何庆勇运用桂枝甘草汤的经验
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摘要
桂枝甘草汤出自《伤寒杂病论》,为阳虚心悸之证而设。文章从多角度介绍了何庆勇运用桂枝甘草汤的临床经验,何师酷爱经方,擅长用经方治疗多种疑难杂症,尤其擅长治疗心血管领域的疾病。何师认为桂枝甘草汤的临床运用有以下三个关键点:一是抓住主要方证,桂枝甘草汤的主要方证是:心悸而喜按、畏寒、低血压。二是桂枝与甘草的比例应为2∶1,肉桂可以与桂枝同用。三是依照类方加减以及经方叠用,何师临床上常将桂枝甘草汤加减成为桂枝甘草龙骨牡蛎汤、茯苓桂枝甘草大枣汤、茯苓桂枝白术甘草汤,并常与真武汤、泽泻汤、麻黄附子细辛汤、瓜蒌薤白白酒汤等叠用。文章列举了何师运用桂枝甘草汤的3个典型医案。
Guizhi Gancao decoction came from Treatise on Febrile and Miscellaneous Diseases,which is designed for heart yang deficiency leading to palpation. This article introduces the clinical experiences that He Qingyong uses Guizhi Gancao decoction from multy-angles. He loves classic formulas and good at using them in treating difficult miscellaneous diseases,especially cardiovascular diseases. He considers that there are three key points in the uses of Guizhi Gancao decoction: First,recognize the major prescription and syndrome differentiation,which is palpation favoring pressure,chills and hypotension. Second,the dose ratio of cassia twig and liquorice should be 2∶ 1. Cassia bark can be used in the formula with cassia twig. Third,modify the formula according to similar formulas and combine with other formulas. He often modifies Guizhi Gancao decoction into Guizhi Gancao Longgu Muli decotion,Fuling Guizhi Gancao Dazao decotion and Fuling Guizhi Baizhu Gancao decotion. And he often combine the formula with Zhenwu decotion,Zexie decotion,Mahuang Fuzi Xixin decotion and Gualou Xiebai Baijiu decotion. This article also enumerates three typical cases using Guizhi Gancao decoction.
Guizhi Gancao decoction came from Treatise on Febrile and Miscellaneous Diseases,which is designed for heart yang deficiency leading to palpation. This article introduces the clinical experiences that He Qingyong uses Guizhi Gancao decoction from multy-angles. He loves classic formulas and good at using them in treating difficult miscellaneous diseases,especially cardiovascular diseases. He considers that there are three key points in the uses of Guizhi Gancao decoction: First,recognize the major prescription and syndrome differentiation,which is palpation favoring pressure,chills and hypotension. Second,the dose ratio of cassia twig and liquorice should be 2∶ 1. Cassia bark can be used in the formula with cassia twig. Third,modify the formula according to similar formulas and combine with other formulas. He often modifies Guizhi Gancao decoction into Guizhi Gancao Longgu Muli decotion,Fuling Guizhi Gancao Dazao decotion and Fuling Guizhi Baizhu Gancao decotion. And he often combine the formula with Zhenwu decotion,Zexie decotion,Mahuang Fuzi Xixin decotion and Gualou Xiebai Baijiu decotion. This article also enumerates three typical cases using Guizhi Gancao decoction.
引文
[1]杨韬,钟小雪,何庆勇.何庆勇副教授应用薏苡附子散治疗胸痹心痛的思想初探[J].中国中医急症,2016,25(5):821-822.
[2]刘旭东,赵桂芳,何庆勇.何庆勇运用大柴胡汤经验[J].世界中西医结合杂志,2016,11(3):316-318.
[3]张雨晴,钟小雪,何庆勇.何庆勇副教授运用黄芪桂枝五物汤的学术思想初探[J].中国中医急症,2017,26(1):53-55.
[4]吴政远,尹湘君.何庆勇运用瓜蒌薤白半夏汤治疗急性冠脉综合征经验[J].国际中医中药杂志,2015,37(12):1131-1132.
[5]尤在泾.伤寒贯珠集[M].北京:中国医药科技出版社,2011:28.
[6]徐大椿.伤寒论类方·伤寒方论[M].北京:学苑出版社,2009:97.
[7]黄煌.经方100首[M].南京:江苏科学技术出版社,2006:10-12.
[8]聂惠民.三订聂氏伤寒学[M].北京:学苑出版社,2010:161-163.
[9]傅延龄,宋佳,张林.经方本原剂量问题源流[J].北京中医药大学学报,2013,36(5):293-296.
[10]何庆勇.伤寒论钤法[M].北京:人民军医出版社,2015:8-15.
[11]汤小虎,邓中甲.肉桂、桂枝药材分化的年代考证[J].中药材,2008,31(1):156-158.
[12]姜宗瑞.经方杂谈[M].北京:学苑出版社,2009:104-135.
[13]宋立人.桂的考证[J].南京中医药大学学报,2001,17(2):73-75.
[14]许慎.说文解字[M].北京:中华书局,2013:212.
[15]王奇.《伤寒论》方中炙甘草炮制方法探析[J].河北中医,2013,35(11):1654-1655.
[16]徐大椿.伤寒论类方[M].北京:中国中医药出版社,2015:1.
[17]仝小林.方药量效学[M].北京:科学出版社,2013:322.
[18]何庆勇.经方叠用[M].北京:人民军医出版社,2014:2-3.
[19]刘萍,王平.桂枝甘草药对对心血管系统影响的探析[J].辽宁中医杂志,2011,38(2):239-240.
[2]刘旭东,赵桂芳,何庆勇.何庆勇运用大柴胡汤经验[J].世界中西医结合杂志,2016,11(3):316-318.
[3]张雨晴,钟小雪,何庆勇.何庆勇副教授运用黄芪桂枝五物汤的学术思想初探[J].中国中医急症,2017,26(1):53-55.
[4]吴政远,尹湘君.何庆勇运用瓜蒌薤白半夏汤治疗急性冠脉综合征经验[J].国际中医中药杂志,2015,37(12):1131-1132.
[5]尤在泾.伤寒贯珠集[M].北京:中国医药科技出版社,2011:28.
[6]徐大椿.伤寒论类方·伤寒方论[M].北京:学苑出版社,2009:97.
[7]黄煌.经方100首[M].南京:江苏科学技术出版社,2006:10-12.
[8]聂惠民.三订聂氏伤寒学[M].北京:学苑出版社,2010:161-163.
[9]傅延龄,宋佳,张林.经方本原剂量问题源流[J].北京中医药大学学报,2013,36(5):293-296.
[10]何庆勇.伤寒论钤法[M].北京:人民军医出版社,2015:8-15.
[11]汤小虎,邓中甲.肉桂、桂枝药材分化的年代考证[J].中药材,2008,31(1):156-158.
[12]姜宗瑞.经方杂谈[M].北京:学苑出版社,2009:104-135.
[13]宋立人.桂的考证[J].南京中医药大学学报,2001,17(2):73-75.
[14]许慎.说文解字[M].北京:中华书局,2013:212.
[15]王奇.《伤寒论》方中炙甘草炮制方法探析[J].河北中医,2013,35(11):1654-1655.
[16]徐大椿.伤寒论类方[M].北京:中国中医药出版社,2015:1.
[17]仝小林.方药量效学[M].北京:科学出版社,2013:322.
[18]何庆勇.经方叠用[M].北京:人民军医出版社,2014:2-3.
[19]刘萍,王平.桂枝甘草药对对心血管系统影响的探析[J].辽宁中医杂志,2011,38(2):239-240.