《伤寒论》真武汤证理论探讨  

Theoretical Overview on the Syndrome of the Shanghanlun's Zhenwu Decoction

作　　者：黄丽芳[1] 陈明[1] 

机构地区：[1]北京中医药大学基础医学院,北京100029

出　　处：《中华中医药学刊》2016年第1期30-32,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2010CB530604)

摘　　要：真武汤证在《伤寒论》中凡两见,病机为少阴肾脏阳气虚衰,水气内停。肾阳虚水停,除可见肢体水肿,小便不利,便溏下利等证外,还常见水气上冲之表现。水气上冲,多侵犯心肝二脏:水上冲于肝,可见头眩、身瞤动、振振欲擗地等肝风内动之象,谓之"水肝病";水上冲于心,则见心悸,肢体水肿沉重,小便不利等证,谓之"水心病"。尽管症状表现不同,但少阴阳虚水停之病机则一,故均可以用真武汤以温少阴化水气。同时认为,真武汤治疗水气内停是通过调节诸多参与水液代谢之脏腑而完成:附子温补肾阳以复其主水之功,白术健脾以燥湿,生姜宣肺以散水气,茯苓淡渗利湿以利膀胱之水,芍药则走三焦肌腠活血以利水。Objective： Syndrome of the＂Shanghanlun＇s＂Zhenwu Decoction have two difference opinions. The causes of illness are due to the deficiency on kidney yang and water retention. Symptoms noted are heavy limb,edema,urination,unformed stool and diarrhea,etc. The major cause will result in water gushing upwards thus attacking the liver and heart： the attack on the liver,cause visible dizziness,shaking of the body and even fainting etc. We name it ＂Shuiganbing＂. Attack on the heart can cause heart palpitation,heavy limb and edema,urination,etc. We name it ＂Shuixinbing＂. Although both of their syndrome is different,but causes of illness is the same,so we can use the same treatment method on both. Zhenwu Decoction is used to warm the kidney and improve metabolism,so that the kidney can get rid of the excess water. Treatment： Use of Aconite to warm the kidney yang to restore its function. Atractylodes for spleen to reduce dampness,Ginger to reduce water retention. Poria to strengthen the function of the bladder. Peony to promote blood circulation and reduce water retention.

关 键 词：水心病 真武汤 《伤寒论》 肾阳虚证 心下悸 

分 类 号：R222.2[医药卫生—中医基础理论]