论白虎加人参汤证  

Discussion About Syndrome of White Tiger Decoction Combined with Ginseng Decoction

作　　者：王明炯[1] 王润鹏 欧阳峰松[1] WANG Ming-jiong;WANG Run-peng;OUYANG Feng-song(College of Traditional Chinese Medicine of Changsha Medical University,Changsha,Hunan,China,410219)

机构地区：[1]长沙医学院中医学院,湖南长沙410219

出　　处：《河南中医》2022年第3期325-327,共3页Henan Traditional Chinese Medicine

基　　金：长沙医学院《中医学》校级重点学科科研项目{长医研[2016]3号}。

摘　　要：《伤寒论》白虎加人参汤证强调:"口燥渴、心烦、欲饮水,""欲"提示患者并未真正饮水。《金匮要略》言:"湿家,其人但头汗出,背强,欲得被覆向火……渴欲得饮而不能饮,则口燥烦也。"可见白虎加人参汤证中有湿证。湿证形成原因有外因和内因,外因为湿邪中人,内因为饮食劳倦。张仲景秉承前人观点,指出湿证的症状除有"关节疼烦,寒热汗出"外,还有"喘,小便不利,大便快,身黄,身重,背强,舌上苔,脉沉而细(一作缓),脉大等。"暍病为感受暑热邪气而致,夹杂湿邪,张仲景采用白虎加人参汤治疗暍病,提示白虎加人参汤证中有湿证。白虎加人参汤中知母有利水之功,石膏有利水消痰之功,可见白虎加人参汤在发挥清热作用的同时,兼有消痰利水作用。综上可知,白虎加人参汤证之病机当是阳明热证与湿证相互胶结。In Treatise on Cold Damage Diseases,the syndrome of White Tiger Decoction combined with Ginseng Decoction emphasizes that"the patient′s mouth is dry and thirsty,upset and the patient wants to drink water."The"desire"indicates that the patient does not really drink water.Synopsis of the Golden Chamber says:"The head of the patient with dampness is sweating,has rigidity of the back,and he wants to be covered with quilt and close to fire...If he is thirsty to drink but can′t drink,his mouth is dry and irritated."It can be seen that there is dampness syndrome in syndrome of White Tiger Decoction combined with Ginseng Decoction.There are external and internal causes for the formation of dampness syndrome.External cause refers to dampness,while internal causes include improper diet and overstrain.Zhang Zhong-jing adheres to the views of his predecessors and points out that the symptoms of dampness syndrome include"joint pain,cold,heat and sweating",as well as"asthma,inhibited urination,fast defecation,yellow body,heavy body,rigidity of the back,moss on the tongue,heavy and thin pulse(relieved after occurrence),large pulse,etc."Summer-heat stroke is caused by attack of summer heat,mixed with dampness.In White Tiger Decoction combined with Ginseng Decoction,Zhimu(Rhizoma Anemarrhenae)can induce diuresis,Shigao(Gypsum Fibrosum)can induce diuresis and remove phlegm.It can be seen that White Tiger Decoction combined with Ginseng Decoction plays the role of clearing heat and eliminating phlegm and inducing diuresis at the same time.To sum up,the pathogenesis of syndrome of White Tiger Decoction combined with Ginseng Decoction should be the mutual cementation of yang brightness heat syndrome and dampness syndrome.

关 键 词：白虎加人参汤证 阳明热证 湿证 暍病 《伤寒论》 《金匮要略》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]