摘要
《伤寒论》所称"心下痞"即患者自觉心下痞满不舒,按之濡或硬,无疼痛症状。痞证之根本病机为中焦气机壅滞,脾胃升降失和。《伤寒论》中关于心下痞的"泻心汤"有五种,分别为半夏泻心汤、生姜泻心汤、甘草泻心汤、大黄黄连泻心汤及附子泻心汤。五方均主治痞证,然各方所治主证之病机有所差异:半夏泻心汤主治寒热错杂之痞;生姜泻心汤主治太阳少阳并病之胃虚不化水热痞;甘草泻心汤主治少阳阳明并病之胃虚痞;大黄黄连泻心汤主治寒郁化热,热邪壅聚之热痞;附子泻心汤主治热痞兼阳虚之证。五证虽均以痞为患,但病机不同,立法处方也应在辨证论治的基础上灵活施治。
According to Shang Han Lun,"Epigastric Oppression" means that the patient consciously feels the discomfort of full stomach,feeling by others soft or hard,with pain symptoms.The fundamental pathogenesis of that is the Qi stagnation and Blood stasis in middle burner as well as the disharmony between Spleen and Stomach.There are five kinds of "Xie Xin Decoction" in Shang Han Lun,namely,Banxia Xie Xin Decoction,Shengjiang Xie Xin Decoction,Gancao Xie Xin Decoction,Dahuang Huanglian Xie Xin Decoction and Fuzi Xiexin Decoction.The five prescriptions are in charge of the case of "Epigastric Oppression",but the pathogenesis of each one is different:the Banxia Xie Xin Decoction is used in case of the Cold and Heat mixing syndrome;Shengjiang Xie Xin Decoction is used in case of deficiency of stomach due to the sickness both in Taiyang and Shaoyang meridian.Gancao Xie Xin Decoction is mainly used for the treatment of Shaoyang and Yangming meridian sickness related to the deficiency of the stomach;Dahuang Huanglian Xie Xin Decoction is the mainly used in case of Heat stagnation from the accumulation of cold;Fuzi Xie Xin Decoction is used in case of Heat stagnation from the accumulation of cold and Yang deficiency syndrome.Although the five kinds are all called "Epigastric Oppression",the pathogenesis of them is quite different.Therefore,the legislative prescription should be flexible and be used on the basis of syndrome differentiation.
作者
周勇
魏盼
周小康
ZHOU Yong;WEI Pan;ZHOU Xiaokang(TCM Hospital of Wuhan City,Wuhan Hubei China 430014;Wuchang Hospital of Wuhan City,Wuhan Hubei China 430063)
出处
《中医学报》
CAS
2019年第2期248-251,共4页
Acta Chinese Medicine
关键词
张仲景
《伤寒论》
半夏泻心汤
生姜泻心汤
甘草泻心汤
大黄黄连泻心汤
附子泻心汤
心下痞
Zhang Zhongjing
Shang Han Lun
Banxia Xie Xin Decoction
Shengjiang Xiexin Decoction
Gancao Xie Xin Decoction
Dahuang Huanglian Xie Xin Decoction
Fuzi Xie Xin Decoction
Epigastric Oppression
