何庆勇主任医师运用小青龙汤的临证经验  

Clinical experience of chief physician He Qingyong’s experience with Xiaoqinglong Decoction

作　　者：吴海芳 张辉[2] 李淳[3] WU Haifang;ZHANG Hui;LI Chun(Folk Traditional Medicine Research Unit,China Institute for History of Medicine and Medical Literature,China Academy of Chinese Medical Sciences,Beijing100700,China;Department of Cardiology,the First Affiliated Hospital of Henan University of Chinese Medicine,Henan Province,Zhengzhou450000,China;Publishing House of Ancient Chinese Medical Books,China Academy of Chinese Medical Sciences,Beijing100700,China)

机构地区：[1]中国中医科学院中国医史文献研究所民间传统医药研究室,北京100700 [2]河南中医药大学第一附属医院心内科,河南郑州450000 [3]中国中医科学院中医古籍出版社,北京100700

出　　处：《中国医药导报》2024年第18期150-151,155,共3页China Medical Herald

基　　金：中国中医科学院科技创新工程项目(CI2021A00304)。

摘　　要：本文论述了何庆勇主任医师运用小青龙汤的临证经验,主要包括如下内容:第一,“方证”自从孙思邈提出,得到历代医家发展,经方的使用重在方证辨证,尤其是抓主证,临床上遇到小青龙汤主证“咳喘,咳痰,或流涕清稀,后背凉,或遇寒加重”,多可用之。第二,临床上小青龙汤能取胜的关键点是,必须使用细辛、生麻黄。并且遵循相对剂量原则和重视煎煮法,细辛可使用6~12 g,先煎30 min以上,全程打开锅盖、门窗及换气扇,生麻黄6~15 g,先煎30 min以上,去掉上层白沫,再纳余药。第三,临床加减用量遵循古籍原文思想,比如兼有口渴者,常于小青龙汤方中去半夏,加天花粉10~15 g。第四,临床遇复杂证候者,常进行经方叠用,比如见到咳吐块状稠痰,舌淡,苔白,脉滑,则可以合用桔梗汤。This paper discusses the clinical experience of chief physician He Qingyong using Xiaoqinglong Decoction.It mainly includes the following contents:first,“square evidence”since Sun Simiao put forward,has been the development of successive generations of medical doctors,the use of classical prescriptions focuses on the differentiation of prescription syndrome,especially to grasp the main evidence,clinically encountered the main evidence of Xiaoqinglong Decoction“coughing asthma,coughing phlegm,or snotting and thinning,the back is cool,or aggravated by cold”can be used Xiaoqinglong Tang.Secondly,the key point in the clinic where Xiaoqinglong Tang can win is the necessity of using Asari Radix Et Rhizoma and raw Ephedrae Herba.And following the principle of relative dosage and the importance of the decoction method,Asari Radix Et Rhizoma can be used 6-12 g,first decocted for more than 30 min,the whole time open the lid of the pot,windows and doors,and ventilation fan.Raw Ephedrae Herba 6-15 g,first decoct for more than 30 min,remove the upper layer of white foam,and then take the rest of the medicine.Thirdly,the clinical dosage of addition and subtraction follows the original thought of the ancient books,for example,if there is thirst at the same time,Pinelliae Rhizoma is often removed from the formula of Xiaoqinglong Decoction,and 10-15 g of Trichosanthis Radix is added.Fourthly,in the case of complex clinical conditions,the use of meridian formulae is often overlapped,such as coughing and spitting lumpy thick phlegm,with a pale tongue,white moss,and slippery pulse,it can be combined with Jiegeng Decoction.

关 键 词：小青龙汤 抓主证 相对剂量 细辛 

分 类 号：R249[医药卫生—中医临床基础] R289.5[医药卫生—中医学]