从脉象论木防己汤证之虚实  

Discussion About Deficiency and Excess of Radix Cocculi Trilobi Decoction Syndrome from Pulse Condition

作　　者：牛苗苗 李建朋 张效科[1] NIU Miao-miao;LI Jian-peng;ZHANG Xiao-ke(Shaanxi University of Chinese Medicine,Xianyang,Shaanxi,China,712046)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《河南中医》2021年第8期1135-1137,共3页Henan Traditional Chinese Medicine

摘　　要：对于《金匮要略》木防己汤证中的虚实,各医家或从胃中论,或从痰饮论,或从病位深浅论,或从邪正盛衰论。张仲景重视脉法,常以脉证诊断疾病,判断预后,指导临床用药。木防己汤证中的虚实当指脉象而言,以脉之变化判断支饮之预后。“虚者即愈”指服木防己汤后,脉象变缓和,心下痞坚变虚软,疾病预后良好,当效不更方;“实者三日后复发”指服木防己汤后,脉象依旧沉紧,虽其他症状有所缓解,然心下痞坚之症仍在,故三日后复发,疾病预后不良,当脉证合参,变更方药。In terms of deficiency and excess of Radix Cocculi Trilobi Decoction syndrome in Synopsis of the Golden Chamber,each physician discusses it either from the stomach,or from the phlegm retention,or from the disease location,or from the ups and downs of pathogenic factors and healthy qi.Zhang Zhong-jing pays attention to pulse diagnosis method,often diagnoses diseases with pulse syndrome,judges prognosis and guides clinical medication.Deficiency and excess of Radix Cocculi Trilobi Decoction syndrome refers to the degree of pulse condition,and the prognosis of thoracic fluid retention can be judged by the change of pulse condition."The fact that the patient with deficiency syndrome can recover"means that after drinking Radix Cocculi Trilobi Decoction,the patient′s pulse condition becomes mild,epigastric stuffiness and rigidity become soft,the prognosis of the disease is good,so the effect is good,and the formula should not be modified."The fact that the patient with excess syndrome will reoccur in three days"means that after drinking Radix Cocculi Trilobi Decoction,the patient′s pulse condition is still tight,although other symptoms have been alleviated,but epigastric stuffiness and rigidity still exist,so the disease may reoccur in three days,and the prognosis of the disease is poor.At this time,it is necessary to adopt comprehensive analysis of the pulse and syndrome,and modify the formula properly.

关 键 词：木防己汤证 虚实 脉象 支饮 脉证合参 《金匮要略》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]