从“病-证-方-药-量”角度探讨升阳散火汤治疗顽固性发热  

Medium-term and long-term fever treated by Shengyang Sanhuo Decoction from the perspective of “disease-pattern-formula-medicinal-dose”

作　　者：潘中艺[1] 宋文杰[2] 倪胜楼[2] 傅延龄[2] 裴相俊 孙晓峰[3] Pan Zhongyi;Song Wenjie;Ni Shenglou;Fu Yanling;Pei Xiangjun;Sun Xiaofeng(China Minmetals Corporation,Beijing 100010;Beijing University of Chinese Medicine,Beijing;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences)

机构地区：[1]中国五矿集团有限公司,北京100010 [2]北京中医药大学 [3]中国中医科学院中医药信息研究所

出　　处：《现代中医临床》2018年第5期46-49,共4页Modern Chinese Clinical Medicine

基　　金：北京中医药大学校级课题(No.2010072220010)

摘　　要：目的从"病-证-方-药-量"角度探析运用升阳散火汤治疗中长程发热的临床经验,总结临床思维和用药用量特点。方法对2016年1月至2018年4月在北京中医药大学国医堂中医门诊部运用升阳散火汤诊治的20例发热(持续2~6个月)病例进行统计分析。结果运用升阳散火汤治疗的发热,其常见临床表现除发热外,还有乏力、恶风寒、食欲一般、口干、大便溏薄等。方中药物常用剂量:辛温发散药防风、升麻、羌活、独活6~10 g;解肌退热药柴胡8~20 g,葛根10~20g;健脾补中药人参6~15 g(党参15~20 g),黄芪15~20 g,炙甘草3~10 g;清热解毒药生甘草5~10 g;滋阴养血药白芍6~20 g。从性味、归经来看,药物以微温、辛甘味为主,多入脾、肺二经。结论取"火郁发之"之意,临床选用升阳散火汤治疗中长程发热,处方精简,用量得当,疗效确切。Objective To explore the clinical thinking and characteristics of applying herbs in different doses from the perspective of ＂disease-pattern-formula-medicinal-dose＂on using Shengyang Sanhuo Decoction in the treatment of fever. Methods A total of 20 patients with fever lasting 2 m to 6 m treated using Shengyang Sanhuo Decoction in Outpatient Department of Guoyitang,Beijing University of Chinese Medicine from January 2016 and April 2018 were statistically analyzed. Results Fever treated with Shengyang Sanhuo Decoction,the common clinical manifestations besides fever,included lassitude,aversion to wind and cold,not so good appetite,dry mouth,and sloppy stool,etc. Dosages of commonly used herbs in the formula： acrid-warm medicinals with a dispersing effect such as Fangfeng,Shengma,Qianghuo,Duhuo all ranging from 6 ~ 10 g; medicinals releasing the flesh and abating fever such as Chaihu 8 ~ 20 g and Gegen 10 ~ 20 g; medicinals fortifying the spleen and tonifying the middle such as Renshen 6 ~ 15 g or Dangshen 15 ~ 20 g,Huangqi 15 ~ 20 g,Zhigancao 3 ~ 10 g; medicinals clearing heat and resolving toxins such Shenggancao 5 ~ 10 g; medicinals enriching yin and nourishing the blood 6~ 20 g. In terms of natures and flavors,and tropism,these herbs present mainly with slightly warm in nature and acrid and sweet in flavors. They mostly enter the spleen and lung channels. Conclusion By means of the concept of ＂dispersion of fire constraint＂,Shengyang Sanhuo Decoction is frequently used for medium-term and long-term fever at advantages of concise ingredients of the formula,appropriatedose,definite effect.

关 键 词：病-证-方-药-量 升阳散火汤 中长程发热 临床经验 

分 类 号：R255.1[医药卫生—中医内科学]