桂枝汤类方在风湿痹病中的应用  

Application of Classified Cinnamon Twig Decoction in Rheumatic Diseases

作　　者：桑永浩 宋立群[2] SANG Yonghao;SONG Liqun(Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang,China,150040;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang,China,150036)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150036

出　　处：《河南中医》2024年第4期490-492,共3页Henan Traditional Chinese Medicine

基　　金：宋立群全国名老中医药专家传承工作室建设项目{国中医药人教函[2022]75号}。

摘　　要：风湿痹内因为正气不足、机体营卫失调,外因为感受风寒湿等外邪,外湿侵袭肌表,正气不足,营卫失调,腠理疏松,汗出当风,外邪入体,流窜全身、流注关节,发为风湿痹病,治应调和营卫。桂枝汤用于治疗风寒邪伤人肌表,腠理疏松,卫外不固,营阴不守之证,切中风湿痹病病机。风重于湿,痹着肌表,阻滞营卫,气血不利,选桂枝附子汤;太阳中风兼经气不利者,选桂枝加葛根汤;风湿侵袭入体,在体郁遏日久,化热伤阴者,选桂枝芍药知母汤;营卫气血俱不足之血痹重证,选黄芪桂枝五物汤。The internal etiology of rheumatic diseases is that they are caused by lack of healthy qi and disharmony between nutrient and defensive qi,while the external etiology is that they are caused by wind-cold-dampness and other external pathogens.If external damp-ness invades the muscle surface,combined with lack of healthy qi,disharmony between nutrient and defensive qi,loose striae,perspira-tion when facing wind,external pathogens will infiltrate the body and flow into the joints,which lead to rheumatic diseases.The treat-ment should focus on coordinating nutrient and defensive qi.For Cinnamon Twig Decoction can be used to treat deficiency of nutrient yin syndrome caused by wind-cold injuring the muscle surface,loose satire,weak defensive qi.For wind heavier than dampness,rheumatic symptoms on the muscle surface,blocking the body nutrient and defensive qi,poor blood and qi circulation,Cinnamon Twig and Aconite Decoction can be adopted.For greater yang wind-invasion syndrome combined with unsmooth meridian qi,Cinnamon Twig Decoction plus Pueraria can be adopted.For long-time exogenous wind-cold invasion into the body transforming into heat and hurting yin,Cinna-mon Twig and Peony and Rhizoma Anemarrhenae Decoction can be adopted.For severe blood rheumatic syndrome marked by insuffi-cient nurrient and defensive qi and blood,Astragalus and Cinnamon Twig Five Substances Decoction can be adopted.

关 键 词：风湿痹病 桂枝汤类方 桂枝附子汤 桂枝加葛根汤 桂枝芍药知母汤 黄芪桂枝五物汤 《伤寒杂病论》 张仲景 

分 类 号：R222.22[医药卫生—中医基础理论]