大黄临床应用及其用量
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摘要
整理古医籍及现代医家临证经验及临床应用,总结大黄临床用量及配伍具有以下特点。1)临床多用3～120 g。2)结合疾病、证型、症状选择大黄最佳剂量。如泻下攻积、利湿退黄消脂,治疗胆囊炎、胆囊结石、急性胰腺炎、黄疸、上消化道出血、代谢综合征,为6～75 g;逐瘀通经止血,常治疗吐血、衄血、下焦蓄血之妇科疾患,为10～120 g。3)根据疾病、证型及症状配伍相应中药。如泻下攻积、利湿退黄消脂常配伍郁金、金钱草、栀子、茵陈、车前子、黄连、黄芩,逐瘀通经止血常配伍桃仁、石菖蒲、赤芍等。
Summarize the clinical experience and application of Rhubarb from Ancient medical books and modern physicians, and draw the following conclusion: First, the clinical dosage range is 3-120 g. Second, according to diseases, syndromes type, symptoms, we choose the best dosage of Rhubarb. For instance, when treating cholecystitis, the gallbladder stones, acute pancreatitis, jaundice, upper gastrointestinal bleeding, metabolic syndrome using its eliminating waste, dampness, jaundice and cellulite, its dosage is 6-75 g. When treating hematemesis, bleeding disease, the gynecological disease of blood storage using its dissipating blood stasis to activate blood circulation and stop hemorrhage, its dosage is 10-120 g. Third, when treating diseases, syndromes and symptoms, Rhubarb compatibles with diff erent herb. For example, Rhubarb often compatibles with curcuma, Lysimachia christinae Hance, gardenia, oriental wormwood, Semen plantaginis, Rhizoma coptidis, scutellaria baicalensis using its eliminating waste, dampness, jaundice and cellulite. It often compatibles with Peach kernel, Rhizoma acori graminei, Radix paeoniae rubra using its dissipating blood stasis to activate blood circulation and stop hemorrhage.
Summarize the clinical experience and application of Rhubarb from Ancient medical books and modern physicians, and draw the following conclusion: First, the clinical dosage range is 3-120 g. Second, according to diseases, syndromes type, symptoms, we choose the best dosage of Rhubarb. For instance, when treating cholecystitis, the gallbladder stones, acute pancreatitis, jaundice, upper gastrointestinal bleeding, metabolic syndrome using its eliminating waste, dampness, jaundice and cellulite, its dosage is 6-75 g. When treating hematemesis, bleeding disease, the gynecological disease of blood storage using its dissipating blood stasis to activate blood circulation and stop hemorrhage, its dosage is 10-120 g. Third, when treating diseases, syndromes and symptoms, Rhubarb compatibles with diff erent herb. For example, Rhubarb often compatibles with curcuma, Lysimachia christinae Hance, gardenia, oriental wormwood, Semen plantaginis, Rhizoma coptidis, scutellaria baicalensis using its eliminating waste, dampness, jaundice and cellulite. It often compatibles with Peach kernel, Rhizoma acori graminei, Radix paeoniae rubra using its dissipating blood stasis to activate blood circulation and stop hemorrhage.
引文
[1]姬航宇.《伤寒论》本源药物剂量探索[D].北京:北京中医药大学, 2009
[2]张锡纯著.医学衷中参西录[M].太原:山西科学技术出版社, 2009.
[3]缪正来.章次公的学术经验及其医案[J].新中医, 1981(4):14-18.
[4]张家骏,王瑞春.王正公善用汗吐下治青少年哮喘[J].上海中医药杂志, 1992(10):26-27.
[5]朱泓,孙伟.朱良春治疗肾病常用药对拾贝[J].江苏中医药,2015, 47(6):9-12.
[6]朱良春,陈淑媛.口疮(口腔溃疡)[J].江苏中医杂志,1980(4):17-18.
[7]朱良春.朱良春医集[M].南京:中南大学出版社, 2008:53.
[8]戴克敏.姜春华运用大黄的经验[J].山西中医, 1997(5):8-11.
[9]李翰卿著述;张文康主编;王象礼,赵通理册主编.李翰卿——中国百年百名中医临床家丛书[M].北京:中国中医药出版社, 2001.
[10]叶进.叶景华医技精选[M].上海:上海中医药大学出版社,1997.
[11]杜书学.重用大黄车前子治黄疸[J].河北中医, 1989(4):23.
[12]张云鹏.张云鹏内科经验集[M].王红仙,整理.北京:人民卫生出版社, 2006.
[13]朱葛馨,周强.仝小林运用大黄经验[J].辽宁中医杂志,2013, 40(10):1988-1989.
[14]周强,赵锡艳,逄冰,等.仝小林教授运用大黄黄连泻心汤验案解析[J].天津中医药, 2013, 30(5):259-261.
[15]刘桂芳,周强,仝小林.仝小林教授采用温通泄浊法治疗慢性肾衰竭的经验[J].中国中西医结合肾病杂志, 2010,11(7):631-633.
[16]金末淑.仝小林应用抵当汤加减治疗糖尿病肾病验案举隅[J].山东中医药大学学报, 2012, 36(2):130-131.
[17]王济梅,赵文娟.杨明会应用大柴胡汤治疗骨蒸发热探析[J].世界中西医结合杂志, 2016, 11(2):174-176.
[18]呼健,杨明会.寻常痤疮辨治体会[J].中国中医急症,2004, 13(12):851-852.
[19]支艳,杨明会.老年性便秘辨治体会[J].中国中医药信息杂志, 2009, 16(11):79, 107.
[20]杨赛,池晓玲.经方辨证应用治疗黄疸[J].亚太传统医药,2015, 11(19):74-75.
[21]毛科明.黄煌教授运用大柴胡汤经验[J].光明中医, 2014,29(12):2641, 2648.
[22]潘佳蕾,李赛美.李赛美教授治疗神志病经验拾零[J].浙江中医药大学学报, 2016, 40(2):122-124.
[23]潘佳蕾,李赛美.李赛美经方运用举隅[J].中医药通报,2015, 14(4):27-28, 31.
[24]张美菁,陈汉江,马融.马融运用下法治疗儿科疾病举隅[J].湖南中医杂志, 2016, 32(1):96-98.
[25]钟柳娜,沈毅,关伟,等.便秘辨治举隅[J].北京中医药,2011, 30(5):391-393.
[26]范为民,李艳.国医大师李济仁教授诊治肿瘤用药经验菁华[J].湖北民族学院学报(医学版), 2015, 32(4):75-76,78.
[27]李济仁.中药治愈再次胆道术后化脓性总胆管炎[J].湖北中医杂志, 1981(5):17.
[28]陈杰,赵晓平.祛瘀化痰通腑法治疗高血压性脑出血的临床观察[J].世界最新医学信息文摘, 2017, 17(91):122.
[29]俎振恒.大黄车前子煎剂治疗上消化道出血50例观察[J].河北中医, 1988(6):7.
[30]何时希著.近代医林轶事[M].上海:上海中医药大学出版社, 1997.
[31]郑丽莉,高霞,朱述英,等.大黄配伍土茯苓降浊利湿在慢性肾衰竭治疗中的应用[J].中国中医基础医学杂志,2015, 21(1):110-111.
[32]李叔国.赤芍大黄煎剂早期辅治重症急性胰腺炎45例[J].中国中医药科技, 2013, 20(3):328.
[33]王小坤.凉血解毒重用赤芍大黄治疗淤胆型肝炎[J].四川中医, 2001, 19(10):45.
[34]舒德云,黄翔.重用赤芍、大黄治疗急性黄疸型肝炎23例疗效观察[J].黔南民族医专学报, 1996(S1):5-6.
[35]李梅,董坚.大黄杏仁煎剂送服补中益气丸治疗老年性便秘[J].包头医学院学报, 1999(1):68-69.
[36]蒋森.大黄栀子汤治疗急性水肿型胰腺炎28例[J].中国中西医结合杂志, 1999(3):56.
[37]刘天骥.大黄栀子酒治甲沟炎[J].四川中医, 1990(5):42.
[38]陈彬.大黄伍石膏临床运用举隅[J].湖南中医杂志,1997(S1):73-74.
[39]楮东宁.大黄石膏汤治疗小儿春温临床举隅[J].中医杂志,2001, 42(5):274-275.
[2]张锡纯著.医学衷中参西录[M].太原:山西科学技术出版社, 2009.
[3]缪正来.章次公的学术经验及其医案[J].新中医, 1981(4):14-18.
[4]张家骏,王瑞春.王正公善用汗吐下治青少年哮喘[J].上海中医药杂志, 1992(10):26-27.
[5]朱泓,孙伟.朱良春治疗肾病常用药对拾贝[J].江苏中医药,2015, 47(6):9-12.
[6]朱良春,陈淑媛.口疮(口腔溃疡)[J].江苏中医杂志,1980(4):17-18.
[7]朱良春.朱良春医集[M].南京:中南大学出版社, 2008:53.
[8]戴克敏.姜春华运用大黄的经验[J].山西中医, 1997(5):8-11.
[9]李翰卿著述;张文康主编;王象礼,赵通理册主编.李翰卿——中国百年百名中医临床家丛书[M].北京:中国中医药出版社, 2001.
[10]叶进.叶景华医技精选[M].上海:上海中医药大学出版社,1997.
[11]杜书学.重用大黄车前子治黄疸[J].河北中医, 1989(4):23.
[12]张云鹏.张云鹏内科经验集[M].王红仙,整理.北京:人民卫生出版社, 2006.
[13]朱葛馨,周强.仝小林运用大黄经验[J].辽宁中医杂志,2013, 40(10):1988-1989.
[14]周强,赵锡艳,逄冰,等.仝小林教授运用大黄黄连泻心汤验案解析[J].天津中医药, 2013, 30(5):259-261.
[15]刘桂芳,周强,仝小林.仝小林教授采用温通泄浊法治疗慢性肾衰竭的经验[J].中国中西医结合肾病杂志, 2010,11(7):631-633.
[16]金末淑.仝小林应用抵当汤加减治疗糖尿病肾病验案举隅[J].山东中医药大学学报, 2012, 36(2):130-131.
[17]王济梅,赵文娟.杨明会应用大柴胡汤治疗骨蒸发热探析[J].世界中西医结合杂志, 2016, 11(2):174-176.
[18]呼健,杨明会.寻常痤疮辨治体会[J].中国中医急症,2004, 13(12):851-852.
[19]支艳,杨明会.老年性便秘辨治体会[J].中国中医药信息杂志, 2009, 16(11):79, 107.
[20]杨赛,池晓玲.经方辨证应用治疗黄疸[J].亚太传统医药,2015, 11(19):74-75.
[21]毛科明.黄煌教授运用大柴胡汤经验[J].光明中医, 2014,29(12):2641, 2648.
[22]潘佳蕾,李赛美.李赛美教授治疗神志病经验拾零[J].浙江中医药大学学报, 2016, 40(2):122-124.
[23]潘佳蕾,李赛美.李赛美经方运用举隅[J].中医药通报,2015, 14(4):27-28, 31.
[24]张美菁,陈汉江,马融.马融运用下法治疗儿科疾病举隅[J].湖南中医杂志, 2016, 32(1):96-98.
[25]钟柳娜,沈毅,关伟,等.便秘辨治举隅[J].北京中医药,2011, 30(5):391-393.
[26]范为民,李艳.国医大师李济仁教授诊治肿瘤用药经验菁华[J].湖北民族学院学报(医学版), 2015, 32(4):75-76,78.
[27]李济仁.中药治愈再次胆道术后化脓性总胆管炎[J].湖北中医杂志, 1981(5):17.
[28]陈杰,赵晓平.祛瘀化痰通腑法治疗高血压性脑出血的临床观察[J].世界最新医学信息文摘, 2017, 17(91):122.
[29]俎振恒.大黄车前子煎剂治疗上消化道出血50例观察[J].河北中医, 1988(6):7.
[30]何时希著.近代医林轶事[M].上海:上海中医药大学出版社, 1997.
[31]郑丽莉,高霞,朱述英,等.大黄配伍土茯苓降浊利湿在慢性肾衰竭治疗中的应用[J].中国中医基础医学杂志,2015, 21(1):110-111.
[32]李叔国.赤芍大黄煎剂早期辅治重症急性胰腺炎45例[J].中国中医药科技, 2013, 20(3):328.
[33]王小坤.凉血解毒重用赤芍大黄治疗淤胆型肝炎[J].四川中医, 2001, 19(10):45.
[34]舒德云,黄翔.重用赤芍、大黄治疗急性黄疸型肝炎23例疗效观察[J].黔南民族医专学报, 1996(S1):5-6.
[35]李梅,董坚.大黄杏仁煎剂送服补中益气丸治疗老年性便秘[J].包头医学院学报, 1999(1):68-69.
[36]蒋森.大黄栀子汤治疗急性水肿型胰腺炎28例[J].中国中西医结合杂志, 1999(3):56.
[37]刘天骥.大黄栀子酒治甲沟炎[J].四川中医, 1990(5):42.
[38]陈彬.大黄伍石膏临床运用举隅[J].湖南中医杂志,1997(S1):73-74.
[39]楮东宁.大黄石膏汤治疗小儿春温临床举隅[J].中医杂志,2001, 42(5):274-275.