麻黄汤的方药用量和临证体会  

Dosage and Clinical Experience of Mahuang Decoction(麻黄汤)

作　　者：何永明[1] 李志鹏[1] 许楠 程赟 周玟[1] HE Yongming;LI Zhipeng;XU Nan;CHENG Yun;ZHOU Min(Jiangsu Cancer Hospital,Jiangsu Institute of Cancer Research,The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu,China)

机构地区：[1]江苏省肿瘤医院,江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院,江苏南京210009

出　　处：《中华中医药学刊》2025年第4期193-196,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：江苏省中医药管理局第四批江苏省中医临床优秀人才研修项目(苏中医科教[2022]1号)。

摘　　要：麻黄汤首见于《伤寒杂病论》,方药由麻黄、桂枝、杏仁、甘草组成,主治外感风寒表实证,典型方证为:恶寒无汗、头疼身痛、脉浮紧。麻黄去根节,无需去茎节。桂枝、肉桂可单用也可合用。光杏仁用时捣碎,药力易煮出。《伤寒论》中炙甘草可能是现代中药饮片生甘草。麻黄汤原方的剂量折算当是:一两约为15.6 g。然而,麻黄量大易致心慌、大汗、失眠等不良反应。若一两按5 g折算,则剂量为:麻黄15 g,桂枝10 g,杏仁7.5 g,甘草5 g,亦可发汗解表。麻黄汤治疗风寒感冒,可加减化裁,大人、小儿、妇女、老人皆可用。药证相对、方证相应,掌握麻黄汤方证和量效关系,是安全有效使用麻黄汤的关键。Mahuang Decoction(麻黄汤)was first seen in Treatise on Febrile and Miscellaneous Diseases.The prescription is composed of Mahuang(Ephedrae Herba),Guizhi(Cinnamomi Ramulus),Xingren(Armeniacae Semen Amarum)and Gancao(Glycyrrhizae Radix et Rhizoma).It is mainly used to treat exogenous wind cold.The typical prescription syndrome is aversion to cold without sweat,headache and body pain,and floating and tense pulse.Mahuang(Ephedrae Herba)needs to remove root nodes without removing stem nodes.Guizhi(Cinnamomi Ramulus)and Rougui(Cinnamomi Cortex)can be used alone or in combination.Xingren(Armeniacae Semen Amarum)is crushed when used and the medicinal power is easy to boil.Gancao(Glycyrrhizae Radix et Rhizoma)in Treatise on Febrile Diseases may be the raw Gancao(Glycyrrhizae Radix et Rhizoma)in modern Chinese medicine.The dose conversion of the original formula of Mahuang Decoction should be one Liang is about 15.6 g.However,large amounts of Mahuang(Ephedrae Herba)can easily cause adverse reactions such as palpitations,sweating and insomnia.If one Liang is converted to 5 g,the dosage of Mahuang Decoction is Mahuang(Ephedrae Herba)15g,Guizhi(Cinnamomi Ramulus)10 g,Xingren(Armeniacae Semen Amarum)7.5 g and Gancao(Glycyrrhizae Radix et Rhizoma)5 g,which can also cause sweating and relieve the exterior.Mahuang Decoction can be modified to treat cold and wind,and can be used by adults,children,women and the elderly.The key to the safe and effective use of Mahuang Decoction is to have a clear understanding of the relationship between medication and prescription as well as the relationship between dosage and efficacy.

关 键 词：麻黄汤 方证 剂量 

分 类 号：R289.5[医药卫生—方剂学]