夫肝之病,补用酸,助用焦苦,益用甘味之药调之 是什么意思 金贵要略中 问曰;上工治未病,何也? 的解释,高手的来
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\u3010\u8bcd\u89e3\u3011
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\u3010\u91ca\u4e49\u3011
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【阐释】
指出肝虚证的三治方法:正治法、旁治法、反治法。
1、肝虚用酸补之,此为正治法;
2、助用焦苦,补心气,“子能令母实”,此为旁治法;
3、甘药入脾,实脾治水,火盛而金平,而使肺金不伤肝木,此为反治法。
凡临床治病,必须明确三治方法,才能提高疗效。
【肝虚证治法】
补用酸,酸入肝,补之本味
助用焦苦,焦苦入心,子令母实
益用甘味之药,甘入脾,五行生禁止化
甘入脾,脾为心之子,甘味之药能调和中气,《难经.十四难》谓“损其肝者缓个中”,所以益用甘味之药。
“酸入肝……此治肝补脾之要妙也”,此段,旨在诠释肝虚病用“酸甘焦苦”治法的意义。其理论依据源于《素问.五运行大论》所云:“气……不及,则己所不胜侮而乘之,己所胜轻而侮之”,肝木既虚,肺金必然会侮其所胜的肝,这是五行生禁止化的规律所决定的。所以,在肺金未侮肝木之前,就得用酸味药来补肝的本体;
用焦苦味药以助心之少火。助心之少火有两种作用:其一,心旺可以感气于肝;其二,心之少火旺可以制约肺金,肺金受制,则木不受克而肝病自愈。
至于用甘味药来调和脾土,目的在于补土制水,肾的阴寒水气不亢而为害,则水不凌心,心的少火之气旺盛,则能制约肺金,肺金受制,肺的邪气不致乘侮肝木,则肝之本气自盛;且土能荣木,脾气健旺,有助于改善肝虚的病变。必须注意,原文“伤”字,据公元1174年宋。陈言(无择)《三因方》,应作“制”。
《三因方》对本段“虚则补其子”的治法,有深刻阐述:“夫阴阳虚实者,乃脏腑更相胜复也,若其子母相感,则母虚能令子虚,子实能令母实,经曰:实则泻其母,虚则补其子,如肝实则泻肾,肝虚则补心,如百姓足,君孰与不足,此经之本意也。
及不雅《金匮》之论,肝虚补用酸,助用焦苦,益用甘味之药,酸入肝,焦苦入心,甘入脾,脾能制肾,肾气微弱,则水不行,水不行,则心火盛,心火盛则肺金受制,肝气乃舒,肝气舒则肝病自愈,此补子之意也,肝虚则用此,实则反之。
翻译:针对肝脏内的疾病,如果想起到滋补的疗效,用酸性的事物,想有所助力,就用苦性药材,增进肝脏功能就用药效平和的药材
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