张仲景巧用麻黄治疗咳嗽探析  

Study on Zhang Zhongjing′s Skillful Use of Mahuang in Treating Cough

作　　者：王仪 石梦瑶 杨程[2] WANG Yi;SHI Mengyao;YANG Cheng(The First Clinical Medical College of Anhui University of Chinese Medicine,Hefei,Anhui,China,230031;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui,China,230031)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《河南中医》2024年第9期1297-1301,共5页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82104780);中医药防治肺系重大疾病应用转化安徽省重点实验室项目(L2014369)。

摘　　要：麻黄可发汗以解表,宣肺以平喘,利水以消肿,重在宣通,能达表入里,只要配伍得当,把握剂量,发挥其“通”的特性,便能有效治疗咳嗽。麻黄汤用于治疗外感风寒,郁滞肌表,肺气失宣所致的伤寒表实证;小青龙汤用于治疗寒饮伏肺证;大青龙汤用于治疗寒邪郁于肌表入里化热证;射干麻黄汤为治疗寒哮的经典名方;小青龙加石膏汤用于治疗外感风寒、内有饮邪郁热之证;厚朴麻黄汤用于治疗外邪引动内饮,挟热迫肺之证;麻黄杏仁甘草石膏汤用于治疗表邪入里化热,邪热内陷,导致肺气郁闭或逆乱之证;越婢加半夏汤治疗饮邪蕴热,肺失通调导致的上气喘咳诸证;麻黄细辛附子汤用于治疗太阳表证兼少阴阳虚证;桂枝加葛根汤适用于体虚之人,太阳受邪,营卫失调,气机不畅,筋脉失养之证。无论寒热、表里、虚实所致咳嗽,均可用麻黄治疗,不过针对热证时注意麻黄的剂量,且常配伍石膏以制约麻黄的辛温之性,治疗表虚证用麻黄时更需慎重,剂量不可大,以患者微微汗出为度。Mahuang(Herba Ephedrae) can induce sweating to release the exterior,ventilate the lung to alleviate wheezing,and promote urination to reduce swelling.Its primary function is to ventilate and dredge,and it can reach both exterior and interior.When used with appropriate combinations and dosages,its "dredging" characteristic can effectively treat cough.Ephedra Decoction is used for externally contracted wind-cold with obstructed muscle layer and lung qi failing in dispersion.Minor Green Dragon Decoction is used for treating cold-damp accumulation in the lung.Major Green Dragon Decoction is used for syndrome of cold pathogens obstructing the muscle layer and transforming into heat.Belamcanda and Ephedra Decoction is a classic formula for treating cold asthma.Minor Green Dragon Decoction combined with Gypsum Decoction is used for externally contracted wind-cold with internal stagnant heat.Officinal Magnolia Bark and Ephedrae Decoction is used for exterior pathogens inducing internal phlegm with heat pressing on the lung.Ephedra and Apricot Kernel and Gypsum and Licorice Decoction is used for exterior pathogens transforming into heat,with heat and pathogens penetrating into the lung,causing lung qi stagnation or reversal.Maidservant From Yue Decoction plus Banxia(Rhizoma Pinelliae) is used for phlegm-heat accumulation and lung qi obstruction causing upper respiratory symptoms.Ephedra and Aconite and Asarum Decoction is used for greater yang exterior syndrome complicated with lesser yin yang deficiency.Cinnamon Twig Decoction plus Gegen(Radix Puerariae Lobatae) is suitable for individuals with physical deficiency,exterior pathogens affecting the greater yang,and imbalance of defense qi and nutrient qi,resulting in qi stagnation and loss of nourishment to the muscles.Regardless of whether the cough is caused by cold,heat,exterior,or interior conditions,Mahuang can be used,but caution is needed when treating heat syndrome by adjusting the dosage and often combining it with Shigao(Gypsum Fibrosum) to moderate its warm and

关 键 词：咳嗽 麻黄 《伤寒论》 《金匮要略》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]