hou)樸(pu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)倍于(yu)(yu)大(da)黃(huang)(huang)，故瀉(xie)(xie)下(xia)(xia)(xia)(xia)與(yu)行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)并(bing)重(zhong)(zhong)，攻下(xia)(xia)(xia)(xia)力(li)(li)最峻，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)痞(pi)、滿(man)、燥(zao)(zao)、實(shi)(shi)俱(ju)備之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)明(ming)(ming)熱結(jie)(jie)(jie)重(zhong)(zhong)證(zheng)(zheng)，為(wei)(wei)峻下(xia)(xia)(xia)(xia)劑(ji)(ji)(ji)(ji)(ji)(ji)；而(er)(er)(er)(er)小(xiao)(xiao)承(cheng)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)則不(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)芒(mang)(mang)硝(xiao)，厚(hou)(hou)樸(pu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)為(wei)(wei)大(da)黃(huang)(huang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)半(ban)，且三物(wu)同(tong)(tong)(tong)(tong)(tong)(tong)煎，故瀉(xie)(xie)下(xia)(xia)(xia)(xia)熱結(jie)(jie)(jie)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)力(li)(li)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)輕(qing)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)痞(pi)、滿(man)、實(shi)(shi)而(er)(er)(er)(er)不(bu)燥(zao)(zao)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)明(ming)(ming)熱結(jie)(jie)(jie)輕(qing)證(zheng)(zheng)，為(wei)(wei)輕(qing)下(xia)(xia)(xia)(xia)劑(ji)(ji)(ji)(ji)(ji)(ji)；調(diao)胃(wei)承(cheng)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)不(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)枳實(shi)(shi)、厚(hou)(hou)樸(pu)，芒(mang)(mang)硝(xiao)溶服，大(da)黃(huang)(huang)與(yu)甘(gan)草(cao)(cao)同(tong)(tong)(tong)(tong)(tong)(tong)煎，故瀉(xie)(xie)下(xia)(xia)(xia)(xia)熱結(jie)(jie)(jie)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)力(li)(li)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)緩(huan)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)燥(zao)(zao)、實(shi)(shi)同(tong)(tong)(tong)(tong)(tong)(tong)見而(er)(er)(er)(er)無痞(pi)、滿(man)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)明(ming)(ming)熱結(jie)(jie)(jie)證(zheng)(zheng)，為(wei)(wei)緩(huan)下(xia)(xia)(xia)(xia)劑(ji)(ji)(ji)(ji)(ji)(ji)。這(zhe)(zhe)(zhe)就(jiu)(jiu)從組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)、用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)量(liang)(liang)、煎法(fa)等(deng)(deng)(deng)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)變(bian)化(hua)(hua)(hua)(hua)(hua)來(lai)理(li)(li)(li)(li)解(jie)和(he)(he)(he)(he)推斷其(qi)(qi)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)及主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)差異(yi)(yi)。再(zai)(zai)如(ru)(ru)(ru)藥(yao)(yao)(yao)(yao)味(wei)(wei)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)多的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)獨(du)活(huo)寄(ji)生(sheng)(sheng)(sheng)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，相(xiang)關內(nei)(nei)(nei)容(rong)比較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)難(nan)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)，但根(gen)(gen)據臨(lin)(lin)床(chuang)辨(bian)證(zheng)(zheng)論治(zhi)(zhi)(zhi)(zhi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)思路，可(ke)(ke)從主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)病(bing)(bing)(bing)(bing)(bing)(bing)因(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)入手。該方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)久痹(bi)證(zheng)(zheng)，其(qi)(qi)病(bing)(bing)(bing)(bing)(bing)(bing)因(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)特點(dian)(dian)是(shi)(shi)風(feng)寒(han)(han)(han)(han)濕(shi)邪合而(er)(er)(er)(er)為(wei)(wei)痹(bi)，日久不(bu)愈，累及肝(gan)(gan)腎(shen)，耗傷氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)血(xue)(xue)(xue)，故治(zhi)(zhi)(zhi)(zhi)療（即功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)）既要(yao)(yao)(yao)(yao)(yao)(yao)(yao)祛(qu)(qu)風(feng)濕(shi)，止(zhi)痹(bi)痛(tong)(tong)(tong)，又要(yao)(yao)(yao)(yao)(yao)(yao)(yao)益(yi)肝(gan)(gan)腎(shen)，補(bu)(bu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)血(xue)(xue)(xue)。在(zai)理(li)(li)(li)(li)解(jie)其(qi)(qi)病(bing)(bing)(bing)(bing)(bing)(bing)因(yin)(yin)、病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)、立法(fa)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)后(hou)(hou)，再(zai)(zai)分(fen)(fen)(fen)析(xi)其(qi)(qi)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)藥(yao)(yao)(yao)(yao)物(wu)和(he)(he)(he)(he)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)義(yi)：方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)名(ming)上(shang)(shang)(shang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)兩藥(yao)(yao)(yao)(yao)獨(du)活(huo)和(he)(he)(he)(he)桑寄(ji)生(sheng)(sheng)(sheng)，既祛(qu)(qu)風(feng)濕(shi)，又益(yi)肝(gan)(gan)腎(shen)；秦艽、防(fang)風(feng)、細辛(xin)、桂(gui)心助(zhu)獨(du)活(huo)祛(qu)(qu)風(feng)濕(shi)止(zhi)痹(bi)痛(tong)(tong)(tong)，溫(wen)經(jing)散(san)(san)寒(han)(han)(han)(han)；牛膝、杜仲助(zhu)桑寄(ji)生(sheng)(sheng)(sheng)補(bu)(bu)益(yi)肝(gan)(gan)腎(shen)，強(qiang)(qiang)(qiang)壯筋骨；以(yi)(yi)(yi)四(si)(si)(si)(si)(si)(si)物(wu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)（當(dang)歸(gui)(gui)(gui)(gui)、川芎、地(di)(di)(di)黃(huang)(huang)、白(bai)芍）養血(xue)(xue)(xue)活(huo)血(xue)(xue)(xue)，寓“治(zhi)(zhi)(zhi)(zhi)風(feng)先治(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)，血(xue)(xue)(xue)行(xing)風(feng)自滅”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)意(yi)；以(yi)(yi)(yi)四(si)(si)(si)(si)(si)(si)君(jun)(jun)子(zi)(zi)(zi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)（去(qu)(qu)(qu)白(bai)術）益(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)健(jian)(jian)脾(pi)(pi)，助(zhu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)血(xue)(xue)(xue)生(sheng)(sheng)(sheng)化(hua)(hua)(hua)(hua)(hua)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)源(yuan)。同(tong)(tong)(tong)(tong)(tong)(tong)學(xue)(xue)(xue)(xue)(xue)們(men)覺得(de)(de)通過(guo)(guo)(guo)老(lao)師(shi)在(zai)課(ke)(ke)(ke)堂(tang)上(shang)(shang)(shang)對(dui)(dui)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)進(jin)行(xing)這(zhe)(zhe)(zhe)樣(yang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)分(fen)(fen)(fen)析(xi)、推導(dao)、貫(guan)通，不(bu)但容(rong)易(yi)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)，而(er)(er)(er)(er)且印象(xiang)深(shen)，記(ji)(ji)(ji)(ji)(ji)(ji)(ji)得(de)(de)牢，可(ke)(ke)謂終生(sheng)(sheng)(sheng)難(nan)忘。 4 抓(zhua)住(zhu)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)點(dian)(dian)，巧妙(miao)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 中(zhong)(zhong)醫方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)掌(zhang)握記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)內(nei)(nei)(nei)容(rong)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)多，如(ru)(ru)(ru)何熟(shu)(shu)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)也得(de)(de)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)個技(ji)巧問題，老(lao)師(shi)在(zai)教(jiao)學(xue)(xue)(xue)(xue)(xue)過(guo)(guo)(guo)程中(zhong)(zhong)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)善于(yu)(yu)指導(dao)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)尋找記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)竅門(men)(men)。例(li)如(ru)(ru)(ru)在(zai)講解(jie)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)時(shi)(shi)，根(gen)(gen)據“以(yi)(yi)(yi)法(fa)統(tong)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)”的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)原則，筆(bi)(bi)(bi)者(zhe)首先要(yao)(yao)(yao)(yao)(yao)(yao)(yao)求(qiu)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)住(zhu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)分(fen)(fen)(fen)類(lei)(lei)，在(zai)明(ming)(ming)確(que)共(gong)(gong)性(xing)(xing)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)基(ji)(ji)礎(chu)上(shang)(shang)(shang)，再(zai)(zai)抓(zhua)住(zhu)一(yi)(yi)些(xie)(xie)知(zhi)識(shi)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)點(dian)(dian)區別(bie)(bie)其(qi)(qi)個性(xing)(xing)。以(yi)(yi)(yi)理(li)(li)(li)(li)血(xue)(xue)(xue)劑(ji)(ji)(ji)(ji)(ji)(ji)中(zhong)(zhong)活(huo)血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)為(wei)(wei)例(li)，其(qi)(qi)共(gong)(gong)性(xing)(xing)都(dou)(dou)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)活(huo)血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，而(er)(er)(er)(er)桃(tao)核(he)承(cheng)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)中(zhong)(zhong)因(yin)(yin)含有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)調(diao)胃(wei)承(cheng)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)中(zhong)(zhong)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)大(da)黃(huang)(huang)和(he)(he)(he)(he)芒(mang)(mang)硝(xiao)，故兼(jian)(jian)下(xia)(xia)(xia)(xia)淤(yu)(yu)(yu)瀉(xie)(xie)熱作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，因(yin)(yin)主(zhu)(zhu)(zhu)(zhu)藥(yao)(yao)(yao)(yao)桃(tao)核(he)，祛(qu)(qu)淤(yu)(yu)(yu)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)強(qiang)(qiang)(qiang)，故有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)教(jiao)材(cai)(cai)稱逐(zhu)淤(yu)(yu)(yu)或(huo)(huo)(huo)破(po)血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)；血(xue)(xue)(xue)府(fu)逐(zhu)淤(yu)(yu)(yu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)除(chu)(chu)含有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)桃(tao)紅四(si)(si)(si)(si)(si)(si)物(wu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，還(huan)(huan)寓有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)四(si)(si)(si)(si)(si)(si)逆(ni)散(san)(san)加(jia)(jia)味(wei)(wei)，故功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)除(chu)(chu)活(huo)血(xue)(xue)(xue)化(hua)(hua)(hua)(hua)(hua)淤(yu)(yu)(yu)外(wai)(wai)，尚有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)止(zhi)痛(tong)(tong)(tong)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)；補(bu)(bu)陽(yang)(yang)(yang)還(huan)(huan)五(wu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)重(zhong)(zhong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)生(sheng)(sheng)(sheng)黃(huang)(huang)芪，意(yi)在(zai)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)旺血(xue)(xue)(xue)行(xing)，用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)桃(tao)紅四(si)(si)(si)(si)(si)(si)物(wu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)去(qu)(qu)(qu)生(sheng)(sheng)(sheng)地(di)(di)(di)活(huo)血(xue)(xue)(xue)，加(jia)(jia)地(di)(di)(di)龍(long)通絡，故其(qi)(qi)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)為(wei)(wei)補(bu)(bu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)，活(huo)血(xue)(xue)(xue)，通絡；復(fu)元(yuan)(yuan)活(huo)血(xue)(xue)(xue)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)治(zhi)(zhi)(zhi)(zhi)跌打損傷，脅肋淤(yu)(yu)(yu)腫(zhong)疼(teng)痛(tong)(tong)(tong)，藥(yao)(yao)(yao)(yao)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)柴胡(hu)、穿山甲等(deng)(deng)(deng)，故尚有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)疏(shu)肝(gan)(gan)通絡作(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，本(ben)(ben)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)可(ke)(ke)趣記(ji)(ji)(ji)(ji)(ji)(ji)(ji)為(wei)(wei)：將(jiang)(jiang)軍（大(da)黃(huang)(huang)）穿山，桃(tao)花(hua)（粉）紅，柴草(cao)(cao)貴（歸(gui)(gui)(gui)(gui)），再(zai)(zai)通過(guo)(guo)(guo)聯(lian)想便(bian)可(ke)(ke)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)其(qi)(qi)藥(yao)(yao)(yao)(yao)物(wu)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)；溫(wen)經(jing)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)為(wei)(wei)寒(han)(han)(han)(han)、熱、虛(xu)、實(shi)(shi)（淤(yu)(yu)(yu)），組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)抓(zhua)住(zhu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)、血(xue)(xue)(xue)、陰、陽(yang)(yang)(yang)，補(bu)(bu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)人(ren)參、甘(gan)草(cao)(cao)，養血(xue)(xue)(xue)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)當(dang)歸(gui)(gui)(gui)(gui)、芍藥(yao)(yao)(yao)(yao)、川芎（四(si)(si)(si)(si)(si)(si)物(wu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)去(qu)(qu)(qu)地(di)(di)(di)黃(huang)(huang)），滋陰清虛(xu)熱用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)阿膠、麥(mai)冬，溫(wen)陽(yang)(yang)(yang)（經(jing)）祛(qu)(qu)寒(han)(han)(han)(han)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)吳茱(zhu)萸、桂(gui)枝(zhi)（共(gong)(gong)為(wei)(wei)君(jun)(jun)藥(yao)(yao)(yao)(yao)）和(he)(he)(he)(he)生(sheng)(sheng)(sheng)姜(jiang)，再(zai)(zai)加(jia)(jia)丹(dan)皮(pi)(pi)活(huo)血(xue)(xue)(xue)散(san)(san)淤(yu)(yu)(yu)，又清血(xue)(xue)(xue)分(fen)(fen)(fen)虛(xu)熱，半(ban)夏通降胃(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)，有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)助(zhu)于(yu)(yu)祛(qu)(qu)淤(yu)(yu)(yu)調(diao)經(jing)，諸藥(yao)(yao)(yao)(yao)共(gong)(gong)奏溫(wen)經(jing)散(san)(san)寒(han)(han)(han)(han)，養血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)；生(sheng)(sheng)(sheng)化(hua)(hua)(hua)(hua)(hua)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)因(yin)(yin)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)產(chan)后(hou)(hou)虛(xu)血(xue)(xue)(xue)寒(han)(han)(han)(han)凝淤(yu)(yu)(yu)阻(zu)胞宮之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)惡露不(bu)行(xing)，小(xiao)(xiao)腹冷痛(tong)(tong)(tong)，故功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)為(wei)(wei)養血(xue)(xue)(xue)溫(wen)經(jing)，祛(qu)(qu)淤(yu)(yu)(yu)止(zhi)痛(tong)(tong)(tong)。其(qi)(qi)它如(ru)(ru)(ru)失笑散(san)(san)：活(huo)血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)，散(san)(san)結(jie)(jie)(jie)止(zhi)痛(tong)(tong)(tong)；活(huo)絡效靈(ling)丹(dan)；活(huo)血(xue)(xue)(xue)祛(qu)(qu)淤(yu)(yu)(yu)，通絡止(zhi)痛(tong)(tong)(tong)（功(gong)(gong)(gong)(gong)(gong)(gong)(gong)似復(fu)元(yuan)(yuan)活(huo)血(xue)(xue)(xue)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)）；丹(dan)參飲(yin)(yin)：活(huo)血(xue)(xue)(xue)化(hua)(hua)(hua)(hua)(hua)淤(yu)(yu)(yu)，行(xing)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)止(zhi)痛(tong)(tong)(tong)（效同(tong)(tong)(tong)(tong)(tong)(tong)血(xue)(xue)(xue)府(fu)逐(zhu)淤(yu)(yu)(yu)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)而(er)(er)(er)(er)力(li)(li)弱）；桂(gui)枝(zhi)茯苓(ling)(ling)(ling)(ling)(ling)丸(wan)：活(huo)血(xue)(xue)(xue)化(hua)(hua)(hua)(hua)(hua)淤(yu)(yu)(yu)而(er)(er)(er)(er)緩(huan)消塊等(deng)(deng)(deng)。學(xue)(xue)(xue)(xue)(xue)習(xi)中(zhong)(zhong)只(zhi)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)抓(zhua)住(zhu)了主(zhu)(zhu)(zhu)(zhu)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)知(zhi)識(shi)點(dian)(dian)，才可(ke)(ke)能(neng)類(lei)(lei)推其(qi)(qi)它，也就(jiu)(jiu)便(bian)于(yu)(yu)巧記(ji)(ji)(ji)(ji)(ji)(ji)(ji)這(zhe)(zhe)(zhe)一(yi)(yi)類(lei)(lei)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)重(zhong)(zhong)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)內(nei)(nei)(nei)容(rong)。 5 歸(gui)(gui)(gui)(gui)納對(dui)(dui)比，強(qiang)(qiang)(qiang)化(hua)(hua)(hua)(hua)(hua)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 在(zai)同(tong)(tong)(tong)(tong)(tong)(tong)章(zhang)、同(tong)(tong)(tong)(tong)(tong)(tong)節(jie)或(huo)(huo)(huo)同(tong)(tong)(tong)(tong)(tong)(tong)類(lei)(lei)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)某(mou)些(xie)(xie)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)中(zhong)(zhong)，其(qi)(qi)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)、功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)和(he)(he)(he)(he)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)相(xiang)似之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)處(chu)，因(yin)(yin)此(ci)對(dui)(dui)這(zhe)(zhe)(zhe)樣(yang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)要(yao)(yao)(yao)(yao)(yao)(yao)(yao)加(jia)(jia)以(yi)(yi)(yi)歸(gui)(gui)(gui)(gui)納比較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)，找出(chu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)與(yu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)間的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)異(yi)(yi)同(tong)(tong)(tong)(tong)(tong)(tong)，尋求(qiu)共(gong)(gong)同(tong)(tong)(tong)(tong)(tong)(tong)點(dian)(dian)，區別(bie)(bie)不(bu)同(tong)(tong)(tong)(tong)(tong)(tong)點(dian)(dian)。如(ru)(ru)(ru)五(wu)苓(ling)(ling)(ling)(ling)(ling)散(san)(san)和(he)(he)(he)(he)豬苓(ling)(ling)(ling)(ling)(ling)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)，兩方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)相(xiang)同(tong)(tong)(tong)(tong)(tong)(tong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)(yao)物(wu)是(shi)(shi)茯苓(ling)(ling)(ling)(ling)(ling)、豬苓(ling)(ling)(ling)(ling)(ling)、澤瀉(xie)(xie)，功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)利(li)(li)(li)水滲濕(shi)，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)小(xiao)(xiao)便(bian)不(bu)利(li)(li)(li)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)。不(bu)同(tong)(tong)(tong)(tong)(tong)(tong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)是(shi)(shi)：五(wu)苓(ling)(ling)(ling)(ling)(ling)散(san)(san)中(zhong)(zhong)尚有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)桂(gui)枝(zhi)、白(bai)術，溫(wen)陽(yang)(yang)(yang)健(jian)(jian)脾(pi)(pi)以(yi)(yi)(yi)化(hua)(hua)(hua)(hua)(hua)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)利(li)(li)(li)水，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)外(wai)(wai)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)表證(zheng)(zheng)，內(nei)(nei)(nei)停水飲(yin)(yin)；而(er)(er)(er)(er)豬苓(ling)(ling)(ling)(ling)(ling)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)尚有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)滑(hua)石(shi)、阿膠，清熱養陰以(yi)(yi)(yi)潤(run)燥(zao)(zao)利(li)(li)(li)水，主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)水熱互結(jie)(jie)(jie)，邪熱傷陰之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)。有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)些(xie)(xie)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)，盡(jin)(jin)管分(fen)(fen)(fen)屬(shu)在(zai)不(bu)同(tong)(tong)(tong)(tong)(tong)(tong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)章(zhang)節(jie)，因(yin)(yin)其(qi)(qi)藥(yao)(yao)(yao)(yao)物(wu)組(zu)(zu)(zu)(zu)成(cheng)(cheng)(cheng)部分(fen)(fen)(fen)相(xiang)同(tong)(tong)(tong)(tong)(tong)(tong)，也有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)其(qi)(qi)共(gong)(gong)性(xing)(xing)所(suo)(suo)在(zai)，可(ke)(ke)跨章(zhang)節(jie)前后(hou)(hou)聯(lian)系(xi)(xi)對(dui)(dui)比，同(tong)(tong)(tong)(tong)(tong)(tong)中(zhong)(zhong)求(qiu)異(yi)(yi)，異(yi)(yi)中(zhong)(zhong)析(xi)同(tong)(tong)(tong)(tong)(tong)(tong)，如(ru)(ru)(ru)桂(gui)枝(zhi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)與(yu)小(xiao)(xiao)建中(zhong)(zhong)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、小(xiao)(xiao)青龍(long)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)與(yu)苓(ling)(ling)(ling)(ling)(ling)甘(gan)五(wu)味(wei)(wei)姜(jiang)辛(xin)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、蒿苓(ling)(ling)(ling)(ling)(ling)清膽(dan)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)與(yu)溫(wen)膽(dan)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、導(dao)赤散(san)(san)與(yu)小(xiao)(xiao)薊飲(yin)(yin)子(zi)(zi)(zi)等(deng)(deng)(deng)。有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)些(xie)(xie)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)證(zheng)(zheng)類(lei)(lei)似的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)，其(qi)(qi)病(bing)(bing)(bing)(bing)(bing)(bing)因(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)機(ji)和(he)(he)(he)(he)具(ju)體癥(zheng)狀(zhuang)都(dou)(dou)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)一(yi)(yi)些(xie)(xie)差異(yi)(yi)，亦可(ke)(ke)以(yi)(yi)(yi)比較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)鑒別(bie)(bie)，強(qiang)(qiang)(qiang)化(hua)(hua)(hua)(hua)(hua)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)，如(ru)(ru)(ru)治(zhi)(zhi)(zhi)(zhi)療久瀉(xie)(xie)久痢的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)就(jiu)(jiu)有(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)(you)真(zhen)人(ren)養臟湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、四(si)(si)(si)(si)(si)(si)神(shen)丸(wan)、補(bu)(bu)中(zhong)(zhong)益(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)(tang)、烏梅丸(wan)等(deng)(deng)(deng)。總之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)，方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)間可(ke)(ke)以(yi)(yi)(yi)比較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)內(nei)(nei)(nei)容(rong)較(jiao)(jiao)(jiao)(jiao)(jiao)(jiao)多，筆(bi)(bi)(bi)者(zhe)一(yi)(yi)般利(li)(li)(li)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)多媒體課(ke)(ke)(ke)件(jian)將(jiang)(jiang)其(qi)(qi)制成(cheng)(cheng)(cheng)圖表，以(yi)(yi)(yi)形象(xiang)、直觀(guan)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)效果(guo)，使(shi)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)一(yi)(yi)目(mu)了然。 6 聯(lian)系(xi)(xi)臨(lin)(lin)床(chuang)，鞏(gong)(gong)固(gu)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi) 中(zhong)(zhong)醫學(xue)(xue)(xue)(xue)(xue)本(ben)(ben)身是(shi)(shi)一(yi)(yi)門(men)(men)實(shi)(shi)踐性(xing)(xing)很(hen)強(qiang)(qiang)(qiang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)應用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)性(xing)(xing)學(xue)(xue)(xue)(xue)(xue)科，學(xue)(xue)(xue)(xue)(xue)習(xi)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)目(mu)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)就(jiu)(jiu)是(shi)(shi)為(wei)(wei)了應用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，因(yin)(yin)此(ci)在(zai)教(jiao)學(xue)(xue)(xue)(xue)(xue)中(zhong)(zhong)結(jie)(jie)(jie)合方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)主(zhu)(zhu)(zhu)(zhu)治(zhi)(zhi)(zhi)(zhi)和(he)(he)(he)(he)自己(ji)臨(lin)(lin)床(chuang)使(shi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)這(zhe)(zhe)(zhe)些(xie)(xie)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)經(jing)驗講一(yi)(yi)些(xie)(xie)現(xian)(xian)代應用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)，這(zhe)(zhe)(zhe)樣(yang)可(ke)(ke)以(yi)(yi)(yi)培(pei)養學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)分(fen)(fen)(fen)析(xi)、運(yun)(yun)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)成(cheng)(cheng)(cheng)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)以(yi)(yi)(yi)及臨(lin)(lin)證(zheng)(zheng)組(zu)(zu)(zu)(zu)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)能(neng)力(li)(li)，體會方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)運(yun)(yun)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)規律(lv)和(he)(he)(he)(he)靈(ling)活(huo)性(xing)(xing)，開拓(tuo)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)視野。與(yu)此(ci)同(tong)(tong)(tong)(tong)(tong)(tong)時(shi)(shi)，可(ke)(ke)根(gen)(gen)據所(suo)(suo)學(xue)(xue)(xue)(xue)(xue)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)功(gong)(gong)(gong)(gong)(gong)(gong)(gong)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)、適應證(zheng)(zheng)精(jing)選病(bing)(bing)(bing)(bing)(bing)(bing)案，安排(pai)一(yi)(yi)定(ding)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)時(shi)(shi)間組(zu)(zu)(zu)(zu)織學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)討(tao)論，從而(er)(er)(er)(er)進(jin)一(yi)(yi)步加(jia)(jia)深(shen)其(qi)(qi)對(dui)(dui)所(suo)(suo)講方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)印象(xiang)和(he)(he)(he)(he)理(li)(li)(li)(li)解(jie)，鞏(gong)(gong)固(gu)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)內(nei)(nei)(nei)容(rong)，通過(guo)(guo)(guo)具(ju)體病(bing)(bing)(bing)(bing)(bing)(bing)例(li)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)分(fen)(fen)(fen)析(xi)和(he)(he)(he)(he)討(tao)論，還(huan)(huan)可(ke)(ke)以(yi)(yi)(yi)活(huo)躍課(ke)(ke)(ke)堂(tang)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)氛，逐(zhu)漸(jian)將(jiang)(jiang)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)思維引向(xiang)臨(lin)(lin)床(chuang)，提高(gao)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)分(fen)(fen)(fen)析(xi)辨(bian)證(zheng)(zheng)思維能(neng)力(li)(li)，培(pei)養學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)綜合運(yun)(yun)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)(yong)所(suo)(suo)學(xue)(xue)(xue)(xue)(xue)知(zhi)識(shi)、解(jie)決實(shi)(shi)際問題的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)能(neng)力(li)(li)，為(wei)(wei)今后(hou)(hou)臨(lin)(lin)床(chuang)打下(xia)(xia)(xia)(xia)良好(hao)(hao)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)基(ji)(ji)礎(chu)。方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)學(xue)(xue)(xue)(xue)(xue)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)教(jiao)學(xue)(xue)(xue)(xue)(xue)實(shi)(shi)踐證(zheng)(zheng)明(ming)(ming)，課(ke)(ke)(ke)堂(tang)上(shang)(shang)(shang)適當(dang)地(di)(di)(di)穿插記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)法(fa)教(jiao)學(xue)(xue)(xue)(xue)(xue)，不(bu)僅(jin)能(neng)夠啟發學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)科學(xue)(xue)(xue)(xue)(xue)思維，開發智力(li)(li)和(he)(he)(he)(he)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)憶(yi)(yi)(yi)(yi)(yi)(yi)潛能(neng)，而(er)(er)(er)(er)且使(shi)學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)不(bu)再(zai)(zai)為(wei)(wei)方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)難(nan)記(ji)(ji)(ji)(ji)(ji)(ji)(ji)而(er)(er)(er)(er)苦惱，也避免了方(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)(fang)劑(ji)(ji)(ji)(ji)(ji)(ji)學(xue)(xue)(xue)(xue)(xue)教(jiao)學(xue)(xue)(xue)(xue)(xue)枯燥(zao)(zao)而(er)(er)(er)(er)單一(yi)(yi)的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)模式，增強(qiang)(qiang)(qiang)了學(xue)(xue)(xue)(xue)(xue)生(sheng)(sheng)(sheng)對(dui)(dui)該學(xue)(xue)(xue)(xue)(xue)科的(de)(de)(de)(de)(de)(de)(de)(de)(de)(de)學(xue)(xue)(xue)(xue)(xue)習(xi)興趣，鞏(gong)(gong)固(gu)了專業思想，教(jiao)學(xue)(xue)(xue)(xue)(xue)效果(guo)明(ming)(ming)顯(xian)得(de)(de)到(dao)(dao)提高(gao)。
黃褐斑是發生在面部的黃褐色.或灰黑色斑片，無痛無癢，起病緩慢，常見于女性患者的前額、眉頰、唇周、鼻背等顏面部。黃褐斑屬中醫“肝斑”之范疇，與女性妊娠、內分泌功能紊亂、生殖系統疾患、長期服用避孕藥、使用化妝品、紫外線照射等因素密切相關。近些年來，由于生活節奏加快和生活環境改變，黃褐斑患者日見增多，在辨證癥型上多采用活血化瘀、疏肝理氣、補腎疏肝法辨證治療，可以較為快速的祛除黃褐斑。
活血化瘀法
【醫案分享】患者劉某，女性，40歲，2006年8月16日初診，3年前顏面頰部開始出現黃褐色斑點，后逐漸擴大成片。其間伴有斷斷續續的胸脅脹痛，腰膝酸軟，此次因苦于腰痛及月經不調而求診。刻診:滿臉褐斑，以唇周左右兩側為主，兩目暗黑，舌邊瘀點，脈象遲澀。辨為氣機不展、瘀血阻絡。方用血府逐瘀湯加味，活血化瘀，理經消斑。
【開方組成】內服處方:桃仁，紅花，當歸，生地，川芎，赤芍，牛膝，桔梗，柴胡，枳殼，炙草，蔥白三節(節長寸許)，水煎服，每日一劑，連服7日為一個療程，月經期間停服。
外涂方:取鮮土貝母鱗莖，鮮何首烏塊根，將上藥洗凈，放入木桶或竹桶中，將水徐徐加入，用木棒杵爛為泥，然后過濾取汁，置冰箱內低溫貯存，每晚臨睡前搖勻，用毛筆蘸涂色斑處，至第二天晨起時洗去。兩個月后面部灰黑色斑片及滿臉散在點滴狀褐斑消失70%以上。原方繼續堅持治療一個月，皮損全部消退，顏面膚色正常。
【辨證思路】瘀積體內日久，影響氣機伸展，出現上述諸癥，故用活血化瘀之法，方用四逆散和血疏肝，桔梗載藥上行，枳殼寬胸，牛膝通利血脈、引血下行，加入蔥白取其通竅作用。鮮土貝母塊莖中含有大量的麥芽糖，具有散結毒、消腫之功效。鮮何首烏具有解毒、消癰、養血的功效，塊根中含有大量的卵磷脂，卵磷脂為構成神經組織的主要成分，同時為紅細胞及其他細胞膜的主要原料，并能促進紅細胞的新生及發育。患者內服外涂治療三個月，便使皮科頑疾告愈。
疏肝理氣法
【醫案分享】患者李某，女，46歲，2006年9月16日初診，一年前因工作失意，在家閑坐，逐漸出現神疲乏力、食欲減退、失眠煩躁，面部逐漸出現灰黑色斑片，尤以鼻背兩側左右眼眶下為著。患者自述，近四個月來每次月經均提前8天以上，并伴有經前明顯的乳房脹痛及腹痛。刻診:左右眼眶下錢幣狀對稱性灰黑色斑片，滿臉散在點滴狀褐斑，以唇周左右兩側為著，目窠微腫微青，六脈虛弦。
辨為肝郁血虛、脾失健運。治以疏肝健脾和營，方用丹梔逍遙散加味。
【開方組成】內服處方:熟地，柴胡，當歸，白芍，茯苓，白術，甘草，薄荷，生姜，丹皮，山梔。每日一劑，水煎分二次服，服五天，停一天，連服二月。外涂方仍用前方。兩個月后面部灰黑色斑片及滿臉散在點滴狀褐斑消失30%以上。原方內服外敷三個月，皮損全部消退。
【辨證思路】該患者肝郁日久，化火生熱，煎灼營血，故出現上述諸癥，此時用逍遙散已顯力薄勢單，故選用丹梔逍遙散合黑逍遙散，既解肝郁血虛，又瀉三焦之火，服用近半年，配合外涂方，使患者告愈。
補腎疏肝法
【醫案分享】患者王某，女，46歲，2005年7月7日初診，五年前面部出現黃褐色斑點，后逐漸擴展成片。口服祛斑西藥維生素C、維生素E，并外用3%氫釀霜后，有一定效果，但日曬后色斑更加明顯。四診所見:眩暈少寐，怠倦無力，伴腰膝酸軟，身體羸瘦。舌紅少苔，脈弦細。辨為肝腎陰虛，腎水不能上潤肌膚。
【開方組成】治以滋陰補腎疏肝，方用滋水清肝飲，處方:熟地，山藥，山茱萸，茯苓，丹皮，澤瀉，佛手，山梔，龜板，知母，共10劑，每日一劑，水煎分二次服。外涂方如前不變。二診時腰膝酸軟大減，黃褐斑消失50%以上。前方略加變通內服、外涂二月有余，顏面膚色正常，隨訪一年未見復發。
【辨證思路】中醫認為黑色素乃腎虛所致，肝腎陰虛，肝失疏泄，腎水不能上潤肌膚，而生黑斑。我們用滋陰補腎之法治其根本，佐疏肝之品，共奏補腎疏肝之功。氣血和，經絡通，則患者肌膚能榮，色斑能除。
#祛斑# #色斑# #皮膚(fu)#
柴胡疏肝散出自《醫學統旨》，該方是治療肝氣郁結之脅肋疼痛的常用方劑，以脅肋疼痛、太息稍舒、脈弦為辯證要點。以下是我為你精心整理的，希望你喜歡。
柴胡疏肝散處方
柴胡 6克;陳皮 6克;川芎 4.5克;香附 4.5克;枳殼 4.5克;芍藥 4.5克;炙甘草 1.5克;
柴胡疏肝散相關介紹
柴胡疏肝散是肝氣郁結，不得疏泄，氣郁導致血滯，故見脅肋疼痛諸癥。方用四逆散去枳實，加陳皮、枳殼、川芎、香附，增強疏肝行氣，活血止痛之效，故服后肝氣條達，血脈通暢，痛止而諸癥亦除。
該方癥病變在胃，病機在肝、脾、胃。脾胃居于中焦，中焦受阻，土虛木克，氣機郁滯則克脾犯胃，脾為后天之本，脾胃之氣為一身之氣的樞機，中氣虛弱則樞轉氣機被郁，導致中焦脾胃之氣升降失調，氣血執行受阻出現肝胃不和的一系列癥候。因此治療必須求本，本標結合，故疏肝理氣，暢通氣機，調理脾胃使之脾胃功能恢復。
方中白芍養肝斂陰，和胃止痛，與柴胡相伍一散一收，助柴胡疏肝，相反相成共為主藥;配枳實瀉脾氣之壅滯，調中焦之運動與柴胡同用一升一降，加強疏肝理氣之功，以達郁邪;白芍、甘草配伍緩急止痛，疏理肝氣以和脾胃，且具有保護胃粘膜屏障和修復粘膜之作用;川芎行氣開郁，活血止痛;厚樸、半夏以寬胸暢通宣泄郁氣;香附、陳皮理氣和胃止痛，且有助于消除上腹痛不適等癥。諸藥合用辛以散結，苦以降通，氣滯郁結方可解除。[1]
【功用】疏肝行氣，活血止痛。
【主治】肝氣郁滯證。脅肋疼痛，胸悶喜太息，情志抑郁易怒，或噯氣，脘腹脹滿，脈弦。
【出處】《證治準紀》引《醫學統旨》方。
【來源】《景岳全書》卷五十六。[2]
【組成】陳皮***醋炒*** 柴胡各6克川芎枳殼***麩炒***芍藥各4.5克甘草***炙***1.5克 香附4.5克。
【用法】用水220毫升，煎至180毫升，空腹時服。
【功用】疏肝解郁。
【主治】脅肋疼痛，寒熱往來。
【方解】柴胡疏肝散證是肝氣郁結，不得疏泄，氣郁導致血滯，故見脅肋疼痛諸癥。方用四逆散去枳實，加陳皮、枳殼、川芎、香附，增強疏肝行氣，活血止痛之效，故服后肝氣條達，血脈通暢，痛止而諸癥亦除。
方歌：柴胡疏肝芍藥芎，枳殼陳皮草香附，疏肝解郁行氣滯，脅肋疼痛自能除。
方歌：柴胡疏肝芍川芎，枳殼陳皮草香附，疏肝行氣兼活血，脅肋疼痛皆能除。
柴胡疏肝散相關作用
分開藥理作用
現代藥理研究表明，白芍對中樞神經系統有抑制作用，有鎮靜作用，并對平滑肌有松弛作用。柴胡主含皁甙及揮發油，有鎮靜和鎮痛作用，并有抗炎、利膽作用。陳皮主含揮發油有松弛平滑肌作用，有抗炎，抗潰瘍作用。香附含揮發油和糖類，可提高小鼠的痛閾，有鎮痛作用及健胃，驅除消化道積氣的作用。枳實含揮發油、黃酮甙等，有健胃作用。半夏有鎮吐作用。厚樸主含揮發油，對動物腸管平滑肌有興奮作用，對肌肉和神經有較輕的麻醉作用。
成藥柴胡疏肝丸作用
1.鎮痛，柴胡及香附的提取物能提高小鼠疼痛閾值，具有明顯鎮痛作用。
2.抗炎，柴胡、陳皮、香附、甘草均有抗炎作用，柴胡、陳皮及其所含成分對多種原因引起的血管通透性增加有抑制作用，柴胡還有抗肉芽腫的作用。香附、甘草及其所含成分能抑制角叉菜膠等致炎物質所致的大鼠足趾腫。
3.解痙，枳殼、陳皮、白芍、甘草對胃腸平滑肌均有抑制作用，能解除平滑肌痙攣。
4.護肝利膽，柴胡、甘草對四氯化碳等所致的實驗性肝損傷有明顯的保護作用，可使肝細胞的變化和壞死明顯減輕，陳皮、柴胡尚有利膽作用，可增加膽汁排出量及膽汁內固體物質的排泄量。
5.增加(jia)腦(nao)、肝(gan)(gan)(gan)血流(liu)(liu)(liu)和心搏(bo)出量，柴胡(hu)疏肝(gan)(gan)(gan)散對(dui)家兔腦(nao)，肝(gan)(gan)(gan)阻抗(kang)血流(liu)(liu)(liu)圖和心阻抗(kang)微分圖的影響實驗表明，柴胡(hu)疏肝(gan)(gan)(gan)散可使(shi)腦(nao)血管充(chong)盈度增加(jia)，搏(bo)動性血液供應(ying)增加(jia)，有利于改善(shan)腦(nao)回圈，增加(jia)肝(gan)(gan)(gan)動脈血流(liu)(liu)(liu)量，改善(shan)肝(gan)(gan)(gan)臟血液回圈，改善(shan)心肌收縮力，增加(jia)心搏(bo)出量。
當歸六黃湯 出自李東垣《蘭室秘藏》 ，被譽為“治盜汗之圣藥 ”。本方除治盜汗外，根據其組方還可廣泛的用于兒童多動癥、鼻衄、濕疹等病癥，凡屬氣陰虧損，心肝火旺 者均可以此方加減用之。方中黃芪 補肺健脾，益氣固表；三黃 清上、中、下三焦之熱，量少用還可苦寒健胃；當歸 熟地滋陰養血，又可制三黃苦燥寒涼；生地 滋陰(yin)涼血(xue)，養(yang)血(xue)通痹。諸藥補中(zhong)有瀉(xie)，寒溫并用，故收益氣(qi)固表，瀉(xie)火養(yang)陰(yin)之功效。
臨證對于胃脘痛 可用市售元胡止痛片 ，每次4-6片，口服日3次，或用市售胃蘇沖劑 治療，一次一袋，日3次，均有顯效。元胡止痛片 由延胡索 （醋制）、白芷 兩味中藥組成，具有理氣、活血、止痛功能，常用于氣滯血瘀治胃痛脅痛頭痛及痛經等；胃蘇沖 劑由紫蘇梗、香附、陳皮、香櫞、佛手、枳殼 等組成(cheng)，有理氣消脹和胃止痛(tong)功能(neng)。臨床主要(yao)用于氣滯所致的胃脘脹痛(tong)，可以降胃液酸度，保護胃粘(zhan)膜(mo)，保護潰瘍(yang)面，并能(neng)增加胃腸(chang)蠕動，上藥(yao)服兩周為一療程。
現代藥理研究表明沙參 可提高細胞免疫和非特異性免疫。沙參 有祛痰強心抗真菌作用。臨床上去牛蒡子、沙參、荊芥 三藥配伍對咳喘見胸部憋(bie)悶者有奇效，考慮三藥可能(neng)對肺絡有滋(zi)養和通暢(chang)作用(yong)，可資參考。
臨床藥理研究表明當歸、川芎 有抑制血小板凝集，降低血粘度，改善血液流變，對肺動脈有舒張作用，還能降低肺動脈壓，故在治療咳喘 方藥中將(jiang)二(er)藥加入應證方藥中常(chang)收(shou)良效。
現代臨床研究證明芍藥甘草湯 具有強大解痙 及抑制胃酸 分泌作用；黃連、吳茱萸 合用可抑制胃(wei)酸抗潰瘍(yang)，抑制胃(wei)內(nei)容物(wu)反流。以上四藥合用可以用反流性食管炎之治療，驗之有效。
四逆散 和溫膽湯 加穿山龍、莪術、蒲公英、厚樸 治療反流性食管炎（亦稱癥狀性胃食管反流病）有較好療效。方中穿山龍、莪術、竹茹 能改善食管粘膜血流改善微循環，緩解和消除粘膜充血水腫，清除胃絡瘀毒。方中竹茹 不僅取其化痰止嘔之功而且還能疏通胃絡。正如吳鞠通所謂：“以竹之脈絡而通人之脈絡 ”也。本藥對防(fang)止本病復(fu)發功不可沒，宜細體味。
張山雷 對牛蒡子 之功用有著獨到的見解，對學者有啟發作用。他在《張山雷醫案》中談到牛蒡子 時曰：“顆(ke)粒堅實，則重墜下行，亦順肺(fei)金(jin)右(you)降(jiang)之令(ling)，能(neng)通大腑（腸(chang)），使肺(fei)家之熱(re)下移，從大腸(chang)而泄，故大便不實者禁(jin)之，而溫熱(re)感證不忌，以(yi)地道(dao)即通，即為邪熱(re)辟一出(chu)路也。”
張山雷 認為白芍 “氣清味(wei)薄(bo)”，“雖號酸收而實則酸味(wei)最薄(bo)。但純陰沉(chen)降，能(neng)收攝肝脾腎渙散之(zhi)陰氣，降逆而固護臟真，厥功殊偉(wei)。”
細辛 單味3-5g泡水代茶飲用可治陰寒內盛之陽痿 ，連用2-3周可效。陰虛火旺及陽熱亢盛所致陽痿不宜。臨證治男子陽痿 常用四逆散 加熟地、細辛 ，療效尚滿意。
荊芥、防風 同入肺經，有疏風散寒之功，臨證常用于風寒咳嗽表證較重者。荊芥、薄荷 相伍，一辛溫(wen)，一辛涼(liang)，有辛散透表之力，臨(lin)證常(chang)用于風熱(re)咳(ke)嗽見汗出不徹(che)者(zhe)。
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