瓜蒂散证浅析  

An Analysis of Syndrome of Melon Stalk Powder

作　　者：王勇[1] 蒋涛[1] 卞胡伟 刘金柱 徐晶[1] 钱程 WANG Yong;JIANG Tao;BIAN Huwei;LIU Jinzhu;XU Jing;QIAN Cheng(Changzhou Affiliated Hospital of Nanjing University of Chinese Medicine,Changzhou,Jiangsu,China,213000)

机构地区：[1]南京中医药大学常州附属医院,江苏常州213000

出　　处：《河南中医》2024年第3期328-330,共3页Henan Traditional Chinese Medicine

基　　金：江苏省科学技术厅课题项目(BRA2020149);南京中医药大学自然科学基金项目(ZXR2021066)。

摘　　要：瓜蒂散证病机为邪气在肺,与正气向外交争,其势向外,以瓜蒂作用于中焦,借其春木之性,配合酸平之赤小豆,辛香之淡豆豉,越上而吐,则病可解。脉弦而有力、脾胃不虚者,用之最宜;肝虚者,可加竹茹,柴胡等;若恐伤胃气,可加生麦芽顾脾胃而调肝。应用时需与三物白散证和十枣汤证相鉴别,瓜蒂散证多见弦脉,三物白散证寒实较瓜蒂散证重,脉多沉迟,若化脓亦可见数脉。十枣汤证多喘咳日久,面目浮肿,倚息不得卧,以咳嗽或用力牵引疼痛加剧为鉴别点。《伤寒论》第108条所言之腹满谵语,寸口脉浮而紧亦是痰饮结于胸所致,可用瓜蒂散吐出胸中之邪,使上下交通,诸症得解。无论是寒痰、热痰等实邪,或是宿食、误食毒物等所致结胸之证,皆可谨遵脉证使用瓜蒂散,服后未必呕吐,不断咳吐痰涎即为对证。The pathogenesis of the syndrome of Melon Stalk Powder is pathogenic qi in the lung struggling with the healthy qi,with potential outward trend.Melon Stalk Powder acts on the middle energizer,with the help of spring wood nature,combined with slightly sour and mild Chixiaodou(Semen Phaseoli),spicy and fragrant Dandouchi(Semen Sojae Praeparatum),so it attacks upward leading to vomiting and releasing the disease.If liver pulse is string-like and powerful,but spleen and stomach is not deficient,Melon Stalk Powder is the most appropriate choice;for liver deficiency,Zhuru(Caulis Bambusae in Taenia),Chaihu(Radix Bupleuri),etc.can be added.In order to avoid damaging stomach qi,raw Maiya(Fructus Hordei Germinatus) can be added to nourish the spleen and stomach and regulate the liver.When using it,it is necessary to distinguish it from the Three White Substances Powder syndrome and the Ten Jujubes Decoction syndrome.The syndrome of Melon Stalk Powder often shows string-like symptoms,while cold excess of the Three White Substances Powder syndrome is heavier than that of the syndrome of Melon Stalk Powder with more sinking and slow pulses.If there is suppuration,a quick pulse can also be seen.The Ten Jujubes Decoction syndrome is characterized by a long time of coughing,edema,leaning on something to breathe and inability to lie down,with coughing or forceful traction of the pain intensified as the key point.According to No.108 article in Treatise on Cold Damage Diseases,abdominal fullness,delirium,floating and tight wrist pulse are also caused by phlegm retention in the chest.Melon Stalk Powder can be used to drive out the pathogen in the chest,so that the upper and lower part of the body can be dredged and all the symptoms can be released.Whether for cold phlegm or hot phlegm and other excess pathogens,or the syndrome of the stagnated chest caused by retained food,mistaken poisonous food and so on,Melon Stalk Powder can be adopted according to the exact pulse syndrome.After taking it,vomiting is not necessary the case,and c

关 键 词：瓜蒂散证 瓜蒂散 吐法 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]