五泻心汤治疗不同证型慢性萎缩性胃炎  

Five Kinds of Heart-Draining Decoction in Treating Chronic Atrophic Gastritis of Different Syndromes

作　　者：朱丽 聂炜珏 孙志广[2] ZHU Li;NIE Wei-jue;SUN Zhi-guang(The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210019;Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210023)

机构地区：[1]南京中医药大学第二附属医院,江苏南京210019 [2]南京中医药大学,江苏南京210023

出　　处：《河南中医》2020年第10期1463-1465,共3页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81673795);江苏省自然科学基金项目(BK20181235)。

摘　　要：五泻心汤证病机均为中焦虚弱,胃有热邪,与慢性萎缩性胃炎病机相似,可以半夏泻心汤为基本方加减治疗慢性萎缩性胃炎不同证型。大黄黄连泻心汤证为热陷于胃,治以清热为主;附子泻心汤证为热陷于胃,兼阳虚于外,以阳虚为主,治以扶阳清热;半夏泻心汤证为邪热内聚,胃气不和,治以化痰和胃;生姜泻心汤证为邪热内聚,胃虚食滞,复兼停水,治以健脾清热,兼宣散水饮;甘草泻心汤证为脾胃两虚,治以补益脾胃。五泻心汤证的共同症状为"心下痞",共同药物为黄芩、黄连,共用黄芩、黄连清热消痞,因"痞"的轻重和兼证不同,加减药物也不同。The pathogenesis of five kinds of Heart-Draining Decoction syndrome is deficiency in the middle energizer and pathogenic heat in the stomach,which is similar to the pathogenesis of chronic atrophic gastritis.Pinellia Heart-Draining Decoction can be flexibly taken as the basic formula for the treatment of chronic atrophic gastritis of different syndromes.Syndrome of Rhubarb and Coptis Heart-Draining Decoction is manifested as heat trapped in the stomach,and the treatment should focus on clearing away heat.Syndrome of Aconite Heart-Draining Decoction is manifested as heat trapped in the stomach combined with yang deficiency,and the treatment should focus on strengthening yang and clearing away heat.Syndrome of Pinellia Heart-Draining Decoction is manifested as pathogenic heat accumulated in the interior,and disharmonious stomach qi,and the treatment should focus on resolving phlegm and harmonizing stomach.Syndrome of Fresh Ginger Heart-Draining Decoction is manifested as pathogenic heat accumulated in the interior,stomach deficiency and food retention combined with water retention,and the treatment should focus on invigorating spleen and clearing away heat,and dispersing water retention.Syndrome of Licorice Heart-Draining Decoction is manifested as spleen-stomach deficiency and the treatment should focus on tonifying spleen and stomach.The common symptom of five kinds of Heart-Draining Decoction syndrome is epigastric stuffiness.The common medicinals are Huangqin(Radix Scutellariae) and Huanglian(Rhizoma Coptidis),which can clear away heat and remove stuffiness.Due to the different severity and concurrent syndromes of "stuffiness",the addition and subtraction of medicinals should also be different.

关 键 词：慢性萎缩性胃炎 大黄黄连泻心汤 附子泻心汤 半夏泻心汤 生姜泻心汤 甘草泻心汤 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]