摘要
小柴胡汤事件指20世纪70年代,日本厚生省将小柴胡汤制剂作为治疗肝病的首选药物,贯穿肝病治疗始终,出现不论何种原因导致的肝病,皆用小柴胡汤治疗。20世纪90年代,日本陆续报道了小柴胡汤引起间质性肺炎的案例。从此在日本全面禁止各型肝炎、自身免疫性肝病、肝硬变、肝癌病人服用小柴胡汤相关制剂。“古方今病,不相能也”是易水学派创始人张洁古在《医学启源》中提出的理论,原意是反对拘泥于古方,但通过小柴胡汤事件,被后人曲解为古方不能治疗今病。仲景在应用小柴胡汤时提出“但见一证便是,不必悉具”,意指用小柴胡汤治疗少阳病时,要坚持辨证论治,注重紧抓疾病主证及本质。而临证中不见小柴胡汤证之主证,生搬硬套强予小柴胡汤的小柴胡汤事件,是断章取义的结果,而非“古方今病,不相能也”。
The Xiaochaihu Decoction incident refers to the fact that in the 1970s,Health and Welfare Ministry of Japan established Xiaochaihu Decoction as the first choice for the treatment of liver disease and used throughout the disease Course,which result in a condition that all kind of liver disease were treatment with Xiaochaihu Decoction.In the 1990s,Japan successively reported cases of interstitial pneumonia caused by Xiaochaihu.Since then,patients with any types of hepatitis,autoimmune liver disease,cirrhosis,and liver cancer have been completely banned from taking Xiaochaihu Decoction and related preparations."Ancient prescription cannot harmonious with modern diseases"is a theory raised by Zhang Jiegu,the founder of the Yishui School,in Yi Xue Qi Yuan.The original intention was to oppose sticking to ancient prescriptions,however,after the Xiaochaihu Decoction incident;it was misinterpreted as ancient prescription cannot treat modern diseases.Back when Zhang Zhongjing applying Xiaochaihu Decoction,he proposed that"Knowing the main symptom instead of knowing it all",which means Xiaochaihu Decoction in Shaoyang disease treatment,it is necessary to adhere treatment based on syndrome differentiation and pay attention to the main symptoms and essence of the disease.Misuse Xiaochaihu decoction without evidence of main syndrome of Shaoyang Diseases,the Xiaochaihu decoction incident was the aftermath of mechanically study and quote out of context,rather than"Ancient prescription cannot harmonious with modern diseases."
作者
张洋
石志超
石鉴泉
尹晓磊
王占云
ZHANG Yang;SHI Zhichao;SHI Jianquan;YIN Xiaolei;WANG Zhanyun(The Second Affiliated Hospital of Dalian Medical University,Dalian Liaoning China 116000;Dalian Hospital of Traditional Chinese Medicine,Dalian Liaoning China 116000;National Famous Traditional Chinese Medicine Expert Shi Zhichao Inheritance Studio,Dalian Liaoning China 116000;Jianping County Hospital,Jianping Liaoning China 122400)
出处
《中医学报》
CAS
2021年第6期1172-1175,共4页
Acta Chinese Medicine
基金
全国名老中医药专家传承工作室建设项目{国中医药人教函〔2019〕41号}。
关键词
小柴胡汤
小柴胡汤事件
“古方今病
不相能也”
“但见一证便是
不必悉具”
张洁古
《医学启源》
张仲景
《伤寒论》
Xiaochaihu Decoction
Xiaochaihu Decoction incident
"ancient prescription not coping with modern diseases"
"knowing the main symptom instead of knowing it all"
Zhang Jiegu
Yi Xue Qi Yuan
Zhang Zhongjing
Treatise on Febrile Diseases
