袁金声运用经方治疗荨麻疹经验  

Yuan Jin-sheng′s Experience of Treating Urticaria with Classic Formulas

作　　者：王文佳 胡芳 廖越 徐丽 WANG Wen-jia;HU Fang;LIAO Yue;XU Li(Guizhou University of TCM,Guiyang,Guizhou,China,550025;The Second Affiliated Hospital of Guizhou University of TCM,Guiyang,Guizhou,China,550002)

机构地区：[1]贵州中医药大学,贵州贵阳550025 [2]贵州中医药大学第二附属医院,贵州贵阳550002

出　　处：《河南中医》2020年第8期1178-1181,共4页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验继承工作建设项目{国中医药人教发[2017]29号}。

摘　　要：袁金声教授认为,荨麻疹急性期,多为外感风邪或毒物侵袭;慢性期,多为正气不固、邪气留恋。急性期以祛除风邪为主,并根据风邪所夹寒、热、湿邪的不同,配合散寒、清热、除湿药物;缓解期以扶正消风为主,并根据血虚、阴虚内热、气虚的不同,治以养血、滋阴清热、益气固表之法。袁师强调,在消风的同时,配以凉血活血药物,一方面,防止热盛助长风邪之势入血,清热凉血消风;另一方面,取"治风先治血,血行风自灭"之意。风寒束表证,以疏散风寒,调和营卫为治则,方用桂枝汤或麻黄桂枝各半汤加减;里热表郁证,以外疏风邪,内清郁热为治则,方用麻黄连翘赤小豆汤加减;风湿郁表证,以祛风止痒,清热利湿为治则,方用麻黄杏仁薏苡甘草汤加减;血虚生风证,以滋阴养血,祛风止痒为治则,方用黄连阿胶汤加减;气血亏虚证,以固表御风,调和营卫为治则,方选桂枝人参汤加减。荨麻疹非仅限以上证型,血热生风者、冲任失调者临床亦多见,常予犀角地黄汤清热凉血、四物汤调和冲任。Professor Yuan Jin-sheng believes that urticaria in the acute stage is mostly caused by exogenous wind pathogens or toxins.In the chronic stage,it is mostly because healthy qi is not strong,and the pathogenic qi lingers.In the acute stage,the treatment should focus on dispelling wind pathogen,and according to the difference of combined cold,heat and dampness,the medicinals for dispersing cold,clearing heat and removing dampness should be combined.In the remission stage,the treatment should be based on strengthening the body and eliminating wind.According to the difference of blood deficiency,yin deficiency,internal heat and qi deficiency,the methods of nourishing blood and yin and clearing heat,replenishing qi and consolidating exterior are often used.Professor Yuan emphasizes that in order to eliminate wind pathogen,the medicinals for cooling blood and promoting blood circulation should be combined.On the one hand,it can prevent excessive heat from flowing into blood with the help of wind pathogen.Clearing heat and cooling blood can remove wind.On the other hand,this takes the meaning that"treating blood stasis should go first in order to remove wind,because moving qi can eliminate wind pathogen."For wind-cold fettering exterior syndrome,the treatment principle is to disperse wind cold and harmonize nutrient-defense,Cinnamon Twig Decoction,or Modified Half Ephedra and Half Cinnamon Twig Decoction can be used.For interior heat and exterior stagnation syndrome,the treatment principle is to disperse exterior wind and interior heat,and Modified Ephedra and Coptis and Semen Phaseoli Decoction can be used.For wind-dampness stagnated in the exterior syndrome,the treatment principle is to disperse wind and relieve itching,clear heat and remove dampness,and Ephedra and Bitter Apricot Seed and Coix Seed and Licorice Decoction can be used.For syndrome of blood deficiency producing wind,the treatment principle is to nourish yin and blood,dispel wind and relieve itching,and Modified Coptis and Colla Corii Asini Decoction can

关 键 词：荨麻疹 桂枝汤 麻黄桂枝各半汤 麻黄杏仁薏苡甘草汤 黄连阿胶汤 桂枝人参汤 袁金声 《伤寒杂病论》 张仲景 

分 类 号：R275.958.24[医药卫生—中西医结合]