摘要
大黄附子汤证症状为胁下偏痛,发热,脉紧弦,病机为阳虚生寒,寒气上逆,方中附子温经祛寒,细辛散寒止痛,大黄破积聚、下逆满,并可制约附子、细辛之温燥,诸药相配,共奏散寒开结,通经止痛之功。该证病位或在脾胃,或在肝肾,其临床表现或为胁痛、腹痛,或为便难,或为发热,也可能诸症并见,临床应用大黄附子汤不必拘泥于偏痛或满痛,也不应将病位定在“胁下”,只要病机相同即可随证治之。《金匮要略·腹满寒疝宿食病脉证治》全篇条文前后联系,先有腹满病,兼有外感发为厚朴七物汤证,不解则邪盛正虚,进而兼腹满虚、实之证,再不解,邪正相搏,发为寒疝,故该篇所言各证为同一类病证失治误治后病机的各种转化,体现了张仲景整体恒动思维。
The symptoms of Rhubarb and Aconite Decoction syndrome are partial pain under the uterus,fever,tight pulse.The pathogen-esis is yang deficiency generating cold,and upward counterflow of cold qi.In the formula,Fuzi(Radix Aconiti Lateralis Preparata)can warm the meridian to eliminate cold;Xixin(Radix et Rhizoma Asari)can disperse cold and relieve pain;Dahuang(Radix et Rhizoma Rhei)can resolve accumulation and undergoes reverse accumulation,and it can also restrict the warm dryness of Fuzi and Xixin.All the drugs match,playing the role of dispersing cold,relieving knots,and relieving pain.The disease site is either in the spleen and stomach,or in the liver and kidney.The clinical manifestations are either partial pain or abdominal pain,or constipation,or fever,or combination of all the symptoms.The clinical application of Rhubarb and Aconite Decoction does not need to be limited to partial or full pain,nor should the disease be located under the hypochondrium.The same pathogenesis can be treated according to the syndrome.Connecting the whole related items in Synopsis ofthe Golden Chamber,first,there is abdominal fullness,complicated with external contraction,lead-ing to Officinal Magnolia Bark Seven-Ingredient Decoction syndrome.If it is not relieved,there will excessive pathogens and deficient healthy qi,then complicated with deficiency and excess syndrome of abdominal fullness.If it is still not relieved,the pathogen will fight against the healthy qi,leading to cold hernia.Therefore,the chapter points out that the syndromes are in fact various transformations of the same type of disease syndrome after loss of treatment or mistreatment,which reflects the overall constant dynamic thinking of Zhang Zhongjing.
作者
雷巧美
袁行勇
符强
LEI Qiaomei;YUAN Xingyong;FU Qiang(Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang,China,150040;Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530000)
出处
《河南中医》
2024年第2期163-166,共4页
Henan Traditional Chinese Medicine
关键词
大黄附子汤证
胁下偏痛
发热
《金匮要略》
张仲景
Rhubarb and Aconite Decoction
partial pain unden thoracic rib
fever
Synopsis ofthe Golden Chamber
Zhang Zhongjing
