中医学报2012，Vol.27Issue(12)：1565-1567,1586,4.
伤寒论评话:伤寒中风并非泾渭分明,麻黄桂枝或可相兼应用——太阳伤寒和中风的交叉证候
Discussion of Shanghanlun:Typhoid Fever and Wind-stroke Cannot Be Distinguished Completely,Mahuang and Guizhi May Be Applied Complementarily——Cross Syndrome between Typhoid and Stroke of Taiyang
摘要
Abstract
Objective: To discuss the similarities and differences between typhoid fever and wind-stroke, Syndrome of Mahuang Decoction and Guizhi Decoction,and syndrome differentiation and treatment mechanism of their cross syndrome. Methods;The twenty-third item, the twenty-fifth item and the twenty-seventh item of Treatise on Febrile Disease were analyzed. Results; It was found that there were similarities and differences between typhoid fever and wind-stroke, Syndrome of Mahuang Decoction and Guizhi Decoction, and cross syndrome of both needed to be carefully differentiated.(1) Syndrome of Mahuang and Guizhi content equality in the twenty-third item was mixedly composed of defense qi obstruction for exterior excess by cold syndrome and nutrient qi leak for wind-stroke exterior deficiency syndrome, Nutrient Yin leaked out but not dispersing from surface,defense qi obstructed internally but not penetrated in the muscle, therefore, defense qi obstruction and nutrient qi leak were stalemated between surface and muscle, then typical symptoms of flushing and pruritus could appear. Mahuang Decoction and Guizhi Decoction were used simultaneously in treatment could achieved effects of working along both lines and killing two birds with one stone, for externally leaking nutrient yin reverting into pluse and obstructed defense qi dispersing to surface through little sweating. (2)"Pulse appeared loud and great after orally taking Guizhi Decoction" in the twenty-fifth item was the reason of improper drug-using method. When wind-pathogen had not be removed, pungent and warm drugs in Guizhi Decoction with effects of agitating and arousing were taken next, also healthy qi had not wane and could resist pathogen qi with enough capability, therefore, enough healthy qi plue agitating wind-pathogen plus arousing medicine lead loud and great pulse, (3)" Pulse appeared loud and great after orally taking Guizhe Decoction" in the twenty-fifth item was the reason of improper drug-using method. When wind-pathogen had not be removed, pungent and warm drugs in Guizhi Decoction with effects of agitating and arousing were taken next, also healthy qi had not wane and could resist pathogen qi with enough capability, therefore, enough healthy qi plue agitating wind-pathogen plus arousing medicine lead loud and great pulse. (4) For Taiyang exterior excess by cold syndrome and Taiyang wind-stroke exterior deficiency syndrome, the former was caused by excessive close of defense qi and the key point was defense qi; the later was caused by excessive discharging of nutrient yin and the key point was nutrient yin. One had no sweat, the other was sweating, through they looked like entirely different, they could appear at the same patient with delay of disease condition, thus, routine of " Mahuang could not be used when sweating,Guizhi could not be used when no sweating" could not be rigidly complied in treatment. Conclusion: typhoid fever and wind-stroke, Syndrome of Mahuang Decoction and Guizhi Decoction and their cross syndrome needed to be " differentiated under normal pulse",treated by syndrome differentiation,can not be rigidly adhered.关键词
伤寒论/太阳伤寒/太阳中风/麻黄汤证/桂枝汤证Key words
Treatise on Febrile Disease/ Taiyang typhoid fever/ Taiyang wind-stroke/ syndrome of mahuang decoction/ syndrome of guizhi decoction分类
医药卫生引用本文复制引用
梁华龙..伤寒论评话:伤寒中风并非泾渭分明,麻黄桂枝或可相兼应用——太阳伤寒和中风的交叉证候[J].中医学报,2012,27(12):1565-1567,1586,4.基金项目
国家中医药管理局专项课题(编号:2009-0001) （编号:2009-0001）
河南省科技厅基金项目(编号:496060303) （编号:496060303）
