| Objective In order to inherit and develop ZHANG Zhong-jing’s pharmaceutical thought,and provide the reference of rational use of Chinese medicine for the majority of Chinese medicine clinical workers,The contents of this paper of pharmaceutical thoughts in Synopsis of the Golden Chamber are systematically arranged from three aspects:the thought of using medicines,the thought of making medicines and the thought of taking medicines.The comprehensive,systematic,rigorous and rational multi-thinking medicine system in Synopsis of the Golden Chamber was summarized.Through sorting and research,I have cultivated my enthusiasm to learn and apply classical Chinese medicine.I hope to improve my clinical ability of integrated Traditional Chinese and Western medicine in the future work and study,which is conducive to further improve the clinical diagnosis and treatment effect.Methods This thesis studies 206 prescriptions of Synopsis of the Golden Chamber,including the original text,prescriptions,decoctions and methods of taking through the methods of traditional Chinese medicine and philology.And combined with the ancient and modern doctors of the commentary,clinical application,and tutor Professor Zhao haibin’s clinical experience in the application of classical prescription,Sorted out pharmaceutical thoughts in Synopsis of the Golden Chamber.Results Systematize the pharmaceutical thought of Synopsis of the Golden Chamber.The contents of pharmaceutical thought in Synopsis of the Golden Chamber are comprehensive,systematic,rigorous and rational multi-thinking system of drug use,which can be divided into three parts:the thought of using medicines,the thought of making medicines and the thought of taking medicines.Conclusion This paper puts forward the multi-thinking of pharmaceutical thought in Synopsis of the Golden Chamber from a new Angle,including the thought of using medicines,the thought of making medicines and the thought of taking medicines.This paper hopes to provide classical references for inheriting and developing Zhongjing’s pharmaceutical thought,serving Traditional Chinese Medicine clinical practice,Traditional Chinese Medicine dispensing,and modern Traditional Chinese Medicine research and production,and has certain theoretical significance and practical value.This paper is divided into three chapters,which are summarized as follows.The first chapter The thought of using medicines in Synopsis of the Golden Chamber.Using of medicines based on syndrome differentiation is one of the characteristics of Traditional Chinese medicine.that is,the Yin and Yang、exterior and interior、cold and heat、deficiency and excess of the syndrome should be identified first.Then,treating diseases base on it.In addition to this,The thought of using medicines in Synopsis of the Golden Chamber are also based on the diseases differentiation、the pulse differentiation、the body constitutions differentiation、the symptoms differentiation、the formula-syndrome differentiation、the drug characteristics differentiation.All these formed a comprehensive,systematic,rigorous and reasonable multi-thinking medication system of pharmaceutical thought of Synopsis of the Golden Chamber.Using medicines based on diseases differentiation.Different from syndrome differentiation,the premise of medication is only to know its disease but not necessarily to recognize its syndrome.Such as "All diseases which belong to Huang Jia,only to facilitate urination",that is to say.Jaundice,although there are Yin and Yang yellow,but treatment should pay attention to the use of drugs to facilitate urine.Differentiation of diseases and medication,not miscellaneous,directly solve the main contradiction of diseases,the main contradiction was solved,the remaining problems,can be "use Rice,meat,fruit and vegetables to treat".The academic thought of identifying diseases and using drugs in Synopsis of the Golden Chamber sets an example for doctors to grasp the train of thought and method of solving the main contradiction of diseases.Using medicines based on pulse differentiation."Su Wen·The Five Zang Organs Are Generated" says:"Can distinguish pulse condition,can diagnose and treat diseases".ZHANG Zhong-jing wrote "Treatise on Febrile and Miscellaneous Diseases"and formed the academic thought of using medicines with the pulse differentiation.For example,water qi disease,we use apricot soup when pulse floating,we use Ephedra Fuzi soup when pulse heavy。"Su Wen·Mai Yao Jing Wei Lun" says:"The subtlety lies in the pulse,take carefully".Therefore,using medicines based on pulse differentiation is one of ZHANG Zhong-jing’s important pharmaceutical thoughts.Using medicines based on formula-syndrome differentiation.Synopsis of the Golden Chamber firstly deals with the condition of the disease,and then shows the prescription for treatment.Feature of Synopsis of the Golden Chamber is to introduct the disease and then shows the prescription for treatment.For example,"the man is very thirsty,but he urinated more.He drank more water and urinated more.He was treated with kidney qi pill.";"Thirsty very want to drink water,parched mouth,with white tiger and ginseng soup treatment" and so on.That is to say,"he urinated more,drank more water,urinated more" this group of diseases,is the kidney qi pill this prescription,referred to as the formula-syndrome.With such formula-syndrome,it is unnecessary to distinguish the attributes of the Syndrome Differentiation with Eight Principles,just treat them with shenqi pill.Similarly,"thirst for water,dry mouth" is white tiger and ginseng soup’s formula-syndrome.As long as the "formula-syndrome" of a certain prescription exists,it is not necessary to identify what disease,what kind of syndrome and what kind of pulse it is.Instead,a certain prescription can be directly used for treatment.This prescription is like a "special" key,which can open the lock of the "formula-syndrome".The most prominent feature of the thought of using medicines in Synopsis of the Golden Chamber is using medicines based on formula-syndrome differentiation.Using medicines based on symptoms differentiation.The thought of using medicine in Synopsis of the Golden Chamber mainly appeared in the addition and subtraction of prescriptions.Such as fangji Astragalus decoction after said:"Asthma plus 7.5 grams of ephedra,stomach uncomfortable plus peony 10.5 grams,gas to go up plus Cassia twig 10.5 grams"。ZHANG Zhong-jing founded this idea of medication,later summarized as "add one symptom,add one drug,reduce one symptom,reduce one drug",is still effectively guiding clinical.Using medicines based on the body constitutions differentiation.The thought of medicine use in Synopsis of the Golden Chamber is mainly embodied in the use of fierce medicines.For example,the Big aconite decoction says:"strong people take 140ml,weak people take 100ml",which sets a precedent for safe use of medicines.Using medicines based on the drug characteristics differentiation.The reason why Chinese medicine prescription is not effective is half due to not being able to differentiate symptoms and half due to not being familiar with the characteristics of drugs.Can differentiate syndrome but won’t can use drugs,not only do not have curative effect,harmful to the body instead.Zhang Zhongjing was very familiar with drugs properties,so the Synopsis of the Golden Chamber which he wrote can grasps the drug properties and adjusted dosage according to the four gases,five tastes.Scatter and converge,rise and fall,float and sink,slow and urgent,toxic and non-toxic and rational dispensing,adjusting dosage,becoming a model for future generations.Through the analysis of the the thought of using medicines in Synopsis of the Golden Chamber,we can find that it has two important characteristics:first,the multi-thinking of pharmaceutical thought,that is,can based on not only according to the method of "Using of medicines based on syndrome differentiation",but also based on diseases differentiation、the pulse differentiation、the body constitutions differentiation、the symptoms differentiation、the formula-syndrome differentiation、the drug characteristics differentiation.Second,"Using medicines based on formula-syndrome differentiation" is the most important part of the whole book.The second chapter The thought of making medicines in Synopsis of the Golden Chamber.The use of Traditional Chinese Medicine is a systematic project,accurate syndrome differentiation and rational prescription is not the only one way which can achieve curative effect.If the drugs is made improperly,it will also affect the efficacy of the drugs.The paper takes the decoction in Synopsis of the Golden Chamber as an example,the pharmaceutical ideas of this book are discussed from four aspects:decocting solvent,decocting concentration,decocting time and special decocting method.Decocting solvent Decocting Chinese medicine,the first is to choose solvent for decocting medicine.Most of the decoctions in Synopsis of the Golden Chamber did not indicate what solvent to use,according to the understanding of modern doctors,the general use of well Water can be,that is,the first bucket of water in the morning,pure.In addition,Synopsis of the Golden Chamber according to the needs of the disease,there are special water,such as spring water,gan lan water,jiang shui’and so on.Besides the water,other medicinal solvents are used.Such as wine,vinegar,honey,Horse manure,etc.Honey decocted medicine is equivalent to the earliest "syrup agent".Decocting concentration This paper studied the concentration of decocted medicine of 23 prescriptions in Synopsis of the Golden Chamber by analyzing the weight of decoction pieces,the amount of water added and the amount of liquid medicine.Converted into the current measurement,that is,the weight g number of decoction pieces in every 100mL liquid medicine to represent the concentration of decocted medicine.It was found that the concentration of solution of 78%of ZHANG Zhong-jing prescriptions was between 20%and 60%(g/100mL),with an average of 40%.If it is the prescription for the treatment of shangjiao disease,the concentration of liquid medicine should be small,can be below 20%,to facilitate the medicinal effect upward.If it is the prescription for the treatment of xiajiao disease,the concentration of liquid medicine should be large,can be more than 60%,to facilitate the medicinal effect downward.It has a high reference value for how to formulate the conventional concentration of liquid medicine and adjust the concentration of liquid medicine according to the treatment of disease and syndrome.Decocting time The decoction in Synopsis of the Golden Chamber is all decocted once,but there is no record of two decoctions or three decoctions.The decocting time in the original book is marked according to the amount of water added and the amount of liquid,and there is no specific time.In this paper,105 decoction which can be counted as "decocting time" in the original book are sorted out and the ratio of the amount of drug liquid to the amount of water added is analyzed.The "decocting time" can be classified as light decocting、medium decocting and long decocting.Among them,there were 73 prescriptions decocted is medium decoction,accounting for 69.5%,and the ratio of the amount of drug liquid to the amount of water added is 30-50%;and 24 prescription decocted is long decoction,the ratio of the amount of drug liquid to the amount of water added is Less than 30%,and 8 prescription decocted is light decoction,the ratio of the amount of drug liquid to the amount of water added is More than 50%.This suggests that the amount of drug liquid accounts for 30-50%of the water added is the the normal "decocting time".For example,1500mL of water is added,the amount of drug liquid decocted is 450～750mL,with an average of about 600mL,and taken in three times,If the treatment of upjiao disease should be light decocted,add water 1200mL,decocted to 600mL,to facilitate the medicinal effect upward;If the treatment of xiajiao disease should be long decocted,add water 2000mL,decocted to 600mL.to facilitate the medicinal effect downward.ZHANG Zhong-jing’s method of "decocting time",which is based on the ratio of the amount of drug liquid to the amount of water added,does not depend on the degree of heat or time,and puts forward a classical law for reference on how to improve the present decocting method.Special decocting method Most prescriptions in Synopsis of the Golden Chamber are decocted together with many medicines,but there are special decoctions such as xianjian or houxia according to different diseases and properties.It is worth noting that there are three points,one is Gypsum’s xianjian.Gypsum is mineral medicine,nowadays,it is required to be decocted first,but Synopsis of the Golden Chamber uses 9 prescriptions of gypsum,none of which is decocted first,does this remind us that gypsum is necessary to be decocted first?The other is to decoct separately and then decoct together.One prescription,each medicine decocted separately,so that the ingredients are fully dissolved,and then the respective decocted solution mix together to go on decocting.This method of decoction also requires in-depth research and clinical trials.The third is to remove the medicine residue and then decoct.This decocting method can make the whole prescription from Yin to Yang,and from Yang to Yin,with the function of harmonizing Yin and Yang.Clinical use of chaihu prescription in Synopsis of the Golden Chamber to treat shaoyang disease and banxia Xiexin decoction to treat spleen and stomach disease is the right method according to ZHANG Zhong-jing’s thought of remove the medicine residue and then decoct.The third chapter The thought of taking medicines in Synopsis of the Golden Chamber.In this paper,there are 110 decoction of thought of taking medicines in Synopsis of the Golden Chamber sorted out,including times of taking medicine,dosage of taking medicine and nursing of taking medicine.Times of taking medicine There were 58 prescriptions in synopsis of golden Chamber,taking medicine three times a day,accounting for 52.9%.There were 21 prescriptions,twice a day,accounting for about 19%.The total amount of prescriptions taken two or three times a day in the book is nearly 72%,which can be regarded as the routine times of taking medicine,which provides a "holy law" reference for revising the "conventional" method of taking decoction twice a day.Dosage of taking medicine In synopsis of the golden chamber 59%of the decoction is taken one liter at a time,about 200mL.21%of the decoction is taken qihe or bahe,namely 140～160mL.It can be seen that 80%of the decoction in Synopsis of the Golden Chamber is in the dosage of 140～200mL,which is the normal dosage.In addition,Synopsis of the Golden Chamber also according to the particularity of the disease and medicine,and adopted a special taking dose method.For example,most prescriptions for treating phlegm-drinking diseases and toxic drugs are less than the conventional dose,taking sihe to Liuhe(80～120mL)each time,so as to avoid taking more medicine liquid and increasing phlegm-drinking or causing toxic and side effects.Nursing of taking medicine Synopsis of the Golden Chamber attaches importance to dietary care,such as guizhi decoction needs to avoid raw cold,sticky,five xin,wine cheese,meat noodles,stench and other food.Not only guizhi decoction,other decoction should also avoid these too.Diaphoresis prescription drug after care,pay attention to grasp the situation of sweating,one is "Sweating all over the body.".If the sweat is not enough sweat,disease refused to go.The second is "Micro sweat".Micro sweat is evil with sweat solution,if the sweat such as shower,not only the disease does not heal,but also hurt the vitality.Nursing and medicine have a synergistic effect,for the treatment and rehabilitation of diseases,has a role that can not be ignored,for Traditional Chinese Medicine syndrome differentiation and medication protection to open up a precedent.Conclusion This paper systematically sorted out the pharmaceutical thoughts of synopsis in Synopsis of the Golden Chamber,and put forward the thought of multi-thinking and paying attention to the use of drugs by distinguishing prescription and syndrome from a new perspective.This paper systematically arranges the pharmaceutical thoughts in Synopsis of the Golden Chamber,puts forward the multi-thinking medication system and the most important formula-syndrome differentiation of using medicines from a new Angle,and discusses the thought of making medicine and taking medicine in Synopsis of the Golden Chamber.This paper hopes to provide classical references for inheriting and developing Zhongjing’s pharmaceutical thought,serving Traditional Chinese Medicine clinical practice,Traditional Chinese Medicine dispensing,and modern Traditional Chinese Medicine research and production,and has certain theoretical significance and practical value. |
PDF Full Text Request