麻黄汤中桂枝的配伍意义解析  

Analysis of The Significance of Compatibility of Guizhi in Mahuang Decoction

作　　者：邵家东 陈萌[2] 都广伍 都广礼[4] SHAO Jia-dong;CHEN Meng;DU Guang-wu;DU Guang-li(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shttguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;DU Guang-wu Clinic of Intergrated Traditional and Western Medicine,Shenyang 110000,China;Basic Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学附属曙光医院,上海201203 [3]都广伍中西医结合内科诊所,沈阳110000 [4]上海中医药大学基础医学院,上海201203

出　　处：《中国中医基础医学杂志》2018年第9期1290-1291,1294,共3页JOURNAL OF BASIC CHINESE MEDICINE

摘　　要：麻黄汤为张仲景《伤寒论》中的发汗名方,方中麻黄、桂枝配伍是发汗的基本配伍,多数医家及中医《方剂学》教材中通行的观点认为桂枝的配伍意在加强麻黄的发汗作用。自陶弘景《本草经集注》起,麻黄被誉为伤寒发表之第一要药,既然麻黄有如此之强的发汗作用,为什么还要配伍桂枝增强其发汗作用呢?参考《伤寒论》使用麻黄发汗时强调不可太过的禁训,又"汗为心之液"、心之阳气是汗液化生的动力源泉,发汗太过则有损伤心阳之虞,而桂枝有温振心阳的作用,且《伤寒论》中每多运用桂枝治疗心阳不振导致的如心悸、脉结代、自汗、奔豚等病证。因此,麻黄汤中桂枝的配伍并非加强麻黄的发汗作用,而是振奋心阳以制约麻黄峻猛发汗而伤心阳之弊。Mahuang Decoction is a well known formula for inducing sweating recorded in Treatise on Febrile Diseases,and the basic sweat inducing compatibility of Mahuang Decoction is Mahuang and Guizhi. It is the popular view that the mutual reinforcement exists between Guizhi and Mahuang,that is to say the two herbs enhances each other to promote sweating in Mahuang Decoction. It is widely accepted that Mahuang is of the strongest sweating inducing effect to resolve the exterior syndrome since the Annotation of Materia Medica from TAO Hongjing,why Guizhi is combined in Mahuang Decoction to further promote sweat inducing effect of Mahuang？ Taking consideration of not excessive sweating in applying Mahuang Decoction in clinic to avoid consuming the heart Yang,sweat is fluids of the heart to TCM,and Guizhi is the most commonly used herb invigorate heart Yang to treat palpitation,irregular pulse,spontaneous perspiration,qi-gushing sensation and other diseases due to hear Yang deficiency,so the compatibility of Guizhi in Mahuang Decoction is not strengthen sweat inducing effect of Mahuang,on the contrary,vitalize the heart Yang to check the side effect of Mahuang to consume the heart Yang.

关 键 词：麻黄汤 麻黄 桂枝 配伍意义 

分 类 号：R289.5[医药卫生—方剂学]