摘要
柴胡加龙骨牡蛎汤证病机为肝胆失疏,三焦不利;少阳火盛,邪热扰心;脾胃失和,中轴不转。柴胡加龙骨牡蛎汤一可调达风木,枢转气机;二可补脾和胃,使中轴得转;三可敛降火热,终得邪祛神安。心悸的病机是水寒土湿,水寒木不能生长,土湿则中气堙塞,升降失政,脾胃不得运转。基于五脏生克制化辨证模式可知,柴胡加龙骨牡蛎汤加减可用于治疗心悸。若中焦脾胃症状较明显者,常合用半夏泻心汤加减;若邪气郁滞,气机不利较甚者,则合用柴胡疏肝散加减;若痰热较甚者,则合用二陈汤。
The pathogenesis of Bupleurum plus Os Draconis and Oyster Shell Decoction includes the liver and gallbladder failing to disperse,disorder of triple energizer;excessive lesser yang fire,and pathogenic heat disturbing the heart;spleen-stomach disharmony failing to function properly.Firstly,Bupleurum Plus Os Draconis and Oyster Shell Decoction can regulate wind and wood.Secondly,it can replenish the spleen and stomach and make the central axis work properly.Thirdly,it can astringe and reduce fire and heat,and finally get rid of pathogens.The pathogenesis of palpitation is that the water is cold and the earth is damp.Cold water makes wood unable to grow,while damp earth leads to obstructed middle energizer qi,disorder of ascending and descending qi,and spleen-stomach dysfunction.Based on syndrome differentiation model of generation-restraint-transformation of five zang organs,Modified Bupleurum plus Os Draconis and Oyster Shell Decoction can be used to treat palpitation.If the symptoms of spleen and stomach in middle severe,it is often combined with Modified Pinellia Heart-Draining Decoction.For stagnant pathogenic qi and disorder of qi movement,Modified Bupleurum Liver-Soothing Powder can be added.For severe phlegm heat,Two Matured Substances Decoction can be combined.
作者
王润英
杜武勋
WANG Run-ying;DU Wu-xun(Tianjin University of Traditional Chinese Medicine,Tianjin,China,300383;Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China,300150)
出处
《河南中医》
2022年第6期815-818,共4页
Henan Traditional Chinese Medicine
基金
天津市教育委员会科研计划项目(2019SK025)。
关键词
心悸
柴胡加龙骨牡蛎汤
五脏生克制化辨证模式
《伤寒论》
张仲景
palpitation
Bupleurum plus Os Draconis and Oyster Shell Decoction
syndrome differentiation model of generation-restraint-transformation of five zang organs
Treatise on Cold Damage Diseases
Zhang Zhong-jing
