CAJ | 학술논문

下法作为中医八大治疗方法之一，具有应用广泛、见效相对迅速的特点及优势。在中医古籍中有丰富的记载与论述。《金匮要略》中涉及下法的条文约五十余条，相关方剂包括大小承气汤、大黄硝石汤、栀子大黄汤、茵陈蒿汤、泻心汤、苓甘五味加姜辛半杏大黄汤、大黄甘草汤、麻子仁丸、猪膏发煎、走马汤、大黄附子汤、大黄圌虫丸、下瘀血汤、大黄牡丹汤、抵当汤、桔梗白散、十枣汤、己椒苈黄丸、大黄甘遂汤、甘遂半夏汤、厚朴三物汤、厚朴七物汤、厚朴大黄汤、大柴胡汤，共计25方，运用下法所治疗的疾病有：胸满、腹满、痰血、黄疸、肠痈、产妇腹痛、产妇少腹坚痛、妇人水与血俱结血室等十七个病证，应用范围相当广泛。本文基于《金匮要略》，对涉及下法的条文、病证、治法、方药进行归纳总结，从下法所治疗疾病的性质、患病部位、阴阳表里、用药特点等6个方面，探讨仲景下法治疗的应用特点，以期对现代中医学临床疾病诊治有所参考。
하법작위중의팔대치료방법지일，구유응용엄범、견효상대신속적특점급우세。재중의고적중유봉부적기재여논술。《금궤요략》중섭급하법적조문약오십여조，상관방제포괄대소승기탕、대황초석탕、치자대황탕、인진호탕、사심탕、령감오미가강신반행대황탕、대황감초탕、마자인환、저고발전、주마탕、대황부자탕、대황천충환、하어혈탕、대황모단탕、저당탕、길경백산、십조탕、기초력황환、대황감수탕、감수반하탕、후박삼물탕、후박칠물탕、후박대황탕、대시호탕，공계25방，운용하법소치료적질병유：흉만、복만、담혈、황달、장옹、산부복통、산부소복견통、부인수여혈구결혈실등십칠개병증，응용범위상당엄범。본문기우《금궤요략》，대섭급하법적조문、병증、치법、방약진행귀납총결，종하법소치료질병적성질、환병부위、음양표리、용약특점등6개방면，탐토중경하법치료적응용특점，이기대현대중의학림상질병진치유소삼고。
Purgative method, as one of the eight therapeutic methods of traditional Chinese medi-cine ( TCM) with many characteristics and advantages such as wide application and relatively quick effect. There are a lot of records and discussions on it in the ancient books of TCM. For example, there are more than 50 articles about purgative method and a total of 25 relevant prescriptions are involved in Synopsis of Golden Chamber. The relevant prescriptions includes Dachengqi Decoction, Xiaochengqi Decoction, Dahuang Xiaoshi Decoction, Zhizi Dahuang Decoction, Yinchenhao Decoction, Xiexin Decoction, Linggan Wuwei Decoction modified with Jiangxin Banxing Dahuang, Dahuang Gancao Decoction, Maziren Pill, Zhugaofa Decoction, Zouma Decoction, Dahuang Fuzi Decoction, Dahuang Zhechong Pill, Xiayuxue De-coction, Dahuang Mudan Decoction, Didang Decoction, Jiegengbai Powder, Shizao Decoction, Jijiao Li-huang Pill, Dahuang Gansui Decoction, Houpo Sanwu Decoction, Houpo Qiwu Decoction, Houpo Dahuang Decoction and Dachaihu Decoction. Besides, there are 17 kinds of diseases are treated with such method, including chest turgor, stomach turgor, bloody phlegm, jaundice, acute appendicitis, maternal abdominal pain, maternal intestinal carbuncle and maternal congestion of water and blood in blood chamber, so it is widely applied. This paper summed up the the provisions, diseases and syndromes, therapies, and pre-scriptions involving purgative method based on Synopsis of Golden Chamber, and discussed the application characteristics of the purgative method of ZHANG Zhong-jing from the following 6 aspects, such as nature of disease, diseased parts, exterior and interior of Yin and Yang, and medication features, in order to provide some reference for the diagnosis and treatment of the clinical diseases in modern TCM.