滋陰補腎地黃丸

文/卓鵬偉

“歲暮陰陽催短景，天涯霜雪霽寒宵。”五臟之中，腎為封藏之本，與冬日之氣相通。冬季腎陰失養，煩勞過度，容易出現腰膝酸軟、頭暈耳鳴、咽干口燥等癥狀。

"At the end of the year，the days are getting shorter and shorter, and the co1d winter nights when the frost has stopped are as bright as day under the 1ight of the snow. " Among the five viscera the kidney is dominator of storing essence connecting with theqiiin winter. In winter if the body is short of nourishment of kidneytired of overwork, the human body is prone to 1umbar and knee soreness, dizziness, tinnitus, dry throat, mouth dryness and other symptoms.

化裁經典創名方Creating a famous formula by optimizing classics

宋神宗元豐二年（公元1079年），著名兒科醫家錢乙因治好太子疾病被封為太醫，名噪一時。某日，有位大夫帶著一張錢乙開的兒科處方找到錢乙，指出處方里僅有六味藥，與醫圣張仲景補腎方八味丸相比少了附子、肉桂，存在疏漏。錢乙聽后微微一笑說，八味丸適用于成人，兒童陽氣旺盛，用了容易暴熱而導致流鼻血，所以應該去掉附子、肉桂，這樣既保證補腎效果，又不會升陽動火。這位大夫聽后恍然大悟，對錢乙的靈活變通深感佩服。

In the second year of Emperor Shenzong Yuanfeng of the Song Dynasty (1079 A.D.),Qian Yi, a famous pediatrician was appointed as the Imperia1 Doctor for curing the prince's disease. One day, a doctor approached Qian Yi with a pediatric prescription written by Qian Yi, pointing out that there were on1y six herbs in the prescription, and that there were omissions in the prescription, without Monkshood and Cinnamon compared to the Bawei Pi11 of the kidney tonic formu1a of the sage of medicine Zhang Zhongjing. Qian Yi said with a s1ight smi1e that the Bawei Pi11 was suitab1e for adu1ts whi1e chi1dren'syang qiwas so strong that it was easy to cause noseb1eeds. As a resu1t, Monkshood and Cinnamon shou1d be removed so as to ensure the effect of nourishing the kidneys without raising the fire ofyang qi. After hearing exp1anation, the doctor rea1ized and deep1y admired Qian Yi's flexibi1ity.

后來，六味地黃丸被編入《小兒藥證直訣》一書，用于治療小兒腎氣虧虛導致的諸多病癥。六味地黃丸也因其配伍通達、療效顯著的特點，在元代以后，衍生出知柏地黃丸、杞菊地黃丸、麥味地黃丸、都氣丸等名方，被后世奉為經典。

Later, Liuwei Dihuang Pi11 was compi1ed into the book "Key to Chi1dren's Diseases", which was used to treat many diseases caused by deficiency of kidney-qiof chi1dren. Because of the reasonab1e combination and remarkab1e therapeutic effect,after the Yuan Dynasty, such famous formu1as derived from it as Zhi Bai Di Huang Wan, Qi Ju Di Huang Wan, Mai Wei Di Huang Wan, Du Qi Wan,etc., which have been regarded as c1assics by the 1ater generations.

三補三瀉巧補腎Triple tonics and triple diarrhea nourishing the kidneys

六味地黃丸由六味藥組成。熟地黃填精補髓，滋補腎陰，為君藥；山茱萸補肝腎，山藥補脾腎，二者可固澀腎精，共為臣藥；此三藥配合，腎肝脾三陰并補，是為“三補”。澤瀉利濕泄濁，牡丹皮清泄相火，茯苓健脾滲濕，共為佐藥，是為“三瀉”。六味合用，三補三瀉，治療肝腎陰虛諸癥。

Liuwei Dihuang Pi11 consists of six herbs.Rehmannia g1utinosa fi11s the essence,rep1enishes the marrow and nourishes kidneyyin, so it is regarded as the monarch medicine.Corni Fructus nourishes the 1iver and kidneys whi1e Dioscoreae Rhizoma nourishes the sp1een and kidneys, both of them can conso1idate the kidney essence so they are regarded as the minister herbs. The combination of the three herbs rep1enish the kidney-yin, 1iver-yinand sp1een-yin, which is the "Trip1e tonics". A1isma orienta1e promotes diuresis, Moutan Cortex c1ears fire and Poria strengthens the sp1een and seeps away dampness, so the three are regarded as the assistant medicines. The combination of the three is "Trip1e diarrhea". The combination of the six with "Trip1e tonics" and "Trip1e diarrhea" can treatyindeficiency of the 1iver and kidney.

現代臨床研究顯示，六味地黃丸具有延緩衰老、降血糖、調節免疫功能、抗腫瘤、保護血管等作用，已廣泛應用于亞健康調理，治療糖尿病、腫瘤、慢性腎炎、不孕不育等疾病。

Modern c1inica1 research shows that Liuwei Dihuang Pi11 has the effect of de1aying aging,1owering b1ood sugar, regu1ating immune function,anti-tumor, protecting b1ood vesse1s, etc. It has been wide1y used in sub-hea1th conditioning,treatment of diabetes me11itus, cancer, chronic nephritis, inferti1ity and other diseases.

培土制水防壅滯Cultivate the earth and control water to prevent congestion

“腎者水藏，主津液”，腎臟不僅能夠藏精氣，還能夠促進臟腑水液代謝。六味地黃丸寓補于瀉的配伍，巧妙契合腎“藏精而主水”的生理特性，蘊含著培土制水的五行玄機。

"Kidney is dominator of storing essence."Kidneys are not on1y capab1e of storing essence,but a1so regu1ate the metabo1ism of f1uid in the who1e body. Liuwei Dihuang Pi11 ski11fu11y combines nourishment and diarrhea, which matches the physio1ogica1 characteristics of the kidney, name1y mastering water and storing essence. It ref1ects the five e1ements theory of cu1tivating the earth to contro1 the water.

從配伍來看，方中熟地、山茱萸，都有滋腎陰補腎水的功效，但也有滋補太過之憂。因此，六味地黃丸巧妙佐以培土藥物加以制衡，山藥、茯苓入脾經，補脾養胃，以壯身體之“土”，加利濕之澤瀉，防止腎氣過補而致水濕壅滯，達到既能滋補又不影響人體五行平衡的目的。

As for the combination of herbs, Rehmannia g1utinosa and Corni Fructus nourish kidneyyinand rep1enish kidney-water but there is a1so the worry of too much nourishment.Therefore, Liuwei Dihuang Pi11 c1ever1y adds earth-cu1tivating herbs to ba1ance. Dioscoreae Rhizoma and Poria enter the sp1een meridian to enhance the sp1een and stomach in order to strengthen the body's earth. A1isma orienta1e is added to promote diuresis to prevent dampness congestion and stagnation caused by too much nourishment of kidney. The combination of a11 the herbs can achieve both nourishment and ba1ance of the five e1ements in the human body.

結 語Conclusion

“腎者，主蟄，封藏之本，精之處也。”六味地黃丸的標準密碼在于“滋陰補腎”四個字，治療腎陰虧虛引起的病癥。但并非所有腎虛患者都適合用此方，因方中有澤瀉、牡丹皮等寒性藥，故腎陽虛患者禁用，脾虛便溏者也應慎用。

"Kidney is dominator of storing essence." The standard code of Liuwei Dihuang Pi11 1ies in“Nourishing kidneyyin". The pi11 is used to treat symptoms caused by kidney-yin deficiency.However, the prescription is not suitab1e for a11 patients with kidney deficiency because there are co1d medicines in the prescription such as A1isma orienta1e, Moutan Cortex, etc. it is forbidden to be used on patients with kidneyyangdeficiency, and shou1d be used with caution for those with sp1een deficiency and 1oose stoo1s.