经方中麻黄的应用规律探析  

Exploration of the Combination Application of Ephedra in Classical Prescriptions

作　　者：孙一焱 彭伟[2] 曲夷[1] Sun Yiyan;Peng Wei;Qu Yi(Shandong University of Traditional Chinese Medicine,Shandong,Jinan 250014,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《中国中医急症》2023年第5期896-899,903,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家中医药管理局齐鲁伤寒流派传承工作室建设项目(国中医药人教函[2019]62号);山东省卫健委齐鲁医派中医药特色技术整理推广项目——齐鲁伤寒六经辨证中医药特色技术(鲁卫函[2021]45号)。

摘　　要：本文考据《伤寒杂病论》原文,从用量用法、主治证候、配伍应用3个方面,考查相关经方中麻黄的运用规律。提出:1)麻黄于经方汤剂中常用量约为30~90 g,明显大于现代习惯用量,与仲景时期麻黄鲜品入药,煎煮时间相对较长有关。2)麻黄散外寒,与桂枝相配主太阳表证,麻黄用量大于或等于“三两”,配“二两”以上桂枝方可发汗解表散寒,若麻黄用量小于桂枝,功在温阳通络化饮;与炮附子、细辛配伍成麻黄细辛附子汤主少阴表证。3)麻黄祛水湿,水湿在表时,大剂量麻黄与石膏配伍可发越水湿兼清内热;麻黄配伍杏仁、薏苡仁可祛风除湿;水湿停滞肌肉关节时,可以麻黄配伍细辛、炮附子、乌头等辛温助阳之品,通阳散结以治风寒湿痹痛;水湿在里时,以麻黄不去节配细辛、干姜通阳散湿,主寒痰水饮停聚于心下胸上。经方中麻黄非发汗解表之专药,通阳治水是其主要功效。This article examines the use of ephedra in related sutra prescriptions from three aspects,namely,dosage and usage,main symptoms,and combination application,based on the original text of the Treatise on Cold Pathogenic and Miscellaneous Diseases.This paper suggests that:1)The amount of ephedra commonly used in classical prescriptions is about 30~90 g,which is significantly greater than the modern customary dosage.This may be related to the fact that ephedra was used fresh in the Zhongjing period and the decoction time was relatively long.2)Ephedra has the effect of dispersing external cold.When the dosage of ephedra is greater than or equal to"three taels",with"two taels"or more of cassia twig,it can sweat and dispel cold;if the dosage of ephedra is less than that of cassia twig,the effect is to warm the Yang,open the channels and dissolve the retention.Ephedra is combined with asarum and processing aconite to form Mahuangfuzi Xixin Decoction for the treatment of Shaoyin superficial symptoms.3)Ephedra has the effect of dispelling water-dampness.When water-dampness is on the surface,large doses of ephedra with gypsum can dispel water dampness and clear internal heat.Ephedra with almonds and coix seeds can dispel wind and remove dampness.When water-dampness is stagnant in muscles and joints,ephedra can be used with pungent and warming products that help Yang,such as asarum,processing aconite,and aconitum,to promote Yang and disperse knots to treat wind-cold-damp paralysis.When water-dampness is in the lining,ephedra without going to the joints with asarum and ginger to promote Yang and disperse dampness to treat cold phlegm and water retention that is stagnant in the lower part of the heart and upper part of the chest.In conclusion,ephedra is not a specific medicine for sweating and relieving symptoms,and its main effect is to pass Yang and cure water.

关 键 词：《伤寒杂病论》 麻黄 经方 配伍应用 

分 类 号：R222[医药卫生—中医基础理论]