温阳开结疗痼疾,凭脉辨证巧化裁——经方大家活用乌头赤石脂丸  

Skillful Treatment on Chronic Diseases by Warming Yang and Pulse Syndrome Differentiation——Application about Wutou Chishizhi Pill by Master of Classic Prescriptions

作　　者：蒋萃[1] 叶莹[1] 袁世清[1] 江泳[1] Jiang Cui;Ye Yin;Yuan Shiqing;Jiang Yong(Chengdu University of Traditional Chiese Medicine,Chengdu,610075,China)

机构地区：[1]成都中医药大学,四川成都610075

出　　处：《成都中医药大学学报》2020年第4期42-44,62,共4页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然基金项目(61801058);成都中医药大学校级教改项目(JGYB201925)。

摘　　要：乌头赤石脂丸为金匮名方,但因其药效猛烈且含有毒药物而临床医家惧而少用之。成都中医药大学傅元谋教授是全国著名经方专家,临证时常用此方,圆机活法,用之甚效。他认为此方不局限于阴寒痼冷证,而适宜于阳虚失于温化,阴寒凝滞导致的病证,广泛运用于心血管与消化系统疾病。用方指征为胸闷、胸痛、胸胁痛、心下痛、心悸、上背痛、身痛、胸前或腋下汗多;舌淡或淡暗或暗红,苔白腻或滑。原方对应脉象为或弦或紧或沉紧;若脉沉缓涩,适当化裁也可运用。本方的核心药组为乌头、附片、赤石脂三味,共用可减毒增效。临床应用此方中尤为注意乌头、附片用量,因其会损耗阴血,故可与养阴补血药同用以固正气。Wutou Chishizhi Pill is a famous prescription of Synopsis of the Golden Chamber,but it is seldom used because of its strong efficacy and toxic drugs.Professor Fu Yuanmou who is a professor of classical prescription at Chengdu University of Traditional Chinese Medicine often uses the prescription flexibly according to his own cognition.He consideres that this prescription is not only limited to the severe cold syndrome,but also suitable for the syndrome of Yang deficiency and Yin Cold stagnation,including cardiovascular and digestive system diseases.The indications include chest distress,chest pain,Hypochondriac pain,gastralgia,palpitation,upper back pain,body pain,chest or axillary sweating;the tongue is light or dark or dark red,and the coating is white,greasy or slippery;The pulse corresponding to the original formula is string or tight or deep;if the pulse is slow and astringent,appropriate cutting can also be used.The core drug group of this prescription is Wutou,Fupian and Chishizhi,which can reduce toxicity and increase efficiency.In clinical application,more attention shall be paid to the dosage of Fupian and Wutou.As Yin blood will be consumed after the usage,they can be used together with drugs that nourish Yin and tonify Blood.

关 键 词：乌头赤石脂丸 病证范围 用方指征 适宜脉象 核心药对 使用注意 

分 类 号：R249[医药卫生—中医临床基础] R289.5[医药卫生—中医学]