乌头汤的临证心得与考证  

Clinical experience and textual research of Wutou Decoction

作　　者：高静[1,2] 何庆勇 卢欣宇[1,2] 李敏 李尚瑾[1,2] GAO Jing;HE Qingyong;LU Xinyu;LI Min;LI Shangjin(Beijing University of Chinese Medicine,Beijing 100029,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院广安门医院,北京100053

出　　处：《中华中医药杂志》2023年第8期3926-3929,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国中医科学院科技创新工程(No.C12021A00101);中国中医科学院研究生教材孵化项目(No.JC21-FH-2);北京中医药大学孙思邈研究院2020年度中医药科研计划资助项目(No.SSMYJY-1-2020-03)

摘　　要：乌头汤出自《金匮要略》,临床上由于乌头的毒性及乌头汤剂量、适应证和煎煮方法不明确,部分医家视之为虎狼而不敢轻易使用,或使用剂量过小而难以取得疗效。文章就临床运用乌头汤的经验进行了总结,并对其中乌头的品种和剂量进行了考证。笔者运用乌头汤的经验有以下3个关键点:一是要符合乌头汤的方证,关节疼痛或伴水肿,难以屈伸,怕风怕冷;二是要遵循原方药物剂量与比例,麻黄与乌头符合比例3∶3.7使用,推荐使用麻黄剂量为6~15 g,乌头剂量为7~18 g,其余药物建议足量使用;三是要遵循古法煎煮,先将乌头与蜂蜜同煮30~60 min,弃去乌头,再加入余下4味药,用蜜煎液煮20~30 min。Wutou Decoction was published in Jinggui Yaolue.Due to the toxicity of Aconitum and the unclear dosage,indication and decoction method of wu-tou decoction,some doctors are so worried that they dare not use it easily,or the dosage is too small to achieve curative effect.This paper summarizes the experience of clinical application of wu-tou decoction,and makes a textual research on the variety and dose of Aconitum.The author's experience in using Wutou Decoction has the following three key points:Firstly,it should conform to the prescription of Wutou Decoction,joint pain or edema,difficult to fex or stretch,afraid of wind and cold.Secondly,the dosage and proportion of the original prescription should be followed.The proportion of Ephedra Herba and Aconitum is 3:3.7,and the recommended dosage of Ephedra Herba is 6-15 g and Aconitum is 7-18 g,and the other drugs should be used in sufficient quantities.Thirdly,follow the ancient method of boiling,first is to boil Aconitum and honey for 30-60 min,discard Aconitum,then add the remaining four herbs,boil with honey decocted solution for 20-30 min.

关 键 词：乌头汤 乌头剂量 煎煮法 经方 文献考证 

分 类 号：R289.5[医药卫生—方剂学]