《金匮要略》瓜蒌瞿麦丸的病机及效用探讨  

Discussion on the Pathogenesis and Effect of Gualou Qumai Pill in Synopsis of Golden Chamber

作　　者：张春艳[1] 王建明 ZHANG Chunyan;WANG Jianming(Department of Nephrology,Yunnan Hospital of Traditional Chinese Medicine,Yunnan Province,Kunming 650021,China;College of Acupuncture and Massage,Yunnan University of Traditional Chinese Medicine,Yunnan Province,Kunming 650000,China)

机构地区：[1]云南省中医医院肾病科,云南昆明650021 [2]云南中医药大学针灸推拿学院,云南昆明650000

出　　处：《中国中医药现代远程教育》2025年第5期47-50,共4页Chinese Medicine Modern Distance Education of China

基　　金：国家中医药管理局第五批全国中医临床优秀人才研修项目【No.国中医药人教函〔2022〕1号】。

摘　　要：瓜蒌瞿麦丸是《金匮要略》经典名方,是治疗下寒上燥消渴、小便不利的方剂,具有温下寒、润上燥、利水湿的作用,用于下寒上燥水停证的治疗。为使瓜蒌瞿麦丸更好地应用于临床,文章通过分析原文,方药与前人、今人对瓜蒌瞿麦丸的病机、效用、方药的分析及临床应用,总结其病机特点及应用范围。瓜蒌瞿麦丸病机为阴阳两伤,水饮内停,上有燥火伤津,津亏口渴,兼有湿热伤阴;在下焦则以阳虚生内寒为因,水气内停为果。症状上抓住小便异常、口渴为要点,寒热错杂、上燥下寒,阴阳两虚,可兼湿热,凡病肾阳虚又兼阴虚之证,或兼有湿热;或脾肾阳虚夹有湿热的疾病均可应用瓜蒌瞿麦丸治疗,尤以肾阳不足、下寒上燥最为恰当。Gualou Qumai pill is a classic prescription of Synopsis of Golden Chamber.It is a prescription for the treatment of lower cold and upper dryness,thirst and urination.It has functions of warming lower cold,moistening upper dryness and improving water dampness,and is used for the treatment of the syndrome of lower cold and upper dryness.In order to better apply Gualou Qumai pill to clinical practice,the pathogenesis and application of Gualou Qumai pill were summarized by analyzing the pathogenesis,effectiveness,prescription analysis and clinical application of the original text,predecessors and the present people to Gualou Qumai pill.The pathogenies of Gualou Qumai pill are deficiency of both yin and yang of heart,fluid retention,there is dryness and fire that impels fluid,thirst,and dampness and heat impels yin.In the lower jiao,yang deficiency produces internal cold as the cause,and internal stagnation of fluid-dampness as the result.Symptom is the urination abnormal,thirst as the main point,the treatment of cold and heat mixed,dry and cold,yin and yang deficiency,can be combined with dampness-heat,where the disease of kidney yang deficiency and yin deficiency syndrome,or both dampness-heat.The diseases of spleen-kidney yang deficiency and dampness-heat can be treated with Gualou Qumai pill,especially the deficiency of kidney yang,lower cold and upper dryness.

关 键 词：《金匮要略》 瓜蒌瞿麦丸 下寒上燥证 

分 类 号：R222.2[医药卫生—中医基础理论]