蒋健以芍药甘草汤治疗痛证验案举隅  

Jiang Jian's Experience in Treating Pain Syndrome with Shaoyao Gancao Decoction

作　　者：崔晨[1] 耿琦[1] 李敬伟[1] 蒋健[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《河南中医》2016年第5期783-785,共3页Henan Traditional Chinese Medicine

基　　金："十二五"重大新药创制项目(编号:2012ZX09303009-001);上海市教委重点学科项目(编号:J50303)

摘　　要：蒋健教授以芍药甘草汤治疗痛证有以下特点:芍药甘草须同用;芍药用量宜大,用量一般30 g起,最高用至60 g;寒热虚实皆可用,蒋健教授认为,举凡胸、胁、背、腹、四肢、头面横纹肌以及内脏平滑肌痉挛性及神经性疼痛,无不可以芍药甘草汤为基础方进行治疗;临证针对患者疼痛性质及寒热虚实整体证候,施以不同配伍。蒋健教授指出:疼痛原因繁杂,需要明辨病机,对某些属于现代医学外科急症类疾病所致腹痛,不可贸然"见痛止痛",以免掩盖病情、延误治疗时机。且芍药甘草汤并非对于一切疼痛均可有效缓解、效如桴鼓,似乎对于轻、中度痛证收效较佳,而重度疼痛(如癌性疼痛)的疗效仍较为有限。The characteristics of Jiang Jian’s experience in treating pain syndrome with Shaoyao Gancao Decoction include： simultaneous use of Shaoyao（ Radix Paeoniae Alba） and Gancao（ Radix et Rhizoma Glycyrrhizae）,large dose（ 30 g- 60 g） of Shaoyao（ Radix Paeoniae Alba）,applicable for all cold,heat,deficiency and excess syndrome. According to Professor Jiang Jian,the spasmodic and neuropathic pain of the chest,hypochondrium,back,abdomen,four limbs,head and face striated muscle and visceral smooth muscle can be treated with the basic formula of Shaoyao Gancao Decoction. The formula can be compatibility of medicines can be modified based on the clinical pain nature and the whole symptoms of cold,heat,deficiency and excess. Professor Jiang points out that the causes of pain are complex,so the pathogenesis should be identified. For some abdominal pain caused by surgical emergency in modern medicine,the principle of ＂ stopping pain when pain is seen＂ cannot be followed without careful consideration in case of covering up the disease condition and delaying the treatment time. Besides,Shaoyao Gancao Decoction is not effective on all kinds of pain. For the mild and moderate pain,it can achieves good effects while for the severe pain（ like cancer pain）,its effect is still limited.

关 键 词：芍药甘草汤 疼痛 脐周自压痛 胃痛 背痛 胁痛 睾丸痛 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]