从痉病发病规律探讨竹叶汤方证  

Syndrome Differentiation of Zhuye Decoction Based on the Occurrence Regularity of Convulsive Disease

作　　者：王承灏 王雪茜[1] 李超瑞 吉静 邵奇 王庆国[1] 程发峰[1] Wang Chenghao;Wang Xueqian;Li Chaorui;Ji Jing;Shao Qi;Wang Qingguo;Cheng Fafeng(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029

出　　处：《中国中医急症》2022年第8期1279-1281,1292,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(U21A20400);国家中医药管理局全国名老中医药专家传承工作室建设项目;国家中医药管理局中医学术流派传承工作室建设项目。

摘　　要：部分注家认为《金匮要略·妇人产后病脉证治第二十一》所载之竹叶汤是治疗妇人产后中风兼阳虚的方剂,此说亦被高校教材所采纳。然该方实属治疗妇人产后中风欲做痉病之剂,且原方应以《千金翼方·妇人中风第四》中所载为是。笔者通过分析《伤寒杂病论》中痉病的发病及用药规律,发现妇人产后中风存在着发生痉病的转归,而竹叶汤以桂枝汤为基础,其组方用意在于治疗中风同时也能截断做痉之病势。方中之附子用意并非止于补阳,而是温阳固表以杜痉病之渐。不能将竹叶汤局限为温阳解表剂,如此则忽视了病势发展的动态性以及仲景治未病的思想。Some commentators believe that the Zhuye Decoction mentioned in Synopsis of Golden Chamber:Treatment of Pulse Syndrome of Women after Childbirth is a prescription for the treatment of women with postpar⁃tum-Zhongfeng and Yang deficiency,which has also been adopted by college textbooks.However,this prescription is actually a prescription for the treatment of postpartum-Zhongfeng and convulsion,and the Zhuye Decoction re⁃corded in A Supplement to Recipes Worth A Thousand Gold-Fourth Women-Zhongfeng is more reasonable.By analyzing the rule of convulsion in Treatise on Febrile and miscellaneous Diseases,the authors found that women with postpartum-Zhongfeng may be complicated with convulsion,and the Zhuye Decoction based on Guizi Decoc⁃tion can treat both of them.The purpose of monkshood in the prescription is not only to supplement Yang,but also to warm Yang and strengthen the surface to prevent convulsion.Therefore,we should not confine Zhuye Decoction to a warming and diaphoretic recipe,so as to ignore the dynamic development of the disease and Zhongjing′s thought of curing the disease before occurrence.

关 键 词：痉病 竹叶汤 《金匮要略》 《伤寒论》 桂枝汤 太阳中风 《千金翼方》 

分 类 号：R222.16[医药卫生—中医基础理论]