白通加猪胆汁汤中猪胆汁的作用探讨  

Discussion on the Function of Pig Bile in Baitong Plus Pig Bile Decoction

作　　者：秦欣欣 吴华阳 QIN Xinxin;WU Huayang(Beijing Longfu Hospi-tal,Beijing,100010,China;Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine)

机构地区：[1]北京市隆福医院,北京100010 [2]北京中医药大学东直门医院

出　　处：《浙江中医药大学学报》2025年第2期185-188,共4页Journal of Zhejiang Chinese Medical University

基　　金：北京中医药大学教育科学研究专项课题(XJZX2008)。

摘　　要：[目的]探析白通加猪胆汁汤中猪胆汁的作用及临床意义。[方法]结合少阴病证脉象及病势的发展,梳理白通加猪胆汁汤证的病机,分析前医对白通加猪胆汁汤中猪胆汁作用认识的局限之处,进一步挖掘古代医籍及现代研究成果中猪胆汁所起的关键作用。[结果]少阴病疾病发展过程中脉由沉紧→沉微→无脉,因心主血脉,相应地心阳虚衰的程度逐渐加重,因此心阳欲脱为白通加猪胆汁汤证病机;前医认为猪胆汁有反佐、滋阴的作用,或有违仲景原意。古代医籍及现代研究成果证实,心胆相通,胆气藏于胆汁,具有镇守心阳的作用,而猪为水畜,猪胆汁较羊胆汁更能制约心阳外越,少量使用猪胆汁,使得脉得微续而有生还之机。[结论]白通加猪胆汁汤中猪胆汁具有镇守心阳、使脉微续的作用,这一认识可以更好地解释《伤寒论》条文内涵,拓展猪胆汁的临床应用范围,从而为更好地应用胆汁类及胆制中药治疗心脏疾患乃至心脏急危重症提供有益参考。[Objective]To explore the function and clinical significance of pig bile in Baitong Plus Pig Bile Decoction.[Methods]The pathogenesis of Baitong Plus Pig Bile Decoction syndrome was re-sorted by combining with the pulse and the development of Shaoyin disease,to analyze the limitations in previous physicians’comprehension of the efficacy of pig bile in Baitong Plus Pig Bile Decoction,and further explore the key roles of pig bile in ancient medical texts and modern research.[Results]As the heart governs blood circulation,in the progression of Shaoyin disease,the pulse transitions from weak to absent,indicating a progressively increasing degree of Yang deficiency,the pathogenesis of heart-Yang desire removal was concluded as Baitong Plus Pig Bile Decoction.Previous physicians held the belief that pig bile possessed properties conducive to using corrigent and nourishing Yin,which may have contradicted ZHANG Zhongjing’s original intentions.It had been proven that the heart and gallbladder were in contact,and the gallbladder’s Qi was hidden in the bile,which had the effect of calming the heart’s Yang.Pig as a water animal,pig bile was more effective than sheep bile in restricting the inner Yang,the use of bile in small quantities could cause the pulse to renew itself slightly,so that there was a chance of survival.[Conclusion]This understanding can better explain the connotation of the articles of Treatise on Febrile Diseases and expand the scope of clinical application of porcine bile,so as to provide a useful reference for better application of animal bile and bile concoctions of traditional Chinese medicines in the treatment of cardiac diseases and even cardiac emergencies and critical illnesses.

关 键 词：白通加猪胆汁汤 猪胆汁 少阴病 心阳欲脱 镇守心阳 心胆相通 《伤寒论》 临床应用 

分 类 号：R452[医药卫生—治疗学]