《活幼心书》治疗惊风的思路及用药规律探讨  

Discussion on the Thoughts and Medication Rules for Treating Infantile Convulsion Recorded in Huo You Xin Shu(Clinical Experience in Treating Pediatric Diseases)

作　　者：洪颖慧 石艳红 黄慧思 张月 HONG Ying-Hui;SHI Yan-Hong;HUANG Hui-Si;ZHANG Yue(Postgraduates in 2020,Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University,Guangzhou 510130 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广州医科大学附属中医医院,广东广州510130

出　　处：《广州中医药大学学报》2023年第5期1281-1286,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20222183);广州市荔湾区科技计划项目(编号:202201015)。

摘　　要：探讨元朝医家曾世荣所著《活幼心书》治疗惊风的思路及用药规律。《活幼心书》诊治惊风重视心火肝风的病机特点和调理脾胃的治疗宗旨,善用攻法分期辨证治疗急惊风。急惊风初期需清解表邪,邪去则正安;中期需清利小便以通心气,泻火安神;对惊风后仍存有痰热之邪、预后不佳的患儿,可针对性地运用化痰逐水的中药,阻断患儿病情进展;对受惊而惊风的患儿,应重视行气法调整气机。在攻邪的同时,注重以寒温并用的方式固护脾胃。用药规律分析结果显示:治疗惊风使用频次较高的药物有甘草、生姜、人参、茯苓、肉桂,用药多选用药性为温性与寒性及药味为辛甘的药物,且多归脾胃二经;挖掘得到2个新方组合,新方组合1(大黄、防风、茯神)具有清热泻火、平肝熄风、宁心安神的作用,可用于急惊风中期以平肝清心;处方2(大黄、防风、生姜)具有发散表邪、清热泻火、温中解毒化痰的作用,可用于急惊风初期以解表合营。《活幼心书》治疗惊风的思路及用药规律可为现代中医临床提供参考。This article discussed the thoughts and the medication rules for treating infantile convulsion recorded in the book of Huo You Xin Shu(Clinical Experience in Treating Pediatric Diseases)written by ZENG Shi-Rong in Yuan Dynasty.In the book of Huo You Xin Shu,the treatment of infantile convulsion focused on the fundamental pathogenesis of heart fire and liver wind and followed the therapeutic principles of regulating spleen and stomach,and the purging therapy has been made good use to treat acute infantile convulsion in staged syndrome differentiation.In the early stage of acute infantile convulsion,clearing the exterior pathogens should be eliminated firstly and then the healthy qi recovered to normal;in the middle stage,therapies of promoting urination to unblock heart qi,and purging fire to calm the mind were recommended.For children who were still affected by the phlegm-heat pathogen after infantile convulsion and had a poor prognosis,targeted herbs of resolving phlegm to dispel water-retention were adopted to stop the progress of the illness.For children with fright-induced infantile convulsion,emphasis should be placed on the method of promoting qi to regulate the qi movement.During the elimination of the pathogens,therapies of strengthening spleen and stomach by simultaneous use of the cold and warm herbs were stressed.The analysis of medication rules shows that the frequently-used herbs in treating infantile convulsion were Glycyrrhiza Rhizoma et Rhizoma,Zingiberis Rhizoma Recens,Ginseng Radix et Rhizomam,Poria,and Cinnamomi Cortex;most of the herbs were warm and cold in nature,and pungent andridian tropism of the spleen and stomach.Two new formulae were mined out.New formula 1(Rhei Radix et Rhizoma,Saposhnikoviae Radix,Sclerotium Poriae Pararadicis)has the actions of clearing heat and purging fire,calming liver and suppressing wind,and calming heart and tranquilizing mind,which can be used in the middle stage of acute infantile convulsion to calm the liver and clear the heart.Formula 2(Rhei Radix et Rhizom

关 键 词：《活幼心书》 惊风 心火肝风 调理脾胃 攻法 用药规律 

分 类 号：R272.3[医药卫生—中医儿科学]