《傅青主女科》柴胡、白芍药对配伍应用探析*

作者：孔令源，夏庆昌

单位：山东中医药大学，山东 济南 250014

引用：引用：孔令源，夏庆昌.《傅青主女科》柴胡、白芍药对配伍应用探析[J].中医药导报,2026,32(3):267-271.

DOI：10.13862/j.cn43-1446/r.2026.03.045

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摘要：

柴胡、白芍药对在《傅青主女科》中共有11处记载，涉及带下、血崩、月经病、难产及产后病等，用法可谓独具特色。该药对通过剂量调控（柴胡用量小于1钱偏于升脾，用至1钱疏肝解郁；白芍5钱可通气血，用至1两兼能滋阴补血）、炮制增效（柴胡生用以保持升发之性；白芍酒炒通利减寒、醋炒入血养肝）及比例（1∶3~1∶5主疏肝；1∶10~1∶20重养阴），实现“疏肝解郁”与“滋阴养血”的动态协同。核心病机干预体现三大特色：（1）协调肝体阴用阳矛盾，柴胡疏肝用、白芍养肝体；（2）枢转气机，柴胡升举配白芍敛降；（3）母子同治，疏肝郁以开肾郁。其配伍规律以“苦寒同泄而一泻一补、同降而一升一降”为理论内核，突破仲景药对框架，为妇科病证遣方用药定量提供参考。

关键词：《傅青主女科》；傅青主；白芍；柴胡；药对

Abstract：

There are 11 records of the medicine pair of Chaihu (Bupleuri Radix) and Baishao (Paeoniae Radix Alba) in FU Qingzhu Nyuke, involving leukorrhea, metrorrhagia and metrostaxis, menstrual diseases, difficult labor, puerperal diseases and so on, with a unique usage. This medicine pair realizes the dynamic synergy of "soothing the liver and relieving stagnation" and "nourishing Yin and enriching blood" through dosage regulation (Chaihu <Bupleuri Radix> in a dosage of less than 1 qian tends to invigorate the spleen, and 1 qian is used to soothe the liver and relieve stagnation. Baishao <Paeoniae Radix Alba> of 5 qian can unblock Qi and blood, and 1 liang is used to nourish Yin and enrich blood), processing for synergism (raw Chaihu <Bupleuri Radix> is used to maintain the ascending and effusing nature, wine-fried Baishao <Paeoniae Radix Alba> promotes circulation and reduces coldness, and vinegar-fried Baishao <Paeoniae Radix Alba> enters the blood to nourish the liver) and ratio (1∶3~1∶5 mainly soothes the liver; 1∶10~1∶20 focuses on nourishing Yin). The intervention of core pathogenesis reflects three major characteristics: (1) coordinating the contradiction between the Yin essence and Yang function of the liver, with Chaihu (Bupleuri Radix) soothing the liver function and Baishao (Paeoniae Radix Alba) nourishing the liver body; (2) pivoting the Qi activity, with Chaihu (Bupleuri Radix) in ascending combination with P Baishao (Paeoniae Radix Alba) in astringing and descending; (3) treating both the mother and the child, soothing liver stagnation to relieve kidney stagnation. Its compatibility law takes "simultaneous purgation with bitter cold nature, one purgation and one tonification, simultaneous descending with one ascending and one descending" as the theoretical core, breaks through the framework of Zhongjing's medicine pair, and provides a reference for the quantification of prescription and medication for gynecological syndromes.

Key words：FU Qingzhu Nvke; FU Qingzhu; Baishao (Paeoniae Radix Alba); Chaihu (Bupleuri Radix); medicine pair

发布时间：2026-03-28

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