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汤液经法图角度分析60首常用补益方剂的组方配伍原理
著作人:金锐、郭红叶、张爽📅 2025
| 第31 卷第 12 期 | | 中国实验方剂学杂志 | | Vol.31,No.12 | | ----------- | --- | --------- | --- | ------------ | 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | 汤液经法图角度分析 | | 60首常用补益方剂的组方配伍原理 | | | | --------- | --- | ---------------- | --- | --- | 金锐 | | | 郭红叶, | 张爽, | | | --- | --- | ----- | ---- | --- | (中国中医科学院 西苑医院,北京 100091) | [摘要] | 目的:中药药性理论认为“甘能补”,似乎所有补益剂均应以甘味为主。但《辅行诀》所载“汤液经法图”认为,不同 | | | | | ----- | ---------------------------------------------------- | --- | ---
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| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | ||
|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | ||||
| 汤液经法图角度分析 | 60首常用补益方剂的组方配伍原理 | |||
| --------- | --- | ---------------- | --- | --- |
| 金锐* | ||||
| 郭红叶, | 张爽, | |||
| --- | --- | ----- | ---- | --- |
| (中国中医科学院 西苑医院,北京 100091) | ||||
| [摘要] | 目的:中药药性理论认为“甘能补”,似乎所有补益剂均应以甘味为主。但《辅行诀》所载“汤液经法图”认为,不同 | |||
| ----- | ---------------------------------------------------- | --- | --- | --- |
| 脏腑各有其补味,即辛补肝、咸补心、甘补脾,酸补肺,苦补肾,不同脏腑虚证应以不同药味为主。该文运用此方法,分析常见中 | ||||
| 医补益方剂的组方配伍原理和功效定位,为临床区别用药提供参考。方法:建立《方剂学》教材中补益类方剂数据库,采用 | ||||
| Excel软件分别统计补益方剂所使用的中药品种数、频次、药味、组方比例等,分类确定各方配伍结构和功效特点。结果:共纳 | ||||
| 入方剂共60首,分为6类,涉及用药110种 469次 。从“汤液经法图”角度看,不同补益剂的主导药味和定位脏腑不同。其中, | ||||
| ( ) | ||||
| 补气剂15首,配伍结构以“甘”补脾为主 补血剂9首,配伍结构以“辛-咸”补肝补心为主 气血双补剂7首,配伍结构以“甘-辛” | ||||
| ; ; | ||||
| 补脾补肝为主 | 补阴剂19首,配伍结构以“苦-酸”补肾补肺为主 | 补阳剂7首,药味结构以“辛-苦”补肝补肾为主 | 阴阳双补剂 | |
| ------ | ----------------------- | --- | ---------------------- | ----- |
| ; | ; | ; | ||
| 3首,配伍结构以“苦-辛-甘”补肾补肝补脾为主。结论:“汤液经法图”能够清晰展示各类补益方剂的组方配伍原理和主要区 | ||||
| 别,提示并非所有补益剂均以甘味为主,为临床组方加减提供新思路。 | ||||
| [关键词] | 辅行诀 补益方剂 汤液经法图 | 组方配伍 | ||
| ------ | ---------------- | ----- | --- | --- |
| ; ; | ; | |||
| [中图分类号] R289;R287;G256 [文献标识码] A [文章编号] 1005-9903(2025)12-0217-07 | ||||
| [doi] | 10.13422/j.cnki.syfjx.20241017 | |||
| --------- | ------------------------------------------------------- | --- | --- | --- |
| [网络出版地址] | https://link.cnki.net/urlid/11.3495.R.20240718.1100.001 | |||
| [网络出版日期] | 2024-07-19 14:31:58 | |||
| Formulation and Compatibility Laws of 60 Commonly Used Tonic Prescriptions from | ||||
| Perspective of Tangye Jingfa Tu | ||||
| GUO Hongye, ZHANG Shuang, JIN Rui* | ||||
| Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China | ||||
| ( | ) | |||
| --- | --- | --- | --- | --- |
| [[Abstract]] Objective:: According to the theory of medicinal properties in traditional Chinese medicine TCM , Tangye | ||||
| ( ) | ||||
| Jingfa Tu, implying that all tonic prescriptions should primarily feature sweetness. However, the "Chart of the Classic Methods of | ||||
| Decoction Therapy" recorded in Mnemonic Aids for Medical Practice( Fuxingjue proposes that each of the Zangfu organs has a | ||||
| ) | ||||
| corresponding tonifying flavor, i.e., pungent for the liver, salty for the heart, sweet for the spleen, sour for the lungs, and bitter | ||||
| for the kidneys. Therefore, deficiency syndromes of different organs should be primarily addressed with specific medicinal flavors. | ||||
| This study applies this theoretical framework to analyze the formulation and compatibility principles and efficacy positioning of | ||||
| commonly used TCM tonic prescriptions, providing a reference for differentiated clinical medication. Methods:: A database of | ||||
| tonic prescriptions was established based on the textbook Science of Prescriptions. Excel software was used to separately calculate | ||||
| the number of medicinal types, frequency of use, flavors, and proportional composition of the prescriptions. The prescriptions were | ||||
| categorized to determine their compatibility structures and functional characteristics. Results:: A total of 60 prescriptions were | ||||
| included, classified into six categories, involving 110 medicinal types with 469 instances of use. From the perspective of the "Chart | ||||
| of the Classic Methods of Decoction Therapy", different tonic prescriptions exhibit distinct dominant medicinal flavors and organ | ||||
| associations. Specifically, 15 Qi-tonifying prescriptions primarily adopted a "sweet flavor" to tonify the spleen. Nine blood- | ||||
| tonifying prescriptions primarily adopted a "pungent-salty flavor" to tonify the liver and heart. Seven Qi-and-blood-tonifying | ||||
| prescriptions primarily featured a "sweet-pungent flavor" to tonify the spleen and liver. Nineteen Yin-tonifying prescriptions | ||||
| [收稿日期] | 2024-04-12 | |||
| ------- | ---------- | --- | --- | --- |
| [基金项目] 中国中医科学院科技创新工程重大攻关项目(CI2021A03805);北京市中医管理局第三批中药骨干人才培养项目(京中医科 | ||||
| 字[2022]59号);全国中药特色技术传承人才培训项目(国中药教函[2023]96号) | ||||
| [第一作者] 郭红叶,硕士,副主任药师,从事中药药性理论及中药临床药学,E-mail:[email protected] | ||||
| [通信作者] * 金锐,博士,主任中药师,从事中药药性理论及中药临床药学,E-mail:[email protected] | ||||
| ·217· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | ||||
|---|---|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | ||||||
| primarily adopted a "bitter-sour flavor" to tonify the kidneys and lungs. Seven Yang-tonifying prescriptions primarily featured a | ||||||
| "pungent-bitter flavor" to tonify the liver and kidneys. Three Yin-and-Yang-tonifying prescriptions primarily featured a "bitter- | ||||||
| pungent-sweet flavor" to tonify the kidneys, liver, and spleen. Conclusion:: The "Chart of the Classic Methods of Decoction | ||||||
| Therapy" clearly illustrates the formulation and compatibility principles and key differences among various tonic prescriptions, | ||||||
| indicating that not all tonic prescriptions are predominantly sweet in flavor. This provides new insights for the clinical modification | ||||||
| and application of tonic prescriptions. | ||||||
| [[Keywords]] Mnemonic Aids for Medical Practice (Fuxingjue tonic prescriptions Tangye Jingfa Tu rules of | ||||||
| ); | ; | ; | ||||
| --- | --- | --- | --- | --- | --- | --- |
| compatibility and formulation | ||||||
| 《辅行诀五脏用药法药》下文简称《辅行诀》为敦煌遗 | ||||||
| ( | ) | |||||
| --- | --- | --- | --- | --- | --- | --- |
| 书,记载的方剂很好地体现了汉以前的用药规律,其中保留 | ||||||
| 的商代伊尹《汤液经法》的原图,即“汤液经法图”,又称“五味 | ||||||
| 体用补泻图”,见图1[1]。该图主要遵循的是中医五腑虚实辨 | ||||||
| 证理论,其独特之处在于中药“药味补泻”与“脏腑虚实”相对 | ||||||
| 应,清晰地展示处方配伍逻辑,有助于分析并掌握中医处方 | ||||||
| 配伍原理。陶弘景在《辅行诀》中提及:“凡学道辈,欲求永 | ||||||
| 年,先须祛疾……服药数剂,必使脏气平和……诸凡杂病,服 | ||||||
| 药汗、吐、下后,邪气虽平,精气被夺,致令五脏虚疲,当即据 | ||||||
| 证服补汤数剂以补之”“经方有救诸劳损病方,亦有五首”[1], | ||||||
| 书中所载五脏补汤皆分大小补汤,有非常严谨格式化的组方 | ||||||
| 规律,如小补汤符合“4 | 味药 | 2 补 1 泻 1 化 | ”,大补汤符 | |||
| ----------- | --------- | -------------------- | ------ | --- | --- | --- |
| ( | )( )( )( | ) | ||||
| 合“7 味药 | 4 补 2 泻 1 | 化 ”[2-3]。《辅行诀》所载方剂中具 | ||||
| ( | )( )( )( | ) | ||||
| 有明显补益作用的方剂为五脏救劳损方,此5首处方也表现 | ||||||
| 出比较相似的组方规律,5首处方皆由6味药组成,处方中其 | ||||||
| 主导药味是五脏的补味,如养生补肝汤中主导药味是辛味, | ||||||
| 图1 汤液经法图 | ||||||
| 宁气补肺汤主导药味是酸味。这为进一步研究相关具有补 | ||||||
| Fig.1 Tangye Jingfa Tu | ||||||
| 益功效的方剂提供了一定的理论参考[4]。目前各类疾病多 | ||||||
| 存在虚证,或虚实夹杂,或本虚标实,尤其是慢病、老年病患 | “汤液经法图”中所用中药药味源自其五行属性,有可能 | |||||
| ---------------------------- | --- | --- | -------------------------- | ------------------------- | --- | --- |
| 者多存在脏腑衰退,功能减弱,正气不足之象,“扶正祛邪” | 与目前本草记载不同,故需要对研究涉及的中药药味进行调 | |||||
| “固本培元”等扶正类治法是中医重要的治疗方法[5],其中 | 整与厘定。定义药味的五行属性理论依据主要来源于《辅行 | |||||
| 诀》[1]、《玄隐遗密》[10]中对药物五行属性的分类,定义方法主 | ||||||
| “补益剂”是中药方剂学中的重要的组成部分之一。中药药 | ||||||
| 性理论认为,“甘能补能缓”,似乎所有补益剂均应以甘味为 | 要参考2020年版《中国药典》和历代本草著作中关于中药药 | |||||
| ---------------------------- | --- | --- | ---------------------------- | --- | --- | --- |
| 主。但《辅行诀》所载“汤液经法图”认为,不同脏腑虚证一一 | 性记载,历代医家对中药性效功用的认识,包括从四气、五 | |||||
| 味、归经、升降沉浮、功效、真实滋味、性状、颜色、生长特点、 | ||||||
| 对应不同药味作为其补味。本文尝试从“汤液经法图”中五 | ||||||
| 产地特点、医家解说、代表方剂等内容,其中功效作为中药五 | ||||||
| 腑虚实辨证方法和五味补泻配伍的方法学入手,分析目前常 | ||||||
| 用补益方剂的五脏定位特点和五味配伍规律,为临床区别应 | 行属性最主要的依据来确定药物主导药味,根据此方法,课 | |||||
| ----------------------------------- | --- | --- | -------------------------------- | --- | --- | --- |
| 用与组方加减提供思路。 | 题组前期已经对150味药药味进行了论证[11-14],对于既往研 | |||||
| 1 资料与方法 | 究不涉及的中药,则依据上述方法重新调整。如女贞子重新 | |||||
| 1.1 数据来源 选择《方剂学》[6-7]教材中补益剂类项下所有 | 定义为苦、酸,锁阳为咸等。 | |||||
| 方剂 共60首 作为研究对象,参考教材分类,具体分为补 1.3 统计学方法 采用Excel 2021版软件分别统计补益方 | ||||||
| ( | ) | |||||
| -------------------------------- | --- | --- | ---------------------------- | --- | --- | --- |
| 气、补血、气血双补、补阴、补阳、阴阳并补6类。以人工录入 | 剂出现中药的品种数、频数、药味、各类处方中“甘、辛、苦、 | |||||
| 方式将60首方剂和中药名称逐一录入Excel表格。 | 咸、酸”五味药味的数量、主要药味配伍结构比例。中药药味 | |||||
| 1.2 数据处理 参照2020年版《中华人民共和国药典》简 | 有单一药味和复合药味,单一药味按整数统计,复合药味按 | |||||
| ( | ||||||
| 》[8]统一规范处方中出现的饮片名称,如缩砂 | 药味比例分别统计[15-16],如生姜味辛,在含有生姜的方剂中 | |||||
| --- | ---------------------- | --- | ------------------------------- | --- | --- | --- |
| 称《中国药典 | ||||||
| ) | ||||||
| 以1统计入辛味 | ||||||
| 仁统一为砂仁,莲子肉统一为莲子,广陈皮统一为陈皮等。 复合药味黄芪,味甘、辛,在含有黄芪的方 | ||||||
| ; | ||||||
| 2020年版《中国药典》未收载品种,按《卫生部药品标准中药 | 剂中分别按0.5统计入甘味,0.5统计入辛味。处方中主要药 | |||||
| ----------------------------- | --- | --- | ----------------------------- | --- | --- | --- |
| 成方制剂》《中华本草》及各地方标准中收录的正名予以规 | 味配伍结构比例计算方法为某种药味的药味数量总和/该处 | |||||
| 范,如麻仁统一为胡麻仁、真贝母统一为川贝母、獭肝统一为 | 方中所有药味数量总和的百分数,如四物汤中总药味数为 | |||||
| 水獭肝等[9]。 | 4,辛味药数量为1,苦味药数量为1,咸味药数量为1,酸味药 | |||||
| ·218· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | ||||||||||||||
| 数量为1,其中“辛”味在处方中的占比为1/4,即25.00%。 频数 5次的中药26种 总使用频数为324次,69.08% ,使 | ||||||||||||||
| ≥ | ( | ) | ||||||||||||
| ----- | --- | --- | --- | --- | --- | --- | --------------------------- | --- | --- | --- | --- | --- | --- | --- |
| 2 结果 | 用前5味的中药分别为熟地黄、茯苓、炙甘草、人参、当归。 | |||||||||||||
| 2.1 补益剂中药用频数和药味标注 补益方剂共60首,分 单 一 药 味 中 药 48 味 43.64% ,复 合 药 味 中 药 62 味 | ||||||||||||||
| ( | ) | |||||||||||||
| ------------------------------ | --- | --- | --- | --- | --- | --- | ------ | --- | --- | --- | --- | --- | --- | --- |
| 为6类,涉及中药110种,总用药频数为469次,见表1。其中 | 56.36% | 。 | ||||||||||||
| ( | ) | |||||||||||||
| 表1 补益剂中单味中药用药频次及药味标注 | ||||||||||||||
| Table 1 Frequency and flavor labeling of single traditional Chinese medicine in tonics | ||||||||||||||
| 中药 | 频数/次 | 主导药味 | 中药 | 频数/次 | 主导药味 | 中药 | 频数/次 | 主导药味 | 中药 | 频数/次 | 主导药味 | |||
| ---- | ---- | ---- | --- | --- | ---- | ---- | --- | --- | ---- | ---- | ---- | --- | ---- | ---- |
| 熟地黄 | 26 | 苦 | 桂枝 | 4 | 辛 | 苦杏仁 | 3 | 苦、咸 | 胡麻仁1 | ) | 2 | 甘 | ||
| 茯苓 | 26 | 甘 | 川贝母 | 4 | 酸、咸 | 广藿香 | 2 | 辛 | 鹿茸 | 1 | 辛、咸 | |||
| 炙甘草1 | 23 | 甘 | 北沙参 | 4 | 酸、甘 | 茯神 | 2 | 甘 | 鹿角 | 1 | 辛、咸 | |||
| ) | ||||||||||||||
| 人参 | 23 | 甘、咸 | 远志 | 3 | 苦 | 杜仲 | 2 | 苦 | 龙眼肉 | 1 | 甘、咸 | |||
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---- | --- | --- | --- |
| 当归 | 19 | 辛、咸 | 酸枣仁 | 3 | 酸 | 川牛膝 | 2 | 苦、甘 | 羚羊角 | 1 | 酸、咸 | |||
| 17 | 3 | 2 | 决明子1 | 1 | ||||||||||
| 山药 | 甘、酸 | 升麻 | 辛 | 百合 | 酸 | ) | 辛、咸 | |||||||
| 白术 | 16 | 甘、苦 | 砂仁 | 3 | 辛 | 艾叶 | 2 | 辛 | 荆芥穗 | 1 | 辛 | |||
| 羊肉1 | ||||||||||||||
| 白芍 | 15 | 酸 | 木香 | 3 | 辛 | ) | 1 | 苦、辛 | 黄芩 | 1 | 苦 | |||
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---- | --- | --- | --- |
| 山茱萸 | 14 | 酸 | 菊花 | 3 | 酸、辛 | 玄参 | 1 | 苦、咸 | 虎骨1 | ) | 1 | 苦 | ||
| 麦冬 | 12 | 酸 | 黄连 | 3 | 苦 | 续断 | 1 | 辛、苦 | 厚朴 | 1 | 咸、辛 | |||
| 地黄 | 12 | 苦 | 黄柏 | 3 | 苦 | 犀角 | 1 | 苦、咸 | 红花 | 1 | 辛 | |||
| 泽泻 | 11 | 咸、甘 | 龟甲 | 3 | 苦、咸 | 天花粉 | 1 | 甘 | 何首乌1 | 1 | 苦 | |||
| ) | ||||||||||||||
| 川芎 | 10 | 辛、咸 | 防风 | 3 | 辛 | 桃仁 | 1 | 辛、咸 | 蛤蚧 | 1 | 咸 | |||
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 9 | 3 | 锁阳1 | 1 | 1 | ||||||||||
| 五味子 | 酸、辛 | 柴胡 | 辛、酸 | ) | 咸 | 龟甲胶 | 苦、咸 | |||||||
| 水獭肝1 | ||||||||||||||
| 生姜 | 9 | 辛 | 半夏 | 3 | 辛、咸 | ) | 1 | 酸 | 葛根 | 1 | 辛、酸 | |||
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 白扁豆1 | ||||||||||||||
| 牡丹皮 | 9 | 苦、咸 | ) | 3 | 甘 | 山楂 | 1 | 酸、辛 | 干姜 | 1 | 辛 | |||
| --- | --- | --- | --- | --- | --- | --- | ---- | --- | --- | --- | --- | --- | --- | --- |
| 枸杞子 | 9 | 苦、甘 | 枳壳 | 2 | 酸、辛 | 沙苑子1 | ) | 1 | 甘 | 独活 | 1 | 辛、苦 | ||
| 黄芪 | 9 | 甘、辛 | 玉竹 | 2 | 酸、甘 | 桑白皮 | 1 | 甘、酸 | 豆蔻 | 1 | 辛 | |||
| 甘草 | 8 | 甘 | 薏苡仁 | 2 | 甘、苦 | 三七 | 1 | 苦、咸 | 磁石 | 1 | 咸、酸 | |||
| 陈皮 | 8 | 辛、酸 | 天冬 | 2 | 酸 | 青葙子1 | 1 | 辛 | 川楝子 | 1 | 辛 | |||
| ) | ||||||||||||||
| 肉桂 | 8 | 辛 | 石斛 | 2 | 酸、甘 | 羌活 | 1 | 辛、苦 | 车前子 | 1 | 甘、苦 | |||
| ------ | --- | --- | --- | --- | --- | --- | ---- | --- | --- | --- | --- | --- | --- | --- |
| 附子 | 7 | 辛、苦 | 石菖蒲 | 2 | 苦、辛 | 芡实 | 1 | 甘、苦 | 补骨脂 | 1 | 苦、辛 | |||
| 7 | 2 | 女贞子1 | 1 | 冰糖1 | 1 | |||||||||
| 大枣 | 甘、咸 | 桑叶 | 酸、辛 | ) | 苦、酸 | ) | 甘 | |||||||
| 知母 | 6 | 酸、咸 | 肉苁蓉 | 2 | 咸 | 牛蒡子 | 1 | 苦、辛 | 柏子仁 | 1 | 辛、甘 | |||
| 糯米1 | 木瓜1 | |||||||||||||
| 菟丝子 | 5 | 甘、酸 | ) | 2 | 甘 | ) | 1 | 酸 | 百部 | 1 | 甘 | |||
| 阿胶 | 5 | 咸、酸 | 牛膝 | 2 | 苦、甘 | 墨旱莲1 | ) | 1 | 苦、咸 | 巴戟天 | 1 | 辛、苦 | ||
| 炙黄芪1 ) | 4 | 甘、辛 | 鹿角胶 | 2 | 咸、辛 | 麦芽 | 1 | 甘 | ||||||
| 桔梗 | 4 | 辛、苦 | 莲子 | 2 | 甘、苦 | 马兜铃1 | 1 | 咸 | ||||||
| ) | ||||||||||||||
| 注:1)课题组既往研究不涉及的中药,重新进行定义的药味 | ||||||||||||||
| 2.2 补益方剂药味配伍结构及原理分析 | 脾。经曰,脾德在缓,以甘补之,辛泻之,苦燥之。故脾土虚 | |||||||||||||
| -------------------------------- | --- | --- | --- | --- | --- | ---- | --------------------------- | --- | --- | --- | --- | --- | --- | --- |
| 2.2.1 补气方剂药味组方配伍结构及原理分析 15首补气 | 证的治疗方,应以甘味为主,苦味为辅,若存在虚实夹杂的症 | |||||||||||||
| 类方剂,均含有甘味药,甘味药在总处方组成中占比 | 40%的 | 状则可加辛味以补泻兼施。从“汤液经法图”构图来看,脾土 | ||||||||||||
| ≥ | ||||||||||||||
| 方剂有8首 | 53.33% | 。整体处方结构药味分布以甘-辛-苦为 | 区对应的组合药味为甘-辛-苦,这与表2中统计结果相符,进 | |||||||||||
| -------------------- | ------ | ------------------ | --- | --- | -------- | --- | ---------------------------- | --- | --- | --- | --- | --- | --- | --- |
| ( | ) | |||||||||||||
| 主,甘-辛-苦药味配伍在总处方组成中占比 | 70%的有14首 | 一步证明,补气剂组方的主要结构式为甘-辛-苦,其中甘味 | ||||||||||||
| ≥ | ||||||||||||||
| 93.33% ,见表2。 | ||||||||||||||
| 为主导药味。 | ||||||||||||||
| ( ) | ||||||||||||||
| 从“汤液经法图”角度看,补气剂所治疗的倦怠乏力,少 | 补气剂的组方配伍加减规律,可以看出以补为主的甘味 | |||||||||||||
| ----------------------------- | --- | --- | --- | --- | --- | --- | ---------------------------- | ------------------------ | ----- | ----------------- | --- | --- | --- | --- |
| 气懒言,属于脾虚病证范畴。《辅行诀》记载,脾实则腹满飧 | 药,如人参、党参、茯苓、甘草类药物,其主要搭配的辅助药味 | |||||||||||||
| 泻,虚则四肢不用,五脏不安[1]。所以,补气方剂的定位为补 | 辛 | 泻味 | -苦 化味 | ,这种结构表达体现了中医配伍的灵活 | ||||||||||
| ( | ) ( | ) | ||||||||||||
| ·219· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | ||||||
|---|---|---|---|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | ||||||||
| 表2 补气类方剂组方药味分布及主要配伍结构比例统计 | 表3 补血类方剂组方药味分布及主要配伍结构比例统计 | |||||||
| ------------------------- | --- | --- | --- | ------------------------- | --- | --- | --- | --- |
| Table 2 Distribution of medicinal flavors and main compatibility Table 3 Distribution of medicinal taste and proportion of main | ||||||||
| structure proportions of Qi tonifying formula groups compatibility structures in blood tonifying formula groups | ||||||||
| 药物 | 五味情况 | 甘-辛- | 药味 五味情况 | 辛占 辛-咸占 | ||||
| ------------ | ----- | --------- | --------------- | --------- | --- | -------- | ----- | --------------- |
| 甘占 | 序号 | 处方 | ||||||
| /个 | 比/% 比/% | |||||||
| 序号 处方 | 数 量 | 苦 占 | 甘 辛 | 苦 咸 | 酸 | |||
| 甘 | 辛 苦 咸 | 酸 比/% | ||||||
| /个 | 比 / % | |||||||
| 1 四物汤 | 4 0 1 | 1 1 | 1 25.00 50.00 | |||||
| 1 四君子汤 | 4 3 | 0 0.5 0.5 | 0 75.00 87.50 | |||||
| 1.1 胶艾汤 | 7 1 2 | 1 1.5 | 1.5 28.57 50.00 | |||||
| 1.1 异功散 | 7 3.5 | 1.5 0.5 1 | 0.5 50.00 78.57 | |||||
| 1.2 圣愈汤 | 6 1 1.5 | 1 1.5 | 1 25.00 50.00 | |||||
| 1.2 六君子汤 | 8 3.5 | 2 0.5 1.5 | 0.5 43.75 75.00 | |||||
| 1.3 桃红四物汤 | 6 0 2.5 | 1 1.5 | 1 41.67 66.67 | |||||
| 1.3 香砂六君 | 9 3 | 4 0.5 1 | 0.5 33.33 83.33 | |||||
| 1.4 | 7 1 1 | 1 1 | 3 14.29 28.57 | |||||
| 子汤 | 补肝汤 | |||||||
| 1.4 | 4 2 | 1.5 0 0.5 | 0 50.00 87.50 | |||||
| 保元汤 | 1.5 养心汤 | 10 3 1.5 | 2 1 | 2.5 15.00 25.00 | ||||
| 2 参苓白术散 10 5.5 1.5 2 0.5 0.5 55.00 90.00 2 当归补血汤 2 0.5 1 0 0.5 0 50.00 75.00 | ||||||||
| 2.1 七味白术散 7 3 2.5 0.5 0.5 0.5 42.86 85.71 2.1 当归生姜羊肉汤 3 0 2 0.5 0.5 0 66.67 83.33 | ||||||||
| 2.2 资生丸 17 7.5 3.5 3.5 1 1.5 44.12 85.29 3 归脾汤 10 4 2 1.5 1.5 1 20.00 35.00 | ||||||||
| 3 补中益气汤 | 8 2.5 | 3 0.5 1 | 1 31.25 75.00 | |||||
| ------- | ----- | ------- | ------------- | --- | --- | --- | --- | --- |
| 咸”结构为主,辛补肝活血,咸补心补血。 | ||||||||
| 3.1 举元煎 | 5 2.5 | 1.5 0.5 0.5 | 0 50.00 90.00 | |||||
| ------- | ----- | ----------- | ------------- | --- | --- | --- | --- | --- |
| 补血剂的组方配伍加减规律,可以看出在补肝补心辛- | ||||||||
| 3.2 升陷汤 | 5 0.5 | 2.5 0.5 0.5 | 1 10.00 70.00 | |||||
| --------- | ------ | ----------- | ------------- | ------------- | --- | -------------- | --- | --- |
| 咸 比如辛咸味的当归、川芎 | 的基础上,辅助以苦、酸、甘不 | |||||||
| 3.3 升阳益胃汤 | 15 4.5 | 4.5 2 2 | 2 30.00 73.33 | ( | ) | |||
| 同药物的配伍后发挥不同的临床治疗作用,比如附方中的胶 | ||||||||
| 4 | 3 1 | 1.5 0.5 0 | 0 33.33 100.00 | |||||
| ---- | --- | --------- | -------------- | --------------------------- | --- | --- | --- | --- |
| 玉屏风散 | 艾汤,苦味地黄的剂量增至6两,加入辛温止血的艾叶,咸酸 | |||||||
| 5 生脉散 3 0.5 0.5 0 0.5 1.5 16.67 33.33 补血止血的阿胶,以达到养血止血的目的。酸味药的加入, | ||||||||
| 6 人参蛤蚧散 8 3 0 0.5 3 1.5 37.50 43.75 如补肝汤,加入酸味的木瓜、酸枣仁,既可柔肝养筋,亦可养 | ||||||||
| 注:备注:按照教材学中的分类,表中序号1、2、3表示基础方, 心安神。另外传统补血剂中的归脾汤 4甘2辛1.5苦1.5咸1 | ||||||||
| ( | ||||||||
| 1.1、2.1为加减方或附方 | 酸 ,实则为心脾同补方,方中甘味为主导药味,子能令母实, | |||||||
| -------------- | --- | --- | --- | ---------------------------- | --- | --- | --- | --- |
| ) | ||||||||
| 通过补脾以补心安神,方中甘味茯神与苦味远志的配伍也体 | ||||||||
| 性。因脾主运化水湿,湿气黏腻易导致气滞,故脾虚常见痰 | ||||||||
| 现了苦甘化咸,咸补心的应用。 | ||||||||
| 湿气滞证,故辛味药的引入主要针对痰湿气机阻滞,比如附 | ||||||||
| 2.2.3 气血双补方剂药味组方配伍结构及原理分析 7首 | ||||||||
| 方六君子汤中陈皮、半夏的加入用于脾虚痰湿证 | 异功散中 | |||||||
| --------------------- | ---------------- | --- | ---- | --------------------- | -------------------- | --- | --- | ----- |
| ; | 气血双补的方剂中,甘-辛药味在总处方中占比 | 50%的有 | ||||||
| 陈皮用于脾虚兼气滞证 | 香砂六君子汤中辛味陈皮、半夏、砂 | ≥ | ||||||
| ; | 6首 85.71% | ,见表4。其方剂药味组合结构符合补气类方 | ||||||
| ( | ) | |||||||
| 仁、木香、生姜的加入,不仅用于脾虚痰阻气滞证,同时由于 | ||||||||
| 剂加补血类方剂主要结构,甘补脾气,辛补肝血,定位基础脏 | ||||||||
| 辛味药味的比例增高,也使处方治疗由甘味补脾转变为辛味 | ||||||||
| 腑为脾、肝两脏,随临床主治脏腑虚实的不同而加减,文中不 | ||||||||
| 泻脾为主的补泻兼施方。而保元汤保留四君子汤中的人参、 | ||||||||
| 过多叙述。 | ||||||||
| 甘草甘味补脾作用,同时加入了辛、甘味的黄芪和辛味的肉 | ||||||||
| 表4 气血双补类方剂组方药味分布及主要配伍结构比例统计 | ||||||||
| 桂,此处的辛味则表达了补肝温阳的作用,保元汤严格意义 | ||||||||
| Table 4 Distribution of medicinal flavors and main compatibility | ||||||||
| 上讲为脾肝同补方。所以从药味的组成比例变化可以清晰 | ||||||||
| structure proportions of Qi and blood double tonifying formula | ||||||||
| 地分辨脏腑定位及主导治疗方向的变化,更方便于临床的实 | ||||||||
| groups | ||||||||
| 际应用。 | ||||||||
| 五味情况 | ||||||||
| 2.2.2 补血方剂药味组方配伍结构及原理分析 9首补血 | 药味 | 甘-辛 | ||||||
| ------------------------------- | --- | --- | --- | --- | --- | --- | --- | --- |
| 序号 处方 | ||||||||
| /个 甘 辛 | 苦 | 咸 酸 占比/% | ||||||
| --- | --- | --- | --- | --- | --- | ------ | --- | -------- |
| 类方剂中,所有补血方剂均含有辛、咸药味,药味配伍结构以 | ||||||||
| 1 八珍汤 | 8 3 1 | 1.5 | 1.5 1 50.00 | |||||
| ---------------------- | --- | --- | ----- | ----- | --- | ----- | --- | ----------- |
| 辛-咸为主,其中辛-咸药味在总处方组成中占比 | 50%的方 | |||||||
| ≥ | ||||||||
| 1.1 十全大补汤 | 13 4 3.5 | 2.5 | 2 1 57.69 | |||||
| ----------- | ----- | --- | --- | --------- | --- | -------- | --- | ----------- |
| 剂有6首 66.67% | 。见表3。 | |||||||
| ( | ) | |||||||
| 1.2 人参养荣汤 | 14 4 4 | 2.5 | 1.5 2 57.14 | |||||
| 从“汤液经法图”角度看,补血剂所治疗的血虚证,属于 | ||||||||
| 2 炙甘草汤 | 9 3 2 | 1 | 1 1 62.50 | |||||
| --- | --- | --- | --- | ------ | --- | ----- | --- | --------- |
| 肝虚心虚病证。肝藏血,血虚所致头晕目眩、爪甲无泽、少腹 | ||||||||
| 2.1 加减复脉汤 | 6 2 0 | 1 | 0.5 2.5 33.33 | |||||
| --- | --- | --- | --- | --------- | --- | ----- | --- | ------------- |
| 疼痛诸证,或妇女月经不调,当从肝虚论治。心主血脉,心藏 | ||||||||
| 3 泰山磐石散 | 12 3.5 3 | 3 | 1.5 1 54.17 | |||||
| --- | --- | --- | --- | ------- | --- | -------- | --- | ----------- |
| 神,故血虚导致心悸,心烦,易惊,失眠,健忘,眩晕,面色苍 | ||||||||
| 3.1 保产无忧散 | 12 2 5 | 0.5 | 2 2.5 58.33 | |||||
| --- | --- | --- | --- | --------- | --- | ------ | --- | ----------- |
| 白,唇舌色淡,当从心虚论治。故补血方剂定位为肝、心。经 | ||||||||
| 曰,肝德在散,以辛补之,以酸泻之,以甘缓之。心德在偄,以 2.2.4 补阴类方剂药味组方配伍结构及原理分析 19首补 | ||||||||
| 咸补之,以苦泻之,以酸收之[1]。故补血方剂中主要以“辛- | 阴方中,处方配伍结构为苦-酸为主,其中苦-酸药味在总处 | |||||||
| ----------------------------- | --- | --- | --- | --------------------------- | --- | --- | --- | --- |
| ·220· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | |||||||
|---|---|---|---|---|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | |||||||||
| 方中占比 50%的有16首 84.21% ,所有方剂都含有酸味 2.2.5 补阳类方剂药味组方配伍结构及原理分析 7首补 | |||||||||
| ≥ | ( | ) | |||||||
| ------ | --- | --- | --- | ------------------ | --- | --- | --- | --- | -------- |
| 药,见表5。 | 阳类处方中,辛-苦药味在总处方中占比 | 50% 有 4首 | |||||||
| ≥ | |||||||||
| 57.14% ,见表6。 | |||||||||
| 表5 补阴类方剂组方药味分布及主要配伍结构比例统计 | ( ) | ||||||||
| ------------------------- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Table 5 Distribution of flavors and main compatibility structure 表6 补阳类方剂组方药味分布及主要配伍结构比例统计 | |||||||||
| proportions of Yin tonifying formula groups Table 6 Distribution of flavors and main compatibility structure | |||||||||
| proportions of Yang tonifying formula groups | |||||||||
| 药味 | 五味情况 | 苦-酸 | |||||||
| --- | --- | ---- | --- | --- | --- | --- | --- | --- | --- |
| 序号 处方 | |||||||||
| /个 甘 | 辛 苦 咸 | 酸 占比/% | 药味 | 五味情况 | 辛-苦味 | ||||
| --------- | ---- | --------- | --------- | ----- | --- | --- | ----- | ----- | ----- |
| 序号 处方 | |||||||||
| /个 | 占比/% | ||||||||
| 1 六味地黄丸 | 6 2 | 0 1.5 1 | 1.5 50.00 | 甘 | 辛 苦 | 咸 酸 | |||
| 1.1 知柏地黄丸 | 8 2 | 0 2.5 1.5 | 2 56.25 | 1 肾气丸 | 8 | 2 | 1.5 2 | 1 1.5 | 43.75 |
| 1.2 杞菊地黄丸 8 2.5 0.5 2 1 2 50.00 1.1 加味肾气丸 10 3 1.5 3 1 1.5 45.00 | |||||||||
| 1.3 | 7 2 | 0.5 1.5 1 | 2 50.00 | 1.2 十补丸 | 10 | 2 | 2.5 2 | 1.5 2 | 45.00 |
| --- | --- | --------- | ------- | ------- | --- | --- | ----- | ----- | ----- |
| 都气丸 | |||||||||
| 2 右归丸 | 10 | 1.5 | 2.5 3 | 1 2 | 55.00 | ||||
| --------- | ---- | --------- | --------- | -------- | --- | --- | ------- | ----- | ----- |
| 1.4 麦味地黄丸 | 8 2 | 0.5 1.5 1 | 3 56.25 | ||||||
| 2.1 右归饮 | 8 | 2 | 1.5 3 | 0 1.5 | 56.25 | ||||
| 1.5 耳聋左慈丸 | 9 2 | 1 2 1.5 | 2.5 50.00 | ||||||
| 3 桂枝加附子汤 | 6 | 1.5 | 2.5 0.5 | 0.5 1 | 50.00 | ||||
| 1.6 石斛夜光丸 | 25 6 | 4.5 5 4 | 5.5 42.00 | ||||||
| 3.1 | 2 | 1 | 1 0 | 0 0 | 50.00 | ||||
| 2 左归丸 | 8 2 | 0.5 2.5 1 | 2 56.25 | 桂枝甘草汤 | |||||
| 2.1 左归饮 | 6 3 | 0 1.5 0 | 1.5 50.00 | ||||||
| 从“汤液经法图”角度看,补阳类方剂所治疗的形寒肢 | |||||||||
| 3 大补阴丸 | 4 0 | 0 2.5 1 | 0.5 75.00 | ||||||
| ------ | --- | ------- | --------- | --- | --- | --- | --- | --- | --- |
| 冷,腰膝酸痛,下肢软弱无力,小便不利或小便频数,少腹拘 | |||||||||
| 3.1 虎潜丸 | 9 0 | 1.5 3.5 2 | 2 61.11 | ||||||
| ------- | --- | --------- | ------- | --- | --- | --- | --- | --- | --- |
| 急,男子阳痿早泄,妇女宫寒不孕,属于肾虚肝虚证。《辅行 | |||||||||
| 3.2 | 2 0 | 0 1 0.5 | 0.5 75.00 | ||||||
| ------- | ---- | ----------- | --------- | ---------------------------- | --- | --- | --- | --- | --- |
| 二至丸 | 诀》记载,肾虚则腰痛,精少,骨痿,大腹小腹痛,小便不利。 | ||||||||
| 3.3 一贯煎 | 6 1 | 1.5 1.5 0.5 | 1.5 50.00 | 肝虚则畏寒肢冷、阳痿不举,肝实则拘挛疼痛。所以补阳方 | |||||
| 4 百合固金汤 | 10 1 | 1 3 1.5 | 3.5 65.00 | 剂的定位主要是肝虚肾虚证。经曰,肾德在坚,以苦补之,以 | |||||
| 甘泻之,以咸润之。肝德在散,以辛补之,以酸泻之,以甘缓 | |||||||||
| 4.1 百合知母汤 | 2 0 | 0 0 0.5 | 1.5 75.00 | ||||||
| --------- | --- | ------- | --------- | --- | --- | --- | --- | --- | --- |
| 之[1]。故补阳剂中,应以辛-苦为主,若存在虚实夹杂的症状 | |||||||||
| 4.2 补肺阿胶汤 | 6 2 | 0.5 2 1 | 0.5 25.00 | ||||||
| --------- | --- | ------- | --------- | --- | --- | --- | --- | --- | --- |
| 可加酸味泻肝,甘味缓肝泻肾,以补泻兼施。 | |||||||||
| 4.3 月华丸 | 14 3 | 1 2.5 1.5 | 6 60.71 | ||||||
| ------- | ---- | --------- | ------- | --- | --- | --- | --- | --- | --- |
| 补阳类方剂临床配伍加减规律,以辛补肝-苦补肾为核 | |||||||||
| 5 益胃汤 | 5 2 | 0 1 0 | 2 60.00 | ||||||
| ----- | --- | ----- | ------- | --- | --- | --- | --- | --- | --- |
| 心结构,比如辛味的附子、肉桂、当归,苦味的地黄、杜仲、枸 | |||||||||
| 5.1 沙参麦冬汤 | 7 4 | 0.5 0 0 | 2.5 35.71 | ||||||
| --------- | --- | ------- | --------- | --- | --- | --- | --- | --- | --- |
| 杞子等。在加减配伍中,若肾阳虚而不制水,则重用辛味补 | |||||||||
| 肝之药,使处方在肝区的作用加强,“子能令母实”通过补肝 | |||||||||
| 从“汤液经法图”角度看,补阴类方剂所治疗的腰膝酸 | |||||||||
| 而达到补肾阳的作用,如加味肾气丸中辛味的桂枝、附子。 | |||||||||
| 软,盗汗遗精,五心烦热,口燥咽痛,属于肾虚肺虚证。《辅行 | |||||||||
| 若肾阳虚导致肾精匮乏,则可加用肾区苦味熟地或咸味鹿角 | |||||||||
| 诀》记载,肾气虚则厥逆,腰中痛,大腹小腹痛,尻阴股膝痛, | |||||||||
| 胶,增加益肾填精的作用。在补阳剂中还有一类传统认为是 | |||||||||
| 胻足皆痛。肺虚则耳聋,咽干[1]。所以补阴的方剂定位就是 | |||||||||
| 补心阳的方剂,如桂枝甘草汤,从“汤液经法图看”,桂枝甘草 | |||||||||
| 补肾补肺。经曰,肾德在坚,以苦补之,甘泻之,咸润之。肺 | |||||||||
| 汤 1辛1甘 实为纯补肝剂,其文记载用于“发汗过多,其人 | |||||||||
| ---------------------------- | --- | --- | --- | ---------------------------- | --- | --- | --- | --- | --- |
| 德在收,酸补之,咸泻之,辛散之。故补阴剂中,应以苦-酸为 | ( ) | ||||||||
| 叉手自冒心,心下悸,欲得按者”,这里“叉手冒心”“欲得按 | |||||||||
| 主,若存在虚实夹杂的症状可酌加甘味泻肾,咸味泻肺,以补 | |||||||||
| 者”应是肝虚气上冲心的症状,其组方为肝区补肝之用。 | |||||||||
| 泻兼施。 | |||||||||
| 2.2.6 阴阳并补类方剂药味组方配伍结构及原理分析 | |||||||||
| 补阴类方剂临床配伍加减规律,以苦补肾-酸补肺为主 | |||||||||
| 3首阴阳并补类处方中,苦-甘-辛药味在总处方中占比 | 60% | ||||||||
| --- | --- | --- | --- | ------------------------- | --- | --- | --- | --- | --- |
| ≥ | |||||||||
| 导配伍结构,比如苦味的地黄、牡丹皮,酸味的山药、白芍。 | |||||||||
| 有3首 100.00% | ,见表7。 | ||||||||
| --- | --- | --- | --- | ----------- | ----- | --- | --- | --- | --- |
| ( | ) | ||||||||
| 比如麦味地黄丸,增加了酸味的麦冬、五味子,酸能补肺,增 | |||||||||
| 阴阳并补剂中可看出仍以肾为核心,苦味补肾药物是基 | |||||||||
| 强了补肺收敛止喘的功效,更适用于肺肾阴虚,或咳或喘者。 | 石,处方构成中若肾阳虚,则加辛味补肝药物辅助,如附子、 | ||||||||
| --------------------------- | --- | --- | --- | --------------------------- | --- | --- | --- | --- | --- |
| 知柏地黄丸,加用了酸咸的知母和苦味的黄柏,增强了全方 | 肉桂,合并肾阴虚证,则需要肺肾同治,处方构成中加用酸味 | ||||||||
| 滋阴清热的作用。补阴剂的组方结构与《辅行诀》记载的大 | |||||||||
| 药,如地黄饮子中酸山茱萸、五味子、麦冬。在阴阳并补剂中 | |||||||||
| 补肺汤 2酸2苦1咸1辛1甘 | 类似,其功效为补肺补肾,治 | ||||||||
| -------------- | --- | ------------- | --- | --- | --- | --- | --- | --- | --- |
| 临床可根据阴、阳亏虚的程度分别选择加减辛或酸味药使处 | |||||||||
| ( | ) | ||||||||
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 疗烦热汗出,少气不足息,口干,耳聋,脉虚而快者[1]。这个 | |||||||||
| 方作用方向偏向肝肾或肺肾。 | |||||||||
| 特点也符合补阴剂中方剂的分布规律,肺虚症状偏重者则加 | 2.3 6种补益方剂药味与脏腑对应关系比较分析 传统 | ||||||||
| --------------------------- | --- | --- | --- | ----------------------------- | --- | --- | --- | --- | --- |
| 重酸味药的使用,如月华丸、麦味地黄丸,肾阴虚症状偏重者 | 6分类下的补益方剂,实际来看,其主要涉及气、血、阴、阳 | ||||||||
| 可以增加苦味补肾药的使用,如大补阴丸等。 | 4个基础因素。在“汤液经法图”体系下,通过对4个基础因 | ||||||||
| ·221· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | |||||||
|---|---|---|---|---|---|---|---|---|---|
| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | |||||||||
| 表7 阴阳并补类方剂药味分布及主要配伍结构比例统计 | 五行学说,并完整保留了五行学说的应用。该图通过五脏虚 | ||||||||
| ------------------------- | --- | --- | --- | --- | --- | -------------------------- | --- | --- | --- |
| Table 7 Distribution of medicinal flavors and main compatibility 实认识疾病,五味补泻治疗疾病,其中五脏与五行相应,五脏 | |||||||||
| structure proportions of Yin Yang complementary prescriptions | |||||||||
| 作为疾病的定位,虚实作为疾病的分类,其中五脏虚实又包 | |||||||||
| 药味 五味情况 | 苦-甘占 | 苦-甘-辛 | 含气血虚实,而本文也证实了气血虚实与相关脏腑虚实的关 | ||||||
| --- | --- | ------- | --- | ---- | ----- | -------------------------- | --- | --- | --- |
| 序号 处方 | |||||||||
| /个 | 比/% | 占比/% | |||||||
| --- | --- | --- | --- | --- | ---- | --------------------------- | --- | --- | --- |
| 甘 辛 | 苦 咸 | 酸 | 系,故“汤液经法图”体系分类对疾病认识治疗一来更加接近 | ||||||
| 1 地黄饮子 12 1.5 2.5 3.5 1 3.5 41.67 66.67 中医五行“本源”,二来分类相对简明且系统完整,为临床在 | |||||||||
| 虚证类疾病的治疗中提供了比较清晰的诊治组方思路。 | |||||||||
| 2 龟鹿二仙胶 | 4 1.5 0.5 | 1 1 | 0 50.00 | 62.50 | |||||
| ------- | --- | --------- | --- | ------- | ----- | --- | --- | --- | --- |
| 3.2 采用“汤液经法图”识方解方的特点与优势 上文从 | |||||||||
| 3 七宝美髯丹 | 7 2.5 1.5 | 2.5 0 | 0.5 71.43 | 85.71 | |||||
| ------- | --- | --------- | ----- | --------- | ----- | --- | --- | --- | --- |
| “汤液经法图”的角度对补益剂中所有处方的功效进行定位 | |||||||||
| 素相关补益方剂进行组方用药分析,可以得到清晰的药味- | 并分析药味组成配伍规律,从脏腑补泻的角度,与传统的解 | ||||||||
| -------------------------- | --- | --- | --- | --- | --- | ----------------------------- | --- | --- | --- |
| 脏腑对应关系。见表8。从表中可以看出补益剂不都是以 | 方比较,识方解方用方裁方更加深刻且简明直观[18]。比如在 | ||||||||
| 甘味为主,以甘味为主的方剂主要是补气剂。不同补法具有 | 识方方面,更容易掌握一类方剂的核心规律特点,如补气剂 | ||||||||
| 不同的组方核心主导药味,比如补气以甘为主,补脾 | 补血以 | 中异功散、保元汤、参苓白术散、七味白术散皆可用于小儿补 | |||||||
| ; | |||||||||
| 辛-咸为主,补肝补心 | 补阴剂以苦-酸为主,补肾补肺 | 补阳 | 气方,无论是用于治疗脾虚夹滞或夹湿或泄泻,用药均以甘 | ||||||
| -------------------------- | --- | -------------- | --- | --- | --- | -------------------------- | --- | --- | --- |
| ; | ; | ||||||||
| 剂以辛-苦为主,补肝补肾。气血双补剂及阴阳并补剂在一 | 味补脾为主,辅助以辛苦药味以补泻兼施,这也充分小儿脏 | ||||||||
| 腑“脾常不足”的特点。另外在清晰的药味-脏腑对应关系 | |||||||||
| 定程度上反映了相对应脏腑的共治关系。比如气血双补即 | |||||||||
| 下,有助于临床对药物合理配伍加减。比如补阴剂,若肾阴 | |||||||||
| 甘补脾补气,辛补肝补血。 | |||||||||
| 亏虚,则需肺肾同治,药味选择以苦-酸为主,若肺阴虚较重, | |||||||||
| 表8 补益方剂药味与脏腑对应关系 | |||||||||
| 则可重用酸味药,如麦冬、天冬、五味子,若肾阴虚较重,可加 | |||||||||
| Table 8 Corresponding relationship between flavor of tonifying | |||||||||
| 用苦味滋补肾阴的药物,如生地黄、熟地黄、枸杞子、女贞子、 | |||||||||
| formulas and organs | |||||||||
| 墨旱莲等。若肾阴虚和并阳虚,则可加用辛味温阳补肝的药 | |||||||||
| 组方核心 | |||||||||
| 方剂 | 药味作用解释 | 代表方剂 | 配伍结构 | ||||||
| --- | --- | ------ | ---- | ---- | --- | --- | --- | --- | --- |
| 物,如附子、肉桂等。 | |||||||||
| 主导药味 | ( | ) | |||||||
| --- | ---- | --- | --- | --- | --- | --- | --- | --- | --- |
| 3.3 本研究的不足之处 本文研究主要针对补益剂中占比 | |||||||||
| 补气 | 甘 | 甘补脾 | 四君子汤 | 3甘0.5苦0.5 | |||||
| --- | --- | --- | ---- | --------- | --- | --- | --- | --- | --- |
| ( | |||||||||
| 咸 | 比较高的主导药味进行了脏腑-药味虚实对应关系分析,其 | ||||||||
| --- | --- | --- | --- | --- | --- | -------------------------- | --- | --- | --- |
| ) | |||||||||
| 辛-咸 | 辛补肝-咸补心 | 桃红四物汤 | 2.5辛1.5 | 中方剂中占比较低的药味可能与不同兼证治疗有关,本文未 | |||||
| --- | --- | ------- | --------- | --- | ------- | -------------------------- | --- | --- | --- |
| 补血 | |||||||||
| ( | |||||||||
| 咸1酸1苦 | 过多讨论,此处仍需将来进一步研究说明。另外,文中涉及 | ||||||||
| --- | --- | --- | ----- | --- | --- | -------------------------- | --- | --- | --- |
| ) | |||||||||
| 补阴 | 苦-酸 | 苦补肾-酸补肺 | 麦味地黄丸 | 3酸2苦1咸 | 中药的药味定位,尤其与2020年版《中国药典》规定中不同 | ||||
| --- | --- | ------- | ----- | --- | ------ | ---------------------------- | --- | --- | --- |
| ( | |||||||||
| 2甘 | |||||||||
| ) | 的药味仍存在争议,将来仍需进一步补充完善中药药味理论 | ||||||||
| --- | --- | ------- | --- | ----------- | --- | --------------------------- | --- | --- | --- |
| 补阳 | 辛-苦 | 辛补肝-苦补肾 | 右归丸 | 2.5辛3苦1.5甘1 | |||||
| ( | 研究。此外,很多中药存在复合药味,非单一药味,复合药味 | ||||||||
| 咸2酸 | |||||||||
| ) | 在组方群药中,如何确定具体发挥的功效,这仍需要进一步 | ||||||||
| ---- | --- | ------- | ----- | --- | ------- | -------------------------- | --- | --- | --- |
| 甘-辛 | 甘补脾-辛补肝 | 4甘4辛2.5 | |||||||
| 气血双补 | 人参养荣汤 | ||||||||
| ( | 研究论证。 | ||||||||
| 苦1.5咸2酸 | |||||||||
| ) | [利益冲突] | 本文不存在任何利益冲突。 | |||||||
| ---- | ----- | ------------ | ----- | --- | -------- | ------- | ------------ | --- | --- |
| 阴阳并补 | 苦-辛-甘 | 苦补肾-辛补肝- | 七宝美髯丹 | 2.5苦1.5辛 | |||||
| ( | |||||||||
| 甘补脾 | 2.5甘0.5酸 | ||||||||
| --- | --- | --- | -------- | --- | --- | --- | --- | --- | --- |
| ) | |||||||||
| [参考文献] | |||||||||
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| ---------------------------- | --- | --- | --- | --- | --- | ------- | ------------- | --- | --- |
| ( ) | |||||||||
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| ( ) | |||||||||
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| ·222· |
| 第31 卷第 12 期 | 中国实验方剂学杂志 | Vol.31,No.12 | ||||||||
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| 2025年6 月 Chinese Journal of Experimental Traditional Medical Formulae Jun.,2025 | ||||||||||
| JIN R,FANG Z H,ZHU H,et al. | Mathematical model for | Publishing House,2023. | ||||||||
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