张影 罗银星 王宪龄

[摘要] 医圣张仲景所著《伤寒杂病论》为中医经典著作，被奉为“方书之祖”。该书所载方剂组方严谨，主次分明，变化巧妙，疗效确切，千百年来一直沿用于临床。本研究通过对仲景常用柴胡药对的整理与分析以及病案举隅，使对柴胡药对的配伍功用有更加明晰的认识。

[关键词] 伤寒杂病论；柴胡；药对；应用

[中图分类号] R242???[文献标识码] A???[文章编号] 2095-0616（2012）15-83-03

An exploration of compatible effects and clinical application on drug pair of bupleurum in Treatise on Febrile and Miscellaneous Diseases

ZHANG?Ying1??LUO?Yinxing1??WANG?Xianling2

1.The Affiliated Hospital of Henan Academy of Traditional Chinese Medicine, Zhengzhou 450004,China;2.Henan University of Traditional Chinese Medicine, Zhengzhou 450046,China

[Abstract] Treatise on Febrile and Miscellaneous Diseases by ZHANG Zhongjing is a traditional classic theoretic works, which are the ancestor of Chinese prescription books.Herbal prescription composing principles of Treatise on Febrile and Miscellaneous Diseases is rigorous and priorities straight.Changes of it is ingenious. The curative effect of it is stable.It is always used in clinical, for thousands of years. Compatible effects on drug pair of bupleurum are clearer through the arrangement and analysis of the drug pair of bupleurum used always by Zhongjing and exemplification of medical records.

[Key words] Treatise on Febrile and Miscellaneous Diseases; Bupleurum; Drug pair; Application

《伤寒杂病论》是我国一部临床医学巨著，以用药精专、组方严谨、疗效卓著，被誉为“经方之祖”，奠定了后世医方的基础。据统计，书中用柴胡者计有9方，方名有柴胡者6方，无柴胡者3方[1]。张仲景在该书中极其重视药物的相互配伍，首创了柴胡与黄芩、芍药与甘草、黄芩与芍药等著名药对，对后世方剂的发展影响很大。药对作为中医临床用药的最基本形式，有着丰富的内涵，广泛应用于临床。笔者试就《伤寒论》中柴胡常用药对的配伍作用加以探析，以便对柴胡药对的配伍功用有更加清晰深刻的认识。

1?《伤寒杂病论》中柴胡常用药对的配伍应用

1.1?柴胡与黄芩

柴胡与黄芩是《伤寒论》最具代表意义的基本配伍，在柴胡剂中居主导地位，是构成和解之剂的重要部分，为枢转少阳邪热的主要药物[2]。书中柴胡类方包括小柴胡汤、大柴胡汤、柴胡加芒硝汤、柴胡加龙骨牡蛎汤、柴胡桂枝汤、柴胡桂枝干姜汤等6方，均有柴胡黄芩药对。《金匮要略》中也有两者配伍6方。后世加减化裁应用柴胡类方者不计其数，然柴胡与黄芩作为和解少阳的基本药对多予保留，备受推崇。……