《伤寒论》大柴胡汤临证应用辨析  

Analysis of Clinical Application of Dachaihu Tang( 大柴胡汤) in Treatise on Cold Pathogenic Disease( 伤寒论)

作　　者：李云虎[1] 李东[1] 王春勇[1] 

机构地区：[1]北京大学第三医院,北京市海淀区花园北路49号100091

出　　处：《中医杂志》2017年第6期475-478,共4页Journal of Traditional Chinese Medicine

摘　　要：《伤寒论》中大柴胡汤与《金匮要略》的大柴胡汤相比在组成上少大黄一味,总结历代医家对大柴胡汤有无大黄的观点论述,通过对历代医家著作中对于大柴胡汤的证治特点的认识,可归纳为加大黄可用于阳明腑实,大便秘结;湿热蕴蒸,大便黏滞不畅;热结胃腑血分,神志异常;腹诊上腹胁肋硬满疼痛等。无大黄之大柴胡汤以和解少阳、疏泄肝胆为其主要功效,其适应证为肝胆郁滞、枢机不利所致疾病。Compared with Dachaihu Tang in Synopsis of Golden Chamber （金匮要略） , Dachaihu Tang was only without Dahuang [ Radix et Rhizoma Rhei, 大黄] on the composition in Treatise on Febrile Diseases. The authors summarize the opinions and discussions of physicians of past generations on whether Dachaihu Tang includes Dahuang. By understanding the characteristic of syndrome and treatment of Dachaihu Tang in work of physicians of past generations, the authors conclude that adding Dahuang is used to treat excess of Yangming fu-viscera and constipation, dampness-heat amassing-steaming and sticky-stagnant stool, heat accumulation of stomach fu-viscera xuefen （血分） and abnormal state of mind, as well as hard, full and pain in epigastrium or rib by abdomen examination, etc. The main effect of Dachaihu Tang without Dahuang is reconciling Shaoyang, as well as conveying and dispersing liver and gallbladder. The indicating syndromes are diseases owing to liver and gallbladder stagnation and dysfunction of the pivot.

关 键 词：大柴胡汤 大黄 少阳腑实 阳明腑实 

分 类 号：R289.5[医药卫生—方剂学]