摘要
烦证之病机,或为实热、或为虚热,热扰心神方可作烦;躁证病机,或为邪热大盛,或为虚阳外浮,见于阳明病和三阴病。烦躁演变规律为“烦-烦躁-躁烦-躁而不烦”。太阳病、少阳病基本以烦证为主,伴阳明病时出现躁证,随着热势的加深,逐渐由“烦重于躁”转化为“躁重于烦”。太阳病见表实郁闭、四肢烦疼者,选用麻黄、桂枝发表解郁、通阳止痛,以达不治烦而除烦之功;少阳气郁、烦热内生者,用柴胡开气分之结、用黄芩泄气分之热;二阳合病,阳热最盛,分别用白虎加人参汤类方、承气汤类方与栀子豉汤类方治疗;三阴病,阴盛于内,虚寒过甚则阳气易浮于上、弱于外,用干姜、附子温中回阳,除烦止躁;安神除烦用龙骨、牡蛎、茯苓等。临证选药时,应先辨六经、次辨方证,注重烦、躁的用药规律。
The pathogenesis of vexation is either excess heat or deficiency heat.Only when heat disturbs the mind can it lead to vexation,while the pathogenesis of agitation is either excessive pathogenic heat or asthenic yang floating upward,which can be seen in yang brightness disease and three-yin disease.The evolution law of vexation and agitation is as follows:"vexation-vexation and agitation-agitated vexation-agitation without vexation." Greater yang disease and lesser yang disease are basically dominated by vexation,and agitation occurs when accompanied by yang brightness disease.With the deepening of heat potential,it gradually changes from "vexation being much heavier than agitation " to "agitation being much heavier than vexation" For those who have greater yang disease marked by stagnated exterior excess and pain in their limbs,Mahuang(Herba Ephedrae) and Guizhi(Ramulus Cinnamomi) can be used to release exterior stagnation,dredge yang and relieve pain,so as to achieve the function of eliminating vexation without treating vexation.For qi depression of lesser yang meridian and internal vexation heat,Chaihu(Radix Bupleuri) can be used to open thestagnation of qi aspect and Huangqin(Radix Scutellariae) can be used to purge the heat of qi aspect.For combination of greater yang and lesser yang diseases,yang heat is the most abundant,which can be treated with classified Ginseng Decoction,classified Purgative Decoction,classified Gardenia and Semen Sojae Preparatum Decoction can be used respectively.For three yin diseases,yin is abundant inside.If deficiency and cold is too severe,yang qi is easy to float above and being weak outside.Ganjiang(Rhizoma Zingiberis) and Fuzi(Radix Aconiti Lateralis Preparata) can be used to warm the middle energizer and restore yang,remove vexation and agitation.In order to calm the mind and remove vexation,Longgu(Os Draconis),Muli(Concha Ostreae),Fuling(Poria),etc.,can be used.It is necessary to distinguish the six meridians,followed by formulas and syndromes,and pay attention to the medica
作者
陈洋
张昊
刘涛
CHEN Yang;ZHANG Hao;LIU Tao(Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210023)
出处
《河南中医》
2022年第5期659-663,共5页
Henan Traditional Chinese Medicine
关键词
烦
躁
烦躁
经方
药证
《伤寒论》
《金匮要略》
张仲景
vexation
agitation
vexation and agitation
classical formulas
medicinal syndromes
Treatise on Cold Damage Diseases
Synopsis of the Golden Chamber
Zhang Zhong-jing
