三仁汤中三焦理论的临床应用及优势探讨

三仁汤始载于清代吴鞠通的《温病条辨》,是治疗湿温病的经典方剂,原方由8味中药组成,其配伍具有分消走泄的特点,湿热之邪从上、中、下三焦驱除;分消走泄法即疏通气机,清泄湿热,使三焦湿热逐步清除的一种治疗方法,"分消"即分开消除,给湿邪以不同出径,导湿热邪浊排除体外,"走泄"即外泄、外透,舒展气机,则气通湿除,祛邪外达。由此可见,三仁汤作为祛湿剂,将"分消走泄"作为立方依据,在治疗内湿兼有邪热证方面疗效显著,临床应用范围也相当广泛。查阅近10年资料,依据三焦辨证理论,概述三仁汤的方证理论和临床应用进展,阐述其在上、中、下三焦疾病应用中的疗效及可能作用机制,为有效开发利用三仁汤提供理论依据。新型冠状病毒肺炎(COVID-19)席卷全球,寻求有效的防治方法是医学界面临的巨大挑战,对于COVID-19,尽管病因属"疫戾"之气,但从致病特点来看,众多医家虽有或"寒"或"热"或"毒"不同见解,但均认同"湿"的临床特点,具有"湿邪"属性的COVID-19,由于湿邪黏腻,"在一经不移",病势缠绵,迁延难愈,除发热、咳嗽等主证外,还突出表现为食少纳呆、脘腹胀满、大便溏泻等湿阻中焦的症状特点。三仁汤作为治疗湿温病的经典方剂在新型冠状病毒肺炎防治的应用前景值得探索。

Clinical Application and Advantages of Sanjiao Theory in Sanren Decoction

Sanrentang,originally contained in the Regulations on Febrile Diseases written by WU Jutong in the Qing dynasty,was composed of eight traditional Chinese herbs to treat damp-warm diseases. It is a treatment method of gradually clearing away damp heat of tri-jiao,with characteristics of separating dispersion and mobilizing discharge. "Separating dispersion" means dispersion in separated ways,with different ways to eliminate dampness to export the dampness,heat,evil and turbid out of the body. "Mobilizing discharge" means discharge to stretch and unblock the Qi,to get rid of dampness and evil. It can be seen,Sanrentang,as a desiccating formula,taking "separating dispersion and mobilizing discharge" as the cubic basis,has a significant effect on both internal and external dampness associated with pathogenic heat syndrome, and its clinical application is quite extensive. After consulting the data of the past 10 years,the authors gave a brief overview on the syndrome theory, clinical application and pharmacological effects of Sanrentang, and elaborated the therapeutic effect and pharmacological effect of Sanrentang in the clinical application of upper,middle and lower Tri-jiao respectively,providing theoretical reference for effective development and utilization of Sanrentang.Coronavirus disease-2019(COVID-19)swept the world in early 2020 and it is a great challenge for the medical community to seek for effective prevention and treatment methods. For COVID-19,although the cause of the disease belongs to the Qi of "pestilence",many doctors have different opinions on the pathogenic characteristics.However,they all agree with the clinical characteristics of "dampness". COVID-19,which has the attribute of "dampness evil",is so sticky that it can’t be cured at once. In addition to the main symptoms such as fever and cough,it is also characterized by the middle-jiao dampness symptoms such as poor appetite,fullness of abdomen,loose stool and diarrhea. It is worthy to further explore the application prospect of Sanrentang in COVID-19 prevention and treatment.