桂枝加葛根汤主治及临床应用探析  

An Analysis of the Main Indications and Clinical Applications of Cinnamon Twig Decoction Plus Pueraria

作　　者：谭王琪 田苗芳 王兴丽 田岳凤 TAN Wangqi;TIAN Miaofang;WANG Xingli;TIAN Yuefeng(Shanxi University of Chinese Medicine,Taiyuan,Shanxi,China,030024;Shanxi Acupuncture Hospital,Taiyuan,Shanxi,China,030006)

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省针灸医院,山西太原030006

出　　处：《河南中医》2024年第11期1650-1653,共4页Henan Traditional Chinese Medicine

基　　金：山西中医药大学“临床科研平台建设”项目(2021PY-PT-02);山西省高等学校人文社会科学重点研究基地项目(20190127)。

摘　　要：桂枝加葛根汤方由“葛根四两、芍药二两、生姜三两(切)、甘草二两(炙)、大枣十二枚(擘)、桂枝二两(去皮)”等6味药物组成,具有解肌发表,宣通经气,调和营卫之功效,主治“项背强几几”,临床多用于风寒客于太阳经输,营卫不和所致的发热、恶风、汗出、项背强而不舒等证。“项背强几几”是指从后头部至后腰部的肌肉拘急疼痛感,有时范围可达到腰部,同时多伴有头痛、眩晕等。后世医家基于《伤寒杂病论》桂枝加葛根汤原方,将其用于风寒引起的颈背疼痛、痘疹、斑疹等。现代医家进一步拓展其临床应用,认为凡是辨证为营卫失和、气血阻滞、筋脉失养者均可使用该方治疗,包括感冒、颈椎病、落枕、肩关节周围炎等,还包括冠状动脉粥样硬化性心脏病的胸背疼痛、高血压动脉硬化所引起的后脑部疼痛等疾病,师古而不泥古。Cinnamon Twig Decoction Plus Pueraria,composed of six ingredients-Gegen(Radix Puerariae Lobatae)4 liang,Shaoyao(Radix Paeoniae Alba seu Rubra)2 liang,Shengjiang(Rhizoma Zingiveris Recens)3 liang(cut),Zhigancao(Radix Glycyrrhizae Praeparata)2 liang,Dazao(Fructus Jujubae)12 pieces(split),and Guizhi(Cinnamon Twig)2 liang(peeled)-functions to release the flesh to relieve the exterior,promote the circulation of qi in the channels,regulate and harmonize the nutrient qi and defense qi,and.It primarily treats"stiffness and tension of the nape and back"associated with external wind-cold invasion in the greater yang meridian and disharmony between the nutrient qi and defense qi,manifesting in symptoms such as fever,aversion to wind,sweating,and stiffness in the nape and back."Stiffness and tension of the nape and back"refers to a feeling of tightness and pain in the muscles from the back of the head to the lower back,sometimes extending to the waist,often accompanied by headache and dizziness.Later generations of physicians,based on Zhang Zhongjing′s original formula from Treatise on Cold Damage and Miscellaneous Diseases,applied the formula to wind-cold-induced neck and back pain,measles,and rashes.Modern practitioners have further expanded its clinical applications,finding it effective for conditions involving disharmony between the nutrient qi and defense qi,qi and blood stagnation,and muscle and tendon malnutrition.It is used to treat ailments such as common cold,cervical spondylosis,stiff neck,periarthritis of the shoulder,as well as chest and back pain caused by coronary atherosclerotic heart disease,and occipital pain due to hypertensive arteriosclerosis,while adhering to but not rigidly following classical principles.

关 键 词：桂枝加葛根汤 “项背强几几” 《伤寒杂病论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]