竹皮大丸治疗“产后虚热烦呕”释疑  

Explanation on Treatment of "Postpartum Deficiency Heat and Nausea" with Zhupi Dawan

作　　者：李铭新[1] 吕翠霞[1] LI Mingxin;LYU Cuixia(Shandong University of Traditional Chinese Medicine,Jinan Shandong China 250014)

机构地区：[1]山东中医药大学,山东济南250014

出　　处：《中医学报》2022年第8期1611-1614,共4页Acta Chinese Medicine

基　　金：山东省中医药管理局基金项目(2018-5)。

摘　　要：《金匮要略》中竹皮大丸为治疗产后虚热烦呕之方,但观竹皮大丸方药组成,以清热祛邪为主,并无明显补药,方药组成与虚热病机似不相符。故竹皮大丸证病机当为“素体中虚,胃中实热”,胃中实热既可来自肝胃郁火,又可兼有产后哺乳期阴血不足所生之虚热。病机为“郁热伤阴”,阴虚生内热。对于虚实错杂之证,纯攻邪易伤正,纯补虚易无功。竹皮大丸以甘寒清热药为主,清热止呕除烦以安中;甘平补脾药为辅,健脾以益气。全方寒热并用,攻补兼施,体现了仲景祛邪扶正的思想。In Jin Gui Yao Lue,Zhupi Dawan is a prescription in treating postpartum deficiency Heat and nausea.However,the composition of Zhupi Dawan is mainly for clearing Heat and expelling pathogens,and there is no obvious tonic medicine.The composition of the prescription seems to be inconsistent with the pathogenesis of deficiency Heat.Therefore,the pathogenesis of Zhupi Dawan syndrome should be "deficiency in body and excess Heat in Stomach".The excess Heat in the stomach can come from the stagnation of Fire in Liver and Stomach,and it can also come from deficiency Heat caused by insufficiency of Yin blood during postpartum lactation.The pathogenesis should be "stagnant Heat injuring Yin",and Yin deficiency generating internal Heat.For the mixed syndrome of deficiency and excessiveness,it is easy to damage the vital Qi by attacking the Heat,and there would be no effect by pure supplement of deficiency.Therefore,this prescription is mainly composed of medicines with sweet,cold and Heat-clearing functions,and it can calm the middle Burner by clearing Heat as well as stopping vomiting and relieving annoyance.Besides,medicines which are sweet and can tonify Spleen and Qi should be applied to strengthen Spleen and Qi.In the whole prescription,the combination of medicines with cold or hot characters,functioning in attacking and supplementing,embodies Zhong Jing′s thought of eliminating Evil factors and supporting healthy Qi at the same time.

关 键 词：竹皮大丸 产后虚热烦呕 虚热证 乳中虚 《金匮要略》 

分 类 号：R222.16[医药卫生—中医基础理论]