仲景桂枝汤的双重效用:"散阳""扶阳"之别在于"桂枝法将息"OA

Guizhi Tang is hailed as the leader of prescriptions in Treatise on Febrile Diseases.Its core academic value lies in Zhang Zhongjing's innovation,which allows this single prescription to possess both the effects of inducing perspiration to disperse yang and warming the middle energizer to replenish yang,breaking through the traditional binary thinking pattern of perspiration therapy and tonification therapy.The prescription uses Guizhi as the mainingredient,which is pungent,sweet,warm,and activating in nature.It can induce perspiration to dispel exterior pathogens and warm and activate meridians to nourish the qi of the middle ener-gizer,thus laying the foundation for the dual therapeutic effects of Guizhi Tang,which are both attacking and nourishing.The bidirec-tional regulatory mechanism of attacking and nourishing in Guizhi Tang is specifically reflected in its clinical application.According to Treatise on Febrile Diseases,the difference between the two uses of Guizhi Tang lies not only in the modifications of the formula(addition or subtraction of medicines),but also potentially in the differences in postscript annotations of analogous formulas.When applying Guizhi Tang and its analogous formulas clinically,the key to distinguishing between its attacking and nourishing thera-peutic orientations lies in whether the postscript emphasizes the regimen of Guizhi Tang method and the method of regimen after sweating.This flexible application,based on the combination of pathogenesis and the method of regimen,enables Guizhi Tang and its analogous formulas to be widely applicable to various external and internal syndromes,profoundly embodying Zhang Zhong-jing's essence of syndrome differentiation and treatment,which is to observe the pulse and symptoms,identify the pathogenetic deviation,and treat accordingly.Therefore,based on Treatise on Febrile Diseases and referencing various discussions,this article aims to clarify that the key to its dual use of a single prescription lies in whether the regimen of Guizhi Tang method is followed,so as to provide reference for colleagues in the field.