邸莎 李青伟 杨映映 宋珏娴 赵林华

摘要 通过梳理历代度量衡对经方本源剂量的影响，分析仲景经方本源剂量折算的历史变迁。介绍历代医家及当代医家在尊崇经方剂量的基础上，结合临床实际灵活加减，尊古而不泥于古。认为仲景经方本源剂量的折算应用探索应在综合考虑临床用药疗效与保证安全性的基础上明确量效关系，寻找最佳临床合理用量，从而提高临床疗效。

关键词 历代度量衡;经方本源剂量;张仲景;量-效关系;合理用量;因药施量;因病施量;因方施量

Abstract Through the analysis of the effects of ancient weights and measures on dosage of classical prescription，the historical changes of dosage conversion of ZHANG Zhongjing′s classical prescription were observed.On the basis of respecting the dosage of classical prescription，ancient and contemporary doctors control dosage flexibly combining with clinical practice，which was systematically introduced.In the future，the dosage conversion and application of ZHANG Zhongjing′s classical prescription should be explored on the basis of comprehensive consideration of clinical efficacy and safety.The dosage-effect relationship should be clarified，and the optimal clinical dosage should be sought，so as to improve clinical efficacy.

Keywords Ancient weights and measures; Dosage of classical prescription origin; ZHANG Zhongjing; Dosage-effect relationship; Optimal clinical dosage; Dosage based on herbs; Dosage based on diseases; Dosage based on prescription

中图分类号：R289文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.09.026

张仲景的《伤寒杂病论》确立了中医辨证论治体系基本框架与临床理法方药应用的基本规范，是集秦汉以来医药理论之大成，并广泛应用于医疗实践的专书，在中医学史上地位极高，在近现代国际中医学术界影响极为广泛。何谓经方，说法众多。经方是汉以前临床医方著作及方剂的泛称，又专指《伤寒论》《金匮要略》中的方剂等[1]。《金匮心典·徐序》云：“惟仲景则独祖经方，而集其大成，惟此两书，真所谓经方之祖。”经方是《伤寒杂病论》辨证论治理法方药的核心所在，是后世医家最为看重和最常运用的方剂，但从东汉至今已近2 000年，经方剂量的换算逐渐扑朔迷离。经方用量是决定临床疗效的关键因素，是经方的“灵魂”所在。然而，经方用量在历史传承上存在重大分歧，其折算方法竟有32种之多，临床应用莫衷一是，无“法”可依，直接影响经方的临床应用效果[2]。……