世界中医药

“一方两法”是指方剂组成药味相同，因剂型、剂量、煎煮方法或服用方法不同从而导致方剂功效有所差异的用药方法；或指方剂的基本组方结构相同，随兼证的不同而适当加减变换某些药味，从而导致方剂功用及治疗效果发生变化的用药方法，即柯韵伯所言“方内之方”，包括仲景5个或然证方及方后注中所列加减法者，如理中丸作汤法等等［1］。此处应指出：“一方两法”之“两”并非“二”之意，亦可有一方三法、四法等等，为“多”之意，其变换之因在于邪之深浅、正邪之盛衰以及兼证之不同。此文举《伤寒论》及《金匮要略》中几个典型方剂以探讨“一方两法”思想的运用方法，以启迪临床灵活运用经方的思路并提高疗效。

English Summary:

“One Prescription with Two Directions” is a medication method that means prescriptions constituted by the same herbal medicines have diverse efficacy of prescription as the differences of dosage forms，doses，decoction methods or methods of taking medicine. The thought is as the same as the statement of “the formula of the prescription” said by Ke Yunbo，which means the basic group structures of the prescriptions are as usual，as well as adding or subtracting some herbs of the prescriptions appropriately on the basis of accompanying syndromes. Thus，it can lead to several changes of the efficacy and the treatment effects of prescriptions. It contains 5 probabilistic methods founded by Zhang Zhongjing and the addition or subtraction of the formulas noted after the prescriptions，such as taking Lizhong Bolus as decoction method，and so on. It is indispensable to point out that the “two” of “One Prescription with Two Directions” means not only the number of “two”，but also “One Prescription with Three Directions” or “four directions”. Its meaning is “many”. The reasons for changing the directions are dominated by the depth of pathogenic factors，the vicissitude of vital qi and pathogens，and the imparity of accompanying syndromes. The purport of this paper is to illustrate some typical examples in Treatise on Febrile Diseases and Synopsis of Golden Chamber to discuss the application of the thought of “One Prescription with Two Directions”，so as to enlighten the train of thought to use the classical prescriptions neatly and improve the efficacy.

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