《金匮要略》瓜蒌薤白三方再辨析  

Further Analysis of the Three Decoctions of Gualou Xiebai in Synopsis of Prescription of the Golden Chamber

作　　者：陈文豪 陈丽名[1] 李小会[1] 李红[1] 田维维 王爽 谭颖颖[1] CHEN Wenhao;CHEN Liming;LI Xiaohui(Shanxi University of Chinese Medicine,Xianyang Shaanxi 712046,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《四川中医》2024年第5期23-26,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81873296);陕西省中医药管理局伤寒学与经方辨治疑难病重点研究室项目;陕西中医药大学学科创新团队项目(编号:2019-QN04)。

摘　　要：本文通过仲景《金匮要略·胸痹心痛短气篇》瓜蒌薤白三方来探讨胸痹心痛的证治,发现“阳微阴弦”为瓜蒌薤白三方主要的病机,即上焦阳虚故在下之阴邪伺机逆而上乘,闭塞胸中阳气,阻滞不通则胸痹心痛,其关键在于胸阳不足所致。后世医家在《伤寒杂病论》六经辨证指导下遣方用药,均是在此基础上应用发挥的。以此将通过探讨瓜蒌薤白白酒汤、瓜蒌薤白半夏汤、枳实薤白桂枝汤三方的病因病机、方药配伍、实验研究、临床应用等,挖掘其所蕴含的学术思想,以期更好的拓宽临证思路为临床所应用。This article explores the syndrome and treatment of chest pain and heartache through the three prescriptions of Gualou Xiebai in Zhongjing's“Synopsis of Prescription of the Golden Chamber-Chest Pain and Short Qi Chapter”.It is found that the main pathogenesis of Gualou Xiebai is the“weak pulse at yang and wiry pulse at yin”.Due to the deficiency of yang in the upper jiao,the yin evil in the lower jiao waits for the opportunity to reverse and become superior,blocking the yang qi in the chest,and blocking the obstruction leads to chest pain and heartache;The key is due to insufficient chest yang.Under the guidance of differentiation of symptoms and signs in the Six Meridians of the Treatise on Cold Damage and Miscellaneous Diseases,later medical practitioners used prescriptions and medicines based on this foundation.In this way,we will explore the etiology and pathogenesis,prescription compatibility,experimental research,clinical application,etc.of Gualou Xiebai Baijiu Decoction,Gualou Xiebai Banxia Decoction,Zhishi Xiebai Guizhi Decoction,excavate the academic ideas contained in them,so as to better broaden the clinical thinking for clinical application.

关 键 词：阳微阴弦 瓜蒌薤白类方 金匮要略 胸痹 方药配伍 临床应用 

分 类 号：R222.3[医药卫生—中医基础理论]