2026年中医临床方剂君臣佐使经典方剂解析试卷

2026年中医临床方剂君臣佐使经典方剂解析试卷一、单项选择题（每题1分，共20分。每题只有一个正确答案，请将正确选项的字母填入括号内）1.下列哪一味药在“四君子汤”中属于“君药”？A.白术  B.人参  C.茯苓  D.炙甘草（  ）2.“桂枝汤”中，桂枝与芍药的配伍体现了何种治法？A.辛甘化阳  B.酸甘化阴  C.辛散酸收  D.甘缓辛开（  ）3.在“补中益气汤”中，升麻与柴胡共为佐使，其主要作用是：A.升阳举陷  B.疏肝解郁  C.清热解毒  D.引药上行（  ）4.“当归补血汤”中，黄芪五倍于当归，其配伍比例体现的治法是：A.补气以生血  B.补血以载气  C.气血双补  D.气行则血行（  ）5.“小青龙汤”中，干姜与细辛共为臣药，其配伍意义在于：A.温肺化饮  B.温中散寒  C.回阳救逆  D.温经通脉（  ）6.“六味地黄丸”中，泽泻与丹皮共为佐药，其作用是：A.泄肾浊、清虚热  B.利水渗湿、活血散瘀C.降相火、坚肾阴  D.泄浊阴、引药入肾（  ）7.“炙甘草汤”中，炙甘草用量达四两，其君药地位确立的依据是：A.用量最大  B.主治脉结代、心动悸C.调和诸药  D.补中益气（  ）8.“真武汤”中，附子为君，白术、茯苓为臣，其配伍体现了：A.温阳利水  B.健脾渗湿  C.回阳救逆  D.温肾助阳（  ）9.“温经汤”中，吴茱萸与桂枝共为臣药，其共同作用是：A.温经散寒  B.暖肝散寒  C.温中止痛  D.通利血脉（  ）10.“血府逐瘀汤”中，桃仁、红花共为臣药，其配伍意义是：A.活血祛瘀  B.破血下瘀  C.活血通络  D.化瘀生新（  ）11.“阳和汤”中，熟地为君，麻黄为臣，其配伍体现了：A.滋阴透表  B.温阳散寒  C.补血通滞  D.填精透毒（  ）12.“清营汤”中，银花、连翘共为佐药，其作用是：A.清热解毒、透营转气  B.清热凉血、解毒散结C.清气分热、护阴津  D.清虚热、除骨蒸（  ）13.“竹叶石膏汤”中，竹叶与石膏共为君药，其主治证候为：A.余热未清、气津两伤  B.暑热伤气、汗出烦渴C.阳明气分热盛  D.热病后期、低热不退（  ）14.“半夏厚朴汤”中，苏叶为佐使，其作用是：A.宣肺利咽  B.行气宽中  C.引药上行  D.芳香化湿（  ）15.“苓桂术甘汤”中，桂枝为臣，其配伍茯苓的意义是：A.温阳化饮  B.通阳利水  C.化气行水  D.温中降逆（  ）16.“大黄牡丹汤”中，大黄为君，其用量宜：A.先煎  B.后下  C.同煎  D.冲服（  ）17.“乌梅丸”中，黄连、黄柏共为佐药，其作用是：A.苦寒坚阴  B.清热燥湿  C.泻肝安蛔  D.清上热（  ）18.“补阳还五汤”中，黄芪用量达四两，其君药地位确立的依据是：A.补气行血  B.气旺则血行  C.托毒生肌  D.升阳举陷（  ）19.“桑杏汤”中，沙参为臣，其配伍意义是：A.养阴润燥  B.清肺生津  C.益胃生津  D.润肺止咳（  ）20.“柴葛解肌汤”中，羌活、白芷共为臣药，其共同作用是：A.解表散寒  B.祛风止痛  C.宣痹止痛  D.透疹解毒（  ）二、配伍选择题（每题2分，共20分。每题由一组试题共用五个备选答案，备选答案可重复选用，也可不选用）【21-25】A.君  B.臣  C.佐  D.使  E.反佐21.“四物汤”中，熟地属于（  ）22.“四物汤”中，川芎属于（  ）23.“四物汤”中，白芍属于（  ）24.“四物汤”中，当归属于（  ）25.“四物汤”中，炙甘草若加入，则属于（  ）【26-30】A.辛开苦降  B.辛甘化阳  C.酸甘化阴  D.苦辛通降  E.辛散酸收26.“枳实薤白桂枝汤”中，枳实与厚朴配伍体现（  ）27.“芍药甘草汤”中，芍药与甘草配伍体现（  ）28.“桂枝汤”中，桂枝与芍药配伍体现（  ）29.“半夏泻心汤”中，半夏与干姜配伍体现（  ）30.“甘草干姜汤”中，甘草与干姜配伍体现（  ）三、方剂默写与君臣佐使标注（每题5分，共20分。请完整写出方剂组成，并于每味药后括号内注明君、臣、佐、使）31.写出“生脉散”组成并标注：_____________________________________________________________________32.写出“温胆汤”组成并标注：_____________________________________________________________________33.写出“八正散”组成并标注：_____________________________________________________________________34.写出“独活寄生汤”组成并标注：_____________________________________________________________________四、病案分析题（每题10分，共20分。要求：辨证、立法、处方、分析君臣佐使）35.患者，男，56岁。反复胃脘隐痛10年，加重1月。喜温喜按，空腹痛甚，得食痛减，神疲乏力，面色萎黄，舌淡胖有齿痕，苔薄白，脉沉细。胃镜示：十二指肠球部溃疡。要求：（1）辨证：__________________________________________________________（2）立法：__________________________________________________________（3）处方：__________________________________________________________（4）方义分析（君臣佐使）：_______________________________________________________________________________________________________________36.患者，女，34岁。经行腹痛3年，痛有定处，拒按，经色紫暗有块，块下痛减，伴胸胁胀闷，舌紫暗，边有瘀斑，脉弦涩。B超：子宫肌壁间肌瘤2.3cm×2.1cm。要求：（1）辨证：__________________________________________________________（2）立法：__________________________________________________________（3）处方：__________________________________________________________（4）方义分析（君臣佐使）：_______________________________________________________________________________________________________________五、计算与剂量换算题（共10分）37.《伤寒论》桂枝加葛根汤原方：葛根四两，桂枝三两，芍药三两，生姜三两，炙甘草二两，大枣十二枚。已知东汉一两折合现代13.8g，大枣十二枚约重36g。（1）请计算原方总重量（g）。（2）若现代成人每日推荐剂量为原方1/3量，求各药日用量（g），并换算成常用饮片调配量（保留一位小数）。（3）若药房葛根库存为每包10g小包装，需拆包几包方可满足3日量？解：（1）总重量&葛根（2）日用量（1/3量）葛根（3）3日葛根量18.4×3=55.2g⇒⌈55.2/10⌉=6六、论述题（共10分）38.试述“君臣佐使”理论在“复元活血汤”中的体现，并结合现代药理学研究成果，分析其配伍科学性（要求：不少于600字，条理清晰，论据充分）。__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________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