摘要
麻黄连翘赤小豆汤出自《伤寒论》,用于治疗湿热郁结发黄而兼有表证不解,肾病综合征患儿中证属外寒内热,湿热内蕴者可用此方治疗。以下三种类型的证候同时出现时,适合使用本方治疗儿童难治性肾病综合征:一是表证(多为表有寒邪):恶风寒,恶寒发热,舌质淡,苔白或润,脉浮;二是湿证:水肿,身体困重,胸闷腹胀,口中黏腻,大便稀溏,舌边有齿印,苔腻或润,脉滑;三是热证:尿少尿黄,舌红,苔黄等。运用麻黄连翘赤小豆汤辨证治疗儿童难治性肾病综合征时,还应注意补阳、辛开、清热、活血、化湿。需要注意的是,麻黄连翘赤小豆汤药性偏苦寒,易耗伤阳气,在疾病后期,激素减至小量时(泼尼松<0.25 mg·kg^(-1)),一般不轻易用此方。但并非绝对禁忌证,若患儿阳虚证不明显,且确有麻黄连翘赤小豆汤证时,亦可辨证施治,随证加减,阳气衰微患儿禁用麻黄连翘赤小豆汤。
Ephedra and Coptis and Semen Phaseoli Decoction is derived from Treatise on Cold Damage Diseases,and is used to treat dampness-heat stagnation with yellowing and unreleased exterior syndromes.In children with nephrotic syndrome(NS),if the syndrome belongs to external cold and internal heat,with dampness and heat accumulation,the formula can be used.When the following three types of syndromes occur simultaneously,it is suitable to use this formula to treat refractory nephrotic syndrome(RNS)in children:The first type,exterior syndrome(mosdy manifested as cold pathogen):aversion to wind and cold,or aversion to cold and fever,light tongue,white or moist fur,and floating pulse.The second type is dampness syndrome:edema,heavy body,fatigue,chest tightness and abdominal distension,sticky and greasy mouth,loose stools,tooth marks on the tongue edge,greasy or moist fur,and slippery pulse.The third tpye is heat syndrome:low and yellow urine,red tongue,yellow fur,etc.When using Ephedra and Coptis and Semen Phaseoli Decoction for syndrome differentiation and treatment of RNS in children,attention should also be paid to tonifying yang,dispersing with the pungent,clearing heat,promoting blood circulation,and resolving dampness.It should be noted that the formula has a bitter cold nature and is prone to damaging yang qi.In the later stage of the disease,when the hormone is reduced to a small amount(prednisone<0.25 mg·kg^(-1)),it is generally not suitable to use this formula.But it is not an absolute contraindication.If the yang deficiency syndrome of the child is not obvious and there is indeed a syndrome of Ephedra and Coptis and Semen Phaseoli Decoction,it can also be flexibly treated according to the differentiation of symptoms.However,the formula is prohibited for children with very deficient yang.
作者
李燕羽
陈乃清
LI Yan-yi;CHEN Nai-qing(Guangzhou University of Chinese Medicine,Guangzhou,Guangdong,China,510405;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,Guangdong,China,518021)
出处
《河南中医》
2023年第4期500-503,共4页
Henan Traditional Chinese Medicine
基金
国家中医药管理局罗笑容全国名老中医药专家传承工作室建设项目(14GG2X02)。
关键词
难治性肾病综合征
麻黄连翘赤小豆汤
儿童
表证
湿证
热证
《伤寒论》
张仲景
refractory nephrotic syndrome(RNS)
Ephedra and Coptis and Semen Phaseoli Decoction
children
exterior syndrome
dampness syndrome
heat syndrome
Treatise on Cold Damage Diseases
Zhang Zhong-jing
