摘要
三仁汤始载于清代吴鞠通所著的《温病条辨》,是治疗湿温初起或暑温夹湿,邪在气分,湿重于热的经典名方,具有宣畅气机、清利湿热的功效,可治疗以头痛恶寒,面色淡黄,身重疼痛,肢体倦怠,胸闷不饥,午后身热,苔白不渴,脉弦细而濡等为主要表现的病证。中医学提倡“整体观念”与“辨证论治”,针对不同的疾病进行精准辨证,把握其病机特点处以方药治疗。现代临床将三仁汤广泛应用于湿热蕴结、气机不利所致的心系、肺系、脾胃系、肝胆系、肾系、肠腑、糖尿病及其并发症、皮肤类等多系统疾病,并取得了显著效果,尤其对于一些以湿热证表现为主但疗效不佳的难治性疾病,可应用三仁汤联合治疗,延缓病情发展,延长生存期,发挥中医药特色优势,充分体现“证同则治同”的“异病同治”诊疗思想。现代药理学研究表明三仁汤具有抗炎、抗氧化,增强免疫机能,修复黏膜屏障,调节胃肠动力,维持代谢平衡等作用,证实中药复方具有多靶点、多层次、多成分、多途径等特点,可治疗具有炎症改变、免疫失衡等相同病理基础的多系统疾病。通过探讨三仁汤的“异病同治”,对临床应用三仁汤治疗多系统疾病及其作用机制研究的相关文献进行系统回顾与梳理,以期为应用经方治疗多系统疾病,挖掘经方深层次内涵,建立具有中医药特色的精准诊疗体系,促进中医药传承创新发展提供思路与借鉴。
Sanrentang was first recorded in Detailed Analysis of Warm Diseases(Wen Bing Tiao Bian),a work by Wu Jutong in the Qing Dynasty.It is a classic formula for treating the early stages of dampness-warmth or summer heat-warmth with dampness,characterized by pathogenic factors in the Qi aspect and more dampness than heat.This formula has the effects of dispersing Qi and clearing dampness and heat,and it can thus address symptoms such as headache,aversion to cold,pale yellow complexion,heavy body,pain,fatigue,chest fullness with loss of appetite,afternoon fever,white tongue coating without thirst,and a wiry,thready,and soggy pulse.Traditional Chinese medicine(TCM)emphasizes the holistic approach and treatment based on syndrome differentiation,using precise diagnostic methods to understand the characteristics of disease mechanisms and provide targeted treatment with herbal formulas.In modern clinical practice,Sanrentang has been widely employed to treat multi-system diseases caused by dampness-heat accumulation and obstructed Qi movement,including disorders of the heart,lung,spleen,stomach,liver,gallbladder,kidney,and intestine,diabetes and its complications,and dermatological conditions,achieving remarkable therapeutic outcomes.Particularly,for refractory diseases characterized predominantly by dampness-heat syndromes with poor treatment outcomes,the combined use of Sanrentang can delay disease progression,extend the survival time,and highlight the advantages of TCM,fully embodying the diagnostic and therapeutic principle of treating different diseases with same therapy based on the concept that identical patterns warrant identical therapy.Modern pharmacological studies have demonstrated that Sanrentang exerts anti-inflammatory and antioxidant effects,enhances the immune function,repairs the mucosal barrier,regulates the gastrointestinal motility,and maintains the metabolic balance.These findings confirm that TCM compound formulas possess multi-target,multi-dimensional,multi-component,and multi-pathway characteristics,effectively treating multi-system diseases with common pathological foundations such as inflammation and immune imbalance.This paper reviews the relevant literature on the clinical application of Sanrentang in the treatment of multi-system diseases and its mechanism and explores treating different diseases with same therapy(Sanrentang).This review aims to provide insights and references for using TCM compound formulas in treating multi-system diseases,exploring the deeper implications of these formulas,establishing a TCM-based precise diagnosis and treatment system,and promoting the inheritance and innovative development of TCM.
作者
窦鑫
潘海迪
贺昌辉
温晓晴
梅笑
马源鑫
邓华亮
王伟
DOU Xin;PAN Haidi;HE Changhui;WEN Xiaoqing;MEI Xiao;MA Yuanxin;DENG Hualiang;WANG Wei(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine(TCM),Jinan 250014,China;College of TCM,Shandong University of TCM,Jinan 250014,China;The Affiliated Hospital of Shandong University of TCM,Jinan 250012,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第14期243-254,共12页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金青年科学基金项目(81904128)
国家中医药管理局科技司共建科技项目(GZY-KJS-SD-2023-035)
山东省中医药疗效机理重点实验室项目(PKL2024C23)
山东省中医药重点学科项目——中医脾胃病学(鲁卫中医药科教字[2022]4号)
山东省中医药科技项目面上项目(M-2023167)。
关键词
三仁汤
“异病同治”
临床应用
作用机制
研究进展
Sanrentang
treating different diseases with same therapy
clinical application
mechanism
research progress
作者简介
第一作者:窦鑫,在读硕士,从事中医治疗消化系统疾病的研究,E-mail:3109876827@qq.com;通信作者:王伟,博士,副主任医师,从事中医治疗消化系统疾病的研究,E-mail:smiling365@163.com;通信作者:邓华亮,博士,主任医师,从事消化系统疾病中西医结合临证诊疗研究,E-mail:dhl1002@sina.cn。
