桑叶的配伍经验及用量探究
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摘要
通过对近现代名老中医及临床专家临床应用桑叶经验的总结,发现桑叶的临床常用剂量为3～60 g,总体来看,小剂量(3～15 g)多用于疏风散热以治疗发热、咳嗽、咽痛等肺系、官窍疾病(上焦病),大剂量(15～60 g)多用于平肝、止汗、降血糖等中下焦杂病的治疗。个别案例因医家经验的差异而有所出入;桑叶除具疏散风热,清肺润燥,清肝明目的功效外,尚可凉血、止汗、止崩。可用于咳嗽、发热、咽痛、自汗、盗汗、崩漏、糖尿病、肥胖、结膜炎、三叉神经痛、带状疱疹等多种疾病的治疗。且在治疗不同的疾病时,其所配药物及所用剂量均有所不同。桑叶在用于治疗肺系、官窍疾病时,多同连翘、薄荷、菊花、桔梗等辛凉轻清之品相配;用于治疗肝系疾病时,多同菊花、天麻、女贞子、墨旱莲等滋阴熄风之品相配;用于降糖时,多同黄连、知母、赤芍等苦寒之品相配;用于止汗时,多同五味子、黄芪、麦冬等固表敛汗之品相配。
The summary of the clinical experience on Folium Mori by modern and famous TCM doctors led to findings that: The clinical dose range of Folium Mori is between 3 to 60 g. Generally speaking,small doses( 3 to 15 g) are used for scattering wind and dispersing heat in treating fever,cough,sore throat and other pulmonary diseases( upper jiao disease),while large doses( 15 ～ 60 g) are used for calming the liver,arresting sweating and lowering blood glucose in treating middle and lower jiao diseases such as qi uprush of liver,hyperhidrosis and hyperglycemia. Individual cases vary depending on the experience of the doctors; In addition to dispersing the wind-heat,clearing the lung and moistening the dryness,clearing the liver and improving vision,Folium Mori can also cool the blood,arrest sweating and stop profuse uterine bleeding. It can be used in the treatment of various diseases such as cough,fever,sore throat,spontaneous sweating,night sweats,uterine bleeding and spotting,diabetes,obesity,conjunctivitis,trigeminal neuralgia and herpes zoster,etc. And when treating different diseases,the drug combinations and the dosage are different; Acrid-cool and light medicinals like Fructus Forsythiae,Herba Menthae,Flos Chrysanthemi,Radix Puerariae Lobatae could be chosen to combine with Folium Mori when treating lung and facial organ diseases. Medicinals with yin-nourishing and wind-distinguishing functions,such as Flos Chrysanthemi,Rhizoma Gastrodiae,Fructus Ligustri Lucidi,Herba Ecliptae,are more likely to be selected for combination when treating liver-related diseases. For hypoglycemic use,bitter-cold medicinals are more compatible,such as Rhizoma Coptidis,Rhizoma Anemarrhenae,and Radix Paeoniae Rubra; and when used as an antiperspirant,medicinals like Fructus Schisandrae Chinensis,Radix Astragali,Radix Ophiopogonisare more frequently combined with,which can consolidate the exterior and arrest sweating.
The summary of the clinical experience on Folium Mori by modern and famous TCM doctors led to findings that: The clinical dose range of Folium Mori is between 3 to 60 g. Generally speaking,small doses( 3 to 15 g) are used for scattering wind and dispersing heat in treating fever,cough,sore throat and other pulmonary diseases( upper jiao disease),while large doses( 15 ～ 60 g) are used for calming the liver,arresting sweating and lowering blood glucose in treating middle and lower jiao diseases such as qi uprush of liver,hyperhidrosis and hyperglycemia. Individual cases vary depending on the experience of the doctors; In addition to dispersing the wind-heat,clearing the lung and moistening the dryness,clearing the liver and improving vision,Folium Mori can also cool the blood,arrest sweating and stop profuse uterine bleeding. It can be used in the treatment of various diseases such as cough,fever,sore throat,spontaneous sweating,night sweats,uterine bleeding and spotting,diabetes,obesity,conjunctivitis,trigeminal neuralgia and herpes zoster,etc. And when treating different diseases,the drug combinations and the dosage are different; Acrid-cool and light medicinals like Fructus Forsythiae,Herba Menthae,Flos Chrysanthemi,Radix Puerariae Lobatae could be chosen to combine with Folium Mori when treating lung and facial organ diseases. Medicinals with yin-nourishing and wind-distinguishing functions,such as Flos Chrysanthemi,Rhizoma Gastrodiae,Fructus Ligustri Lucidi,Herba Ecliptae,are more likely to be selected for combination when treating liver-related diseases. For hypoglycemic use,bitter-cold medicinals are more compatible,such as Rhizoma Coptidis,Rhizoma Anemarrhenae,and Radix Paeoniae Rubra; and when used as an antiperspirant,medicinals like Fructus Schisandrae Chinensis,Radix Astragali,Radix Ophiopogonisare more frequently combined with,which can consolidate the exterior and arrest sweating.
引文
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[36]赵兴旺,周慢,朱宇溪,等.陈秋教授“以通为法”并巧配桑叶荷叶治疗肥胖经验[J].云南中医中药杂志,2018,39(5):3-5.
[37]逄冰,刘文科,郑玉娇,等.基于中医脾瘅理论探讨代谢综合征血脂异常[J].北京中医药,2016,35(6):573-576.
[38]文静,张德芹,夏佳楠,等.桑叶提取物对MSG肥胖大鼠胰岛素抵抗的影响[J].天津中医药,2015,32(4):234-238.
[39]方鸿浩.基于数据挖掘探讨黎烈荣教授治疗围绝经期功血用药规律[D].武汉:湖北中医药大学:2015
[40]张晓春.陈慧侬教授治疗妇科病经验撷菁[J].广西中医药,2002,25(1):39-40.
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[42]王岩,彭丽娟.程益春教授治疗糖尿病临床辨证论治经验[J].福建中医药,2006,37(2):15-16.
[43]李宏红,张广德,魏子孝.魏子孝教授治疗脱发经验[J].世界中西医结合杂志,2011,6(1):78-79.
[44]赵玉玲,霍青云,周芳,等.邱明义教授治疗脂溢性脱发的经验[J].环球中医药,2017,10(8):891-893.
[2]苏方华.桑叶的化学成分及临床应用研究进展[J].中国医药导报,2010,7(14):9-12.
[3]李玲.桑叶古今研究与临床应用浅析[J].江西中医药,2017,48(5):9-11.
[4]王婷婷,马天宇,李琪,等.桑叶化学成分及生物活性研究进展[J].食品与药品,2018,20(5):67-68.
[5]张子兴.自拟清热消风洗剂治疗急性结膜炎[J].山西中医,1990,6(3):23.
[6]周洵.李宗智教授治疗杂病验案举隅之二[J].北方药学,2015,12(2):57-58.
[7]王大舜,南一.梅核气治疗验案举隅[J].内蒙古中医药,2013,32(5):20-21.
[8]陈玉鹏,刘德荣.刘德荣教授治疗喉喑验案[J].中医药通报,2007,6(4):54-56.
[9]王光林.王文济治疗咽喉病验案3则[J].上海中医药杂志,2008,42(4):15-16.
[10]王秀玲,胡金秀.谢强应用清燥救肺汤加减治疗春季“飘尘”致干燥性鼻炎验案4则[J].江西中医药,2008,39(12):14-15.
[11]龚腾芬,陈贤峰.陈学达治疗带状疱疹验案一则[J].浙江中医杂志,2014,49(12):886.
[12]孙书玉.麻疹验案四则[J].江西中医药,1958,8(12):37.
[13]陈烨文,王鹏程,连建伟.连建伟教授运用轻法临床治验[J].中华中医药杂志,2015,30(3):767-769.
[14]刘书杰.自拟清脑沐方验案3则[J].医学理论与实践,1996,9(12):545.
[15]何永强,殷世鹏.周信有教授高血压病辨治经验[J].光明中医,2012,27(11):2182-2184.
[16]盛宁,何瑛琨,冯慧利,等.半夏泻心汤和鸟嘌呤核苷对APP-swe/PS1dE9双转基因小鼠学习记忆的影响[J].北京中医药大学学报,2017,40(7):558-563.
[17]缪美淑.罗克聪治疗三叉神经痛验案[J].贵阳中医学院学报,1992,14(1):17.
[18]于锡海,张东奎.施今墨治疗不寐验案四则[J].山东中医杂志,1999,18(11):503-504.
[19]魏睦森,张丽珍.著名老中医魏长春的临床经验[J].上海中医杂志,1981,15(2):5-7.
[20]林寿宁.林沛湘教授治疗外感病经验举隅[J].广西中医药,1992,15(3):16-17.
[21]徐金平.李素云教授辨证治疗顽固性咳嗽经验[J].光明中医,2010,25(3):401-402.
[22]邵翠,吴智兵,杨德福.吴智兵教授临床应用桑菊饮验案3则[J].新中医,2015,47(7):300-301.
[23]陈勇,吴春节.学习关幼波教授治疗咳嗽的经验[J].实用中医内科杂志,1987,1(3):103.
[24]李骏,严园,胡亚光,等.严继林教授运用桑叶连贝散治疗风热咳嗽的经验[J].云南中医中药杂志,2017,38(9):1-3.
[25]尹蔚萍,夏杰.杨振邦教授治疗喉源性咳嗽的经验[J].中医药导报,2008,14(12):14-15.
[26]张琦,陈龙,赛若思,等.张云洲教授诊治小儿咳嗽经验[J].广西中医药大学学报,2014,17(3):5-6.
[27]王哲.马智教授治疗风温肺热病经验摭拾[D].沈阳:辽宁中医药大学,2004.
[28]李彦知,杨建宇,张文娟,等.孙光荣教授临证验案举隅[J].中国中医药现代远程教育,2010,8(1):6-7.
[29]梁淼.王安康教授运用首乌延寿丹经验举要[J].新中医,2000,32(4):5-6.
[30]林功铮.中药治愈强直性肌营养不良症并发心包积液1例[J].上海中医药杂志,2000,34(8):23-24.
[31]马凤彬.何炎燊教授临证经验介绍[J].新中医,2006,38(6):11-12.
[32]蒋志达,冯松杰.冯松杰应用桑叶治疗汗证经验[J].河南中医,2013,33(2):185-187.
[33]赵海岳,马华.薛秦名老中医运用当归六黄汤临床经验[J].临床医药实践,2017,26(9):670-671.
[34]程凤银,叶盛英.桑叶抗糖尿病研究概况[J].药学实践杂志,2005,23(2):71-74.
[35]季涛,宿树兰,郭盛,等.桑叶防治糖尿病的效应成分群及其作用机制研究进展[J].中草药,2015,46(5):778-784.
[36]赵兴旺,周慢,朱宇溪,等.陈秋教授“以通为法”并巧配桑叶荷叶治疗肥胖经验[J].云南中医中药杂志,2018,39(5):3-5.
[37]逄冰,刘文科,郑玉娇,等.基于中医脾瘅理论探讨代谢综合征血脂异常[J].北京中医药,2016,35(6):573-576.
[38]文静,张德芹,夏佳楠,等.桑叶提取物对MSG肥胖大鼠胰岛素抵抗的影响[J].天津中医药,2015,32(4):234-238.
[39]方鸿浩.基于数据挖掘探讨黎烈荣教授治疗围绝经期功血用药规律[D].武汉:湖北中医药大学:2015
[40]张晓春.陈慧侬教授治疗妇科病经验撷菁[J].广西中医药,2002,25(1):39-40.
[41]严航,胡一枝.何嘉琳教授治疗妇科疑难病验案4则[J].河南中医,2010,30(12):1162-1163.
[42]王岩,彭丽娟.程益春教授治疗糖尿病临床辨证论治经验[J].福建中医药,2006,37(2):15-16.
[43]李宏红,张广德,魏子孝.魏子孝教授治疗脱发经验[J].世界中西医结合杂志,2011,6(1):78-79.
[44]赵玉玲,霍青云,周芳,等.邱明义教授治疗脂溢性脱发的经验[J].环球中医药,2017,10(8):891-893.