山药配牛蒡子治疗咳嗽的机理探讨
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摘要
山药配牛蒡子是张锡纯《医学衷中参西录》中治疗咳嗽的一个经典对药,在临床治疗咳嗽方面具有显著效果,被诸多后代医家争相引用。结合历代中医本草著作相关条文及其医案,山药配牛蒡子治疗咳嗽的机理,认为山药不仅能补肺气滋肺阴,善治肺气阴两虚咳嗽,还可补脾养胃,培土生金,善治脾虚致肺虚咳嗽,亦可补肾,金水相生,可治疗肾不纳气之咳;牛蒡子辛能散邪,寒能清热,苦能降逆,喜生长于山坡、灌木丛、河边等潮湿地,耐热性强,能润肺解热,可治疗风热咳嗽与痰热咳嗽,二药并用,一补一泻,一宣一降,补泻结合,宣降相宜,以成安肺之功。通过探讨其性味归经及临床运用,发现二药配合对劳热咳嗽的治疗效果甚佳。
Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus) is a classic couplet medicines for cough in Zhang Xichun's book Yixue Zhongzhong Canxi Lu. It has significant effect in clinical treatment of cough, and has been cited by many future generations of physicians. Combining the relevant provisions of traditional Chinese medicine herbal works and their medical records, the mechanism of Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus) in treating cough was summarized. Shanyao(Dioscoreae Rhizoma) can not only nourish lung-qi and nourish lung-yin, but also nourish spleen and stomach, cultivate soil and generate gold, and treat lungdeficiency cough caused by spleen-deficiency. It can also nourish kidney and treat cough caused by failure of shenqi to control inspiration. Niubangzi(Arctii Fructus) can disperse pathogens through pungency, clear away heat, and descend adverse qi through bitterness. It likes to grow in moist areas such as hillsides, shrubs and riversides. It has strong heat resistance, can moisten the lungs and relieve fever, and can treat wind-heat cough and phlegm-heat cough. Two medicines, one reinforce and one reduce, one declaration and one descent, the combination of reinforcing and reducing, the combination declaration and descent, in order to achieve the goal of lung safety. Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus), reinforcing versus reducing, ventilating versus descending, can treat laborheat cough by soothing the lung.
Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus) is a classic couplet medicines for cough in Zhang Xichun's book Yixue Zhongzhong Canxi Lu. It has significant effect in clinical treatment of cough, and has been cited by many future generations of physicians. Combining the relevant provisions of traditional Chinese medicine herbal works and their medical records, the mechanism of Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus) in treating cough was summarized. Shanyao(Dioscoreae Rhizoma) can not only nourish lung-qi and nourish lung-yin, but also nourish spleen and stomach, cultivate soil and generate gold, and treat lungdeficiency cough caused by spleen-deficiency. It can also nourish kidney and treat cough caused by failure of shenqi to control inspiration. Niubangzi(Arctii Fructus) can disperse pathogens through pungency, clear away heat, and descend adverse qi through bitterness. It likes to grow in moist areas such as hillsides, shrubs and riversides. It has strong heat resistance, can moisten the lungs and relieve fever, and can treat wind-heat cough and phlegm-heat cough. Two medicines, one reinforce and one reduce, one declaration and one descent, the combination of reinforcing and reducing, the combination declaration and descent, in order to achieve the goal of lung safety. Shanyao(Dioscoreae Rhizoma) with Niubangzi(Arctii Fructus), reinforcing versus reducing, ventilating versus descending, can treat laborheat cough by soothing the lung.
引文
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[2]吴红彦,徐厚谦.张锡纯“对药”初探[J].甘肃中医,1993(1):42-43.
[3]黄飞霞,陆怡衡,劳力行,等.翁庚民辨治慢性咳嗽经验[J].环球中医药, 2018, 11(10):1556-1558.
[4]李敏,昝俊杰.慢性咳嗽的中医辨治思路探析[J].世界最新医学信息文摘, 2018, 18(76):208, 211.
[5]龙迪.张景岳论治咳嗽的学术思想与方药研究[D].成都:成都中医药大学, 2017.
[6]王晶波,陈名元.基于脏腑辨证论治感染后咳嗽[J].中国中医急症, 2016, 25(10):1918-1921.
[7]蔡林,雷长国.健脾宣肺法论治小儿慢性咳嗽[J].川北医学院学报, 2016, 31(5):635-636.
[8]张立山,戴雁彦.咳嗽的脏腑论治[J].北京中医药大学学报(中医临床版), 2003(4):29-30.
[9]王俊月,谢文英.谢文英教授治疗外感咳嗽经验浅析[J].光明中医, 2018, 33(14):2009-2011.
[10]杨永刚,杨擎,刘柳,等.牛蒡子的药用研究[J].长春中医药大学学报, 2014, 30(5):827-828.
[11]刘丽,梁茂新.牛蒡子潜在功用的发掘与利用[J].吉林中医药, 2016, 36(10):1046-1049.
[12]马荣,高荣林,齐文升,等.白牛宣肺汤治疗感染后咳嗽的临床观察[J].中国中医急症, 2017, 26(11):1999-2002.
[13]么丽春.张吕夫治疗小儿外感发热经验[J].中国中医药信息杂志, 2016, 23(5):116-117.
[14]田发念,朱菊香,杨毅.杨毅从肺阴虚论治慢性咽炎[J].湖北中医杂志, 2018, 40(8):23-24.
[15]袁媛.牛蒡子止咳祛痰药效物质基础研究[J].辽宁中医杂志, 2011, 38(3):516-519.
[16]叶欣,卢金清,曹利,等.牛蒡子炒制前后挥发性成分的比较[J].中药材, 2017, 40(7):1586-1589.