功能主治 : 陽明氣分熱(re)盛。壯熱(re)面(mian)赤,煩渴(ke)引飲,汗出惡(e)熱(re),脈洪(hong)大(da)有力,或滑數。
用法用量 : 水(shui)煎(jian)至米熟湯成,去滓溫服。
摘錄 : 《傷寒論》
功能主治 : 治傷寒脈浮滑者(zhe),表里有熱,若汗(han)下吐(tu)后,七八日不解,熱結在里,大渴,舌上干燥欲飲水者(zhe)。
用法用量 : 上作一服,水(shui)二鐘,煎(jian)至(zhi)一鐘,食遠服。
摘錄 : 明·方賢著《奇(qi)效良方》
炮制 : 上為細末。
功能主治 : 治(zhi)(zhi)傷寒(han)大汗(han)出(chu)后(hou)(hou),表證已解,心(xin)胸(xiong)大煩,渴(ke)欲飲水(shui),及吐(tu)或下后(hou)(hou)七、八日,邪毒(du)不解,熱結在里,表里俱熱,時(shi)時(shi)惡風(feng),大渴(ke),舌上(shang)干燥而煩,欲飲水(shui)數升者,宜服之。又治(zhi)(zhi)夏月中暑毒(du),汗(han)出(chu)惡寒(han),身(shen)熱而渴(ke)。
用法用量 : 每服三(san)錢,水(shui)一盞半,入粳米三(san)十馀粒(li),煎至一盞,濾去(qu)滓,溫服。小兒量力少與之。或(huo)加人叁少許同煎亦(yi)得,食后服。
注意 : 此藥立(li)夏(xia)后、立(li)秋前可服(fu)。春時及立(li)秋后,并(bing)亡血虛家(jia),并(bing)不可服(fu)。
摘錄 : 《宋(song)·太平惠民和劑局方》
藥理作用 : 抗乙(yi)腦(nao)作(zuo)用《中華醫(yi)學(xue)雜志》(1964;7:456),用本(ben)(ben)方煎劑于(yu)實驗(yan)性小白鼠(shu)流行(xing)性乙(yi)型(xing)腦(nao)炎病毒感染的治療中,與大青葉(xie)提(ti)(ti)取物、竹葉(xie)石膏(gao)湯、安宮牛黃散(san)等對(dui)照組相比較,本(ben)(ben)方能提(ti)(ti)高小白鼠(shu)存活率,經統計學(xue)處(chu)理,有顯著性差異。
功能主治 : 清(qing)熱(re)(re)(re)(re)(re)生(sheng)津(jin),解(jie)暑毒(du),解(jie)內外(wai)之(zhi)熱(re)(re)(re)(re)(re),清(qing)肺金(jin),瀉胃火實熱(re)(re)(re)(re)(re)。主陽明(ming)氣(qi)分(fen)盛熱(re)(re)(re)(re)(re)。壯熱(re)(re)(re)(re)(re)面(mian)赤(chi),煩渴引飲,大(da)汗(han)(han)出,脈洪(hong)大(da)有(you)力或(huo)滑數(shu);傷(shang)寒,脈浮滑,此以表有(you)熱(re)(re)(re)(re)(re),里(li)有(you)寒;三陽合病,腹滿身(shen)(shen)重,難以轉(zhuan)側,口(kou)不仁面(mian)垢,譫語(yu)遺尿(niao),發(fa)(fa)汗(han)(han)則(ze)譫語(yu),下之(zhi)則(ze)額上生(sheng)汗(han)(han),手足逆(ni)冷,若自汗(han)(han)出者;傷(shang)寒,脈滑而厥者,里(li)有(you)熱(re)(re)(re)(re)(re);傷(shang)寒大(da)汗(han)(han)出后,表證已解(jie),心中(zhong)大(da)煩,渴欲飲水,及吐或(huo)下后7-8日,邪毒(du)不解(jie),熱(re)(re)(re)(re)(re)結在里(li),表里(li)俱熱(re)(re)(re)(re)(re),時時惡風,大(da)渴,舌上干燥而煩,欲飲水數(shu)升者;夏月中(zhong)暑毒(du),汗(han)(han)出惡寒,身(shen)(shen)熱(re)(re)(re)(re)(re)而渴;一切時氣(qi),瘟疫雜病,胃熱(re)(re)(re)(re)(re)咳嗽、發(fa)(fa)斑,小兒瘡(chuang)皰隱疹伏熱(re)(re)(re)(re)(re);溫病身(shen)(shen)熱(re)(re)(re)(re)(re),自汗(han)(han)口(kou)干,脈來洪(hong)大(da),霍亂,傷(shang)暑發(fa)(fa)痧(sha)。
臨床應用 : 1.溫(wen)熱(re)(re):汪某某,男,54歲(sui)。患(huan)感冒發熱(re)(re),入某某醫(yi)院,在(zai)治(zhi)(zhi)療中(zhong)(zhong)身(shen)(shen)熱(re)(re)逐步上升,曾屢進西藥(yao)(yao)退(tui)(tui)熱(re)(re)劑(ji)(ji),旋(xuan)退(tui)(tui)旋(xuan)起,8天(tian)后(hou)仍持續(xu)(xu)發熱(re)(re)達38.8℃,口(kou)(kou)渴(ke),汗出,咽微痛(tong)(tong),脈(mo)象浮(fu)大(da)(da),舌苔薄(bo)黃。此(ci)為溫(wen)熱(re)(re)已入陽(yang)明,內外雖(sui)俱大(da)(da)熱(re)(re),但(dan)尚在(zai)氣分(fen),以(yi)白虎湯(tang)加味(wei)以(yi)治(zhi)(zhi),處(chu)方(fang)(fang):生石膏(gao)60g,知(zhi)母12g,粳(jing)米12g,炙甘(gan)草(cao)9g,鮮(xian)(xian)茅根30g(后(hou)下),鮮(xian)(xian)蘆根30g,連(lian)翹12g。水(shui)煎,米熟湯(tang)成,溫(wen)服(fu)(fu)。下午及夜間連(lian)進2劑(ji)(ji),熱(re)(re)勢下降,體(ti)溫(wen)38℃,次日(ri)(ri)(ri)原(yuan)(yuan)方(fang)(fang)續(xu)(xu)進2劑(ji)(ji),熱(re)(re)即下降到37.4℃,后(hou)將石膏(gao)量(liang)減(jian)(jian)至(zhi)45g,2劑(ji)(ji)后(hou)體(ti)溫(wen)已正常(chang)(chang)。2.中(zhong)(zhong)暑:某兒(er),8歲(sui),中(zhong)(zhong)暑,身(shen)(shen)灼熱(re)(re)煩渴(ke),四肢懈(xie)惰(duo),一(yi)醫(yi)與(yu)白虎湯(tang),二旬余日(ri)(ri)(ri),猶不(bu)(bu)(bu)效(xiao)(xiao),先生曰(yue):某醫(yi)之(zhi)治(zhi)(zhi),非不(bu)(bu)(bu)當(dang),然其所(suo)不(bu)(bu)(bu)效(xiao)(xiao)者,以(yi)劑(ji)(ji)輕故也,即倍前(qian)藥(yao)(yao)與(yu)之(zhi)(貼重(zhong)10錢(qian)),須(xu)臾發汗如流,至(zhi)明日(ri)(ri)(ri)善食,不(bu)(bu)(bu)日(ri)(ri)(ri)復故。3.三陽(yang)合病(bing)(bing):某男,70余歲(sui)。秋患(huan)傷寒證,不(bu)(bu)(bu)治(zhi)(zhi),久而化(hua)熱(re)(re),便難溲赤,頭(tou)(tou)(tou)常(chang)(chang)暈,漸加劇,不(bu)(bu)(bu)能(neng)(neng)起坐,坐則(ze)房屋旋(xuan)轉。發熱(re)(re)間或惡寒,繼則(ze)昏(hun)蝥(mao)(mao),發則(ze)口(kou)(kou)木舌強不(bu)(bu)(bu)能(neng)(neng)言,手足亦不(bu)(bu)(bu)能(neng)(neng)動,耳聾,呼之(zhi)如無(wu)(wu)所(suo)聞,目灼灼直視,約需1小時(shi)始(shi)復常(chang)(chang)態,時(shi)譫語。曾數(shu)就醫(yi),均以(yi)老年體(ti)虛,治(zhi)(zhi)當(dang)滋補,服(fu)(fu)藥(yao)(yao)無(wu)(wu)效(xiao)(xiao),病(bing)(bing)反日(ri)(ri)(ri)進。其中(zhong)(zhong)有(you)認為病(bing)(bing)有(you)熱(re)(re)象,當(dang)用(yong)清(qing)(qing)涼(liang)者,投之(zhi)小效(xiao)(xiao)。遷延至(zhi)春(chun)不(bu)(bu)(bu)愈(yu),后(hou)來我處(chu)診(zhen)治(zhi)(zhi)。脈(mo)六部洪滑,舌苔黃厚,口(kou)(kou)渴(ke)引飲。與(yu)三陽(yang)合病(bing)(bing)相近,治(zhi)(zhi)當(dang)用(yong)白虎湯(tang)。處(chu)方(fang)(fang):鮮(xian)(xian)茅根120g,生石膏(gao)60g,知(zhi)母、花粉各15g,粳(jing)米9g,甘(gan)草(cao)6g。服(fu)(fu)藥(yao)(yao)后(hou)病(bing)(bing)人(ren)頓覺清(qing)(qing)爽,眩暈大(da)(da)減(jian)(jian),是日(ri)(ri)(ri)昏(hun)蝥(mao)(mao)僅發2次,但(dan)脈(mo)之(zhi)洪滑不(bu)(bu)(bu)減(jian)(jian),知(zhi)其蘊熱(re)(re)尚熾,原(yuan)(yuan)方(fang)(fang)加量(liang),先煎茅根,取(qu)湯(tang)去滓,再入余藥(yao)(yao),煎取(qu)清(qing)(qing)湯(tang)3碗,每小時(shi)1碗,日(ri)(ri)(ri)盡1劑(ji)(ji)。2天(tian)后(hou)身(shen)(shen)即不(bu)(bu)(bu)重(zhong),耳不(bu)(bu)(bu)聾,轉側(ce)自如,昏(hun)蝥(mao)(mao)已不(bu)(bu)(bu)發。又服(fu)(fu)6-7劑(ji)(ji),口(kou)(kou)亦不(bu)(bu)(bu)渴(ke),舌苔漸薄(bo),大(da)(da)便亦通(tong),更進5劑(ji)(ji),頭(tou)(tou)(tou)暈始(shi)去。4.熱(re)(re)厥證:史某某,女性,38歲(sui),農民。急診(zhen)時(shi)病(bing)(bing)人(ren)已陷入昏(hun)迷(mi)3小時(shi)。發熱(re)(re)已2日(ri)(ri)(ri),急性熱(re)(re)性病(bing)(bing)容(rong),體(ti)質(zhi)營(ying)養良好,全身(shen)(shen)多(duo)汗,皮膚濕潤,體(ti)溫(wen)40.5℃,手足微冷,心(xin)跳急速,口(kou)(kou)腔干燥,白色薄(bo)苔,脈(mo)滑而有(you)力,腹(fu)診(zhen)腹(fu)壁緊張度(du)良好,無(wu)(wu)抵(di)抗(kang),壓痛(tong)(tong)。來院后(hou)靜(jing)脈(mo)注射(she)25%葡萄糖(tang)100毫升,為處(chu)白虎湯(tang)原(yuan)(yuan)方(fang)(fang)。6小時(shi)后(hou)病(bing)(bing)人(ren)訴口(kou)(kou)渴(ke),給(gei)飲涼(liang)開水(shui)少量(liang),次日(ri)(ri)(ri)神志清(qing)(qing)楚(chu),訴頭(tou)(tou)(tou)痛(tong)(tong)乏力,體(ti)溫(wen)38.5℃,續(xu)(xu)服(fu)(fu)前(qian)方(fang)(fang),病(bing)(bing)情續(xu)(xu)有(you)好轉,第(di)3日(ri)(ri)(ri)恢復常(chang)(chang)溫(wen),又5日(ri)(ri)(ri)痊愈(yu)。
用法用量 : 以水1斗,煮米熟,湯成(cheng)去滓(zi),溫服1升,日3次。
注意 : 傷寒脈浮,發(fa)熱無(wu)汗,其表不(bu)解者,不(bu)可與(yu)(yu);脈浮弦而細者,不(bu)可與(yu)(yu)也(ye);脈沉者,不(bu)可與(yu)(yu)也(ye);不(bu)渴者,不(bu)可與(yu)(yu)也(ye);汗不(bu)出者不(bu)可與(yu)(yu)也(ye)。
各家論述 : 1.《傷(shang)(shang)(shang)寒(han)(han)(han)(han)明理論》:白虎,西方(fang)金(jin)神也(ye)(ye),應秋(qiu)(qiu)而歸(gui)(gui)(gui)肺(fei)(fei);夏熱(re)(re)(re)秋(qiu)(qiu)涼,暑暍之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi),得(de)(de)秋(qiu)(qiu)而止(zhi)。秋(qiu)(qiu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)令曰處暑,是湯以(yi)(yi)(yi)白虎名(ming)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),謂能止(zhi)熱(re)(re)(re)也(ye)(ye)。知(zhi)(zhi)母(mu)(mu)(mu)味(wei)(wei)苦寒(han)(han)(han)(han),《內(nei)經》曰:熱(re)(re)(re)淫(yin)所勝(sheng)(sheng)(sheng),佐以(yi)(yi)(yi)苦甘(gan)(gan)(gan)(gan)。又曰:熱(re)(re)(re)淫(yin)于(yu)(yu)內(nei),以(yi)(yi)(yi)苦發之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。欲徹(che)表寒(han)(han)(han)(han),必以(yi)(yi)(yi)苦為主,故以(yi)(yi)(yi)知(zhi)(zhi)母(mu)(mu)(mu)為君(jun)。石(shi)(shi)膏味(wei)(wei)甘(gan)(gan)(gan)(gan)微寒(han)(han)(han)(han),熱(re)(re)(re)則傷(shang)(shang)(shang)氣(qi)(qi)(qi),寒(han)(han)(han)(han)以(yi)(yi)(yi)勝(sheng)(sheng)(sheng)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),甘(gan)(gan)(gan)(gan)以(yi)(yi)(yi)緩之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),欲除(chu)其熱(re)(re)(re),必以(yi)(yi)(yi)甘(gan)(gan)(gan)(gan)寒(han)(han)(han)(han)為助,是以(yi)(yi)(yi)石(shi)(shi)膏甘(gan)(gan)(gan)(gan)寒(han)(han)(han)(han)為臣,甘(gan)(gan)(gan)(gan)草(cao)味(wei)(wei)甘(gan)(gan)(gan)(gan)平,粳(jing)米(mi)(mi)味(wei)(wei)甘(gan)(gan)(gan)(gan)平,脾(pi)欲緩,急食甘(gan)(gan)(gan)(gan)以(yi)(yi)(yi)緩之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),熱(re)(re)(re)氣(qi)(qi)(qi)內(nei)蘊,消灼津液,則脾(pi)氣(qi)(qi)(qi)燥,必以(yi)(yi)(yi)甘(gan)(gan)(gan)(gan)平之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)物緩其中(zhong),故以(yi)(yi)(yi)甘(gan)(gan)(gan)(gan)草(cao)、粳(jing)米(mi)(mi)為之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)使(shi),是太陽中(zhong)暍,得(de)(de)此(ci)(ci)(ci)湯則頓除(chu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),即熱(re)(re)(re)見白虎而盡矣。2.《醫方(fang)考》:石(shi)(shi)膏大寒(han)(han)(han)(han),用(yong)戶以(yi)(yi)(yi)清(qing)胃(wei);知(zhi)(zhi)母(mu)(mu)(mu)味(wei)(wei)厚,用(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)以(yi)(yi)(yi)生(sheng)津;大寒(han)(han)(han)(han)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)性行,恐傷(shang)(shang)(shang)胃(wei)氣(qi)(qi)(qi),故用(yong)甘(gan)(gan)(gan)(gan)草(cao)、粳(jing)米(mi)(mi)以(yi)(yi)(yi)養胃(wei)。是方(fang)也(ye)(ye),惟傷(shang)(shang)(shang)寒(han)(han)(han)(han)內(nei)有實(shi)熱(re)(re)(re)者(zhe)可用(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。若血(xue)虛身熱(re)(re)(re),證象(xiang)白虎,誤(wu)服白虎者(zhe)死無(wu)救(jiu),又東垣之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)所以(yi)(yi)(yi)垂戒矣。3.《傷(shang)(shang)(shang)寒(han)(han)(han)(han)來蘇集(ji)》:石(shi)(shi)膏大寒(han)(han)(han)(han),寒(han)(han)(han)(han)能勝(sheng)(sheng)(sheng)熱(re)(re)(re),味(wei)(wei)甘(gan)(gan)(gan)(gan)歸(gui)(gui)(gui)脾(pi),質剛而主降,備中(zhong)土生(sheng)金(jin)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)體;色白通肺(fei)(fei),質重(zhong)而含脂,具金(jin)能生(sheng)水之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)用(yong),故以(yi)(yi)(yi)為君(jun),知(zhi)(zhi)母(mu)(mu)(mu)氣(qi)(qi)(qi)寒(han)(han)(han)(han)主降,苦以(yi)(yi)(yi)泄肺(fei)(fei)火,辛以(yi)(yi)(yi)潤肺(fei)(fei)燥,內(nei)肥白而外皮毛,肺(fei)(fei)金(jin)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)象(xiang),生(sheng)水之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)源(yuan)也(ye)(ye),故以(yi)(yi)(yi)為臣。甘(gan)(gan)(gan)(gan)草(cao)皮赤中(zhong)黃,能土中(zhong)瀉(xie)火,為中(zhong)宮(gong)舟楫(ji),寒(han)(han)(han)(han)藥得(de)(de)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)緩其寒(han)(han)(han)(han),用(yong)此(ci)(ci)(ci)為佐,沉降之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)性,亦(yi)得(de)(de)留(liu)連(lian)于(yu)(yu)脾(pi)胃(wei)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)間矣。粳(jing)米(mi)(mi)稼穡作(zuo)甘(gan)(gan)(gan)(gan),氣(qi)(qi)(qi)味(wei)(wei)溫和,稟(bing)容平之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)德,為后天養命之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)資,得(de)(de)此(ci)(ci)(ci)為佐,陰寒(han)(han)(han)(han)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)物,則無(wu)傷(shang)(shang)(shang)損脾(pi)胃(wei)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)慮也(ye)(ye)。煮湯入(ru)胃(wei),輸脾(pi)歸(gui)(gui)(gui)肺(fei)(fei),水精四布,大煩大渴可除(chu)矣。4.《醫方(fang)集(ji)解(jie)》:煩出于(yu)(yu)肺(fei)(fei),躁出于(yu)(yu)腎,石(shi)(shi)膏清(qing)肺(fei)(fei)而瀉(xie)胃(wei)火,知(zhi)(zhi)母(mu)(mu)(mu)清(qing)肺(fei)(fei)而瀉(xie)腎火,甘(gan)(gan)(gan)(gan)草(cao)和中(zhong)而瀉(xie)心脾(pi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)火,或瀉(xie)其于(yu)(yu),或瀉(xie)其母(mu)(mu)(mu),不專治陽明氣(qi)(qi)(qi)分(fen)熱(re)(re)(re)也(ye)(ye)。
摘錄 : 《傷寒論》
制法 : 上挫細。
功能主治 : 陽毒傷寒,服桂枝湯,大汗出(chu)后,大渴,煩躁不解,脈洪大者。
用法用量 : 以水2大盞,煮米(mi)熟為(wei)度,去滓,分溫3服,不拘時候。
摘錄 : 《普濟方》卷一三(san)五引《三(san)因》
制法 : 上為末。
功能主治 : 肺氣勞傷。
用法用量 : 每服(fu)3錢匕(bi),以水1盞,煎取6分,更入酒半盞,煎至(zhi)8分,去滓溫服(fu)。
摘錄 : 《圣濟總錄》卷八(ba)十(shi)六
制法 : 上銼1劑。
功能主治 : 陽明經汗后脈洪大而渴(ke),或身熱有汗不解(jie)。
用法用量 : 水煎(jian),溫(wen)服。秋(qiu)感熱(re)(re)之疫癘,或陽明(ming)下后,大便不(bu)固,熱(re)(re)不(bu)退(tui)者,或濕溫(wen)證熱(re)(re)不(bu)退(tui)而大便溏者,依本方加(jia)蒼(cang)術;若傷寒汗下后,自(zi)汗虛(xu)熱(re)(re)不(bu)退(tui),加(jia)蒼(cang)術、人參。
注意 : 無汗脈(mo)浮(fu),表(biao)未解(jie)而(er)陰(yin)氣盛,雖(sui)渴不可用(yong)白虎湯;里有熱(re)者(zhe)方(fang)可用(yong)。
摘錄 : 《回春》卷二
功能主治 : 疹已出而煩渴者。
摘錄 : 《顧氏醫徑》卷五
功能主治 : 胃熱作渴,暑(shu)熱尤效;又治(zhi)熱厥(jue)腹滿,身難(nan)轉(zhuan)側,面(mian)垢譫語,不時(shi)遺溺,手足厥(jue)冷,自汗(han),脈浮(fu)滑。
用法用量 : 水煎服。
摘錄 : 《校注婦(fu)人良方》卷(juan)七
處方 : 知(zhi)母、石(shi)膏、甘(gan)草、糯米1合。
功能主治 : :男子婦(fu)(fu)人感(gan)冒風寒,表里俱熱(re),狂言妄語,后(hou)結不(bu)解,大(da)熱(re)大(da)渴;及暑(shu)熱(re)發渴;婦(fu)(fu)人身熱(re)如蒸而渴者。
用法用量 : 知(zhi)母(mu)石膏湯(《鄭氏家傳女科萬金方》卷二)。方中知(zhi)母(mu)、石膏、甘草(cao)用量(liang)原缺。
摘錄 : 《女科萬金方》
制法 : 上銼。
功能主治 : 溫熱(re)及中暑煩渴;并治小兒痘皰、麩疹、癍瘡(chuang)赤(chi)黑,出(chu)不快,及疹毒余(yu)熱(re)。
用法用量 : 糯米(mi)煎,米(mi)熟為(wei)度,子母同服,但(dan)加生姜、大(da)棗煎。渴盛者(zhe),更加干(gan)葛(ge),春冬秋(qiu)寒有證(zheng)亦服,但(dan)加棗煎。小兒減(jian)半。
摘錄 : 《普濟方》卷四○三
用法 : 上四味,以水一斗,煮米熟湯(tang)成,去滓,溫(wen)服一升,日三服。現代用法(fa):水煎服。
功效 : 清熱生津。
主治 : 陽明氣(qi)分熱盛(sheng),癥見壯熱面赤,煩渴引(yin)飲,汗出惡(e)熱,脈洪大有力(li)或(huo)滑數。
方解 : 本(ben)(ben)方(fang)證(zheng)(zheng)是由于傷(shang)寒化熱(re)(re)內傳陽(yang)明(ming)(ming)之經,或溫(wen)病邪(xie)(xie)傳氣分所致(zhi),即(ji)陽(yang)明(ming)(ming)氣分熱(re)(re)盛證(zheng)(zheng)。里(li)熱(re)(re)熾(chi)盛,向外熏(xun)蒸(zheng),迫津(jin)外泄,故(gu)見壯(zhuang)熱(re)(re)面赤,汗出惡(e)熱(re)(re);熱(re)(re)灼津(jin)傷(shang),則(ze)煩渴引飲;脈洪大(da)(da)(da)為(wei)里(li)熱(re)(re)熾(chi)盛之象。治宜直清里(li)熱(re)(re),除煩生(sheng)津(jin)。方(fang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)石(shi)(shi)膏辛甘(gan)大(da)(da)(da)寒,善(shan)于清解陽(yang)明(ming)(ming)經熱(re)(re)邪(xie)(xie),透熱(re)(re)出表,除煩止(zhi)渴,故(gu)重用為(wei)君(jun)(jun)藥(yao)。知母苦寒質潤,苦寒可(ke)(ke)助石(shi)(shi)膏清泄肺胃實(shi)熱(re)(re),質潤能(neng)滋陰(yin)(yin)(yin)潤燥以救陰(yin)(yin)(yin),為(wei)臣藥(yao)。君(jun)(jun)臣相(xiang)須為(wei)用,既可(ke)(ke)大(da)(da)(da)清氣分之熱(re)(re),又能(neng)滋陰(yin)(yin)(yin)生(sheng)津(jin),功效倍(bei)增。炙甘(gan)草、粳米益胃和中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong),并防石(shi)(shi)膏、知母大(da)(da)(da)寒傷(shang)胃,為(wei)佐使(shi)藥(yao)。四(si)藥(yao)合用,使(shi)熱(re)(re)邪(xie)(xie)得清,津(jin)液得復,諸證(zheng)(zheng)自愈。白(bai)虎為(wei)西方(fang)金神,用以名湯(tang),比喻其清熱(re)(re)之力(li)浩(hao)大(da)(da)(da)。白(bai)虎湯(tang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)為(wei)何(he)配伍粳米?本(ben)(ben)方(fang)主(zhu)治陽(yang)明(ming)(ming)胃經熱(re)(re)盛,粳米為(wei)谷物(wu),具(ju)有甘(gan)緩留(liu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)之能(neng),使(shi)方(fang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)石(shi)(shi)膏、知母寒涼苦降(jiang)之力(li)“不速(su)下行”而“留(liu)連(lian)于胃中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)”,以保證(zheng)(zheng)藥(yao)力(li)留(liu)駐中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)焦,以最大(da)(da)(da)限(xian)度發揮本(ben)(ben)方(fang)的(de)(de)“清中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)”的(de)(de)作用。現代研究及臨床實(shi)踐證(zheng)(zheng)明(ming)(ming),本(ben)(ben)方(fang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)粳米可(ke)(ke)使(shi)藥(yao)液質地黏稠,濃度增大(da)(da)(da),有利于方(fang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)石(shi)(shi)膏等有效微細顆(ke)粒盡可(ke)(ke)能(neng)懸浮于藥(yao)液中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong),從而大(da)(da)(da)大(da)(da)(da)地提高(gao)方(fang)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)物(wu)的(de)(de)溶解度,以增強本(ben)(ben)方(fang)的(de)(de)退(tui)熱(re)(re)效應。
臨床應用 : 1.用方(fang)(fang)(fang)要(yao)點(dian):白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)為(wei)(wei)(wei)(wei)(wei)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)陽明(ming)(ming)氣分(fen)(fen)(fen)熱(re)盛證(zheng)的(de)代表(biao)(biao)方(fang)(fang)(fang)。臨床(chuang)以(yi)(yi)(yi)大(da)(da)熱(re)、大(da)(da)渴(ke)、大(da)(da)汗、脈(mo)洪大(da)(da)為(wei)(wei)(wei)(wei)(wei)辨證(zheng)要(yao)點(dian)。2.現代運(yun)用:白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)常用于(yu)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)感(gan)染性(xing)(xing)疾病(bing),如(ru)大(da)(da)葉(xie)性(xing)(xing)肺炎(yan)、流行(xing)(xing)性(xing)(xing)乙型(xing)腦(nao)炎(yan)、流行(xing)(xing)性(xing)(xing)出(chu)血熱(re)、牙齦炎(yan),以(yi)(yi)(yi)及小兒(er)夏季熱(re)、糖(tang)尿(niao)病(bing)等(deng)屬氣分(fen)(fen)(fen)熱(re)盛者。3.病(bing)毒(du)性(xing)(xing)感(gan)冒高(gao)熱(re):以(yi)(yi)(yi)白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)加(jia)黃(huang)芩隨(sui)證(zheng)加(jia)減(jian)(jian)(jian)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)43例(li)(li)(li)(li)(li),更昔洛韋治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)43例(li)(li)(li)(li)(li)為(wei)(wei)(wei)(wei)(wei)對(dui)(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)均(jun)為(wei)(wei)(wei)(wei)(wei)14日(ri)(ri)。總(zong)體(ti)療(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)(xiao)(xiao)(xiao)評(ping)價標準以(yi)(yi)(yi)患者癥(zheng)(zheng)(zheng)狀(zhuang)明(ming)(ming)顯(xian)(xian)(xian)緩(huan)解且體(ti)溫恢復為(wei)(wei)(wei)(wei)(wei)顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao)。結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao)38例(li)(li)(li)(li)(li),有(you)效(xiao)(xiao)(xiao)(xiao)(xiao)5例(li)(li)(li)(li)(li),無(wu)效(xiao)(xiao)(xiao)(xiao)(xiao)0例(li)(li)(li)(li)(li);對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao)16例(li)(li)(li)(li)(li),有(you)效(xiao)(xiao)(xiao)(xiao)(xiao)19例(li)(li)(li)(li)(li),無(wu)效(xiao)(xiao)(xiao)(xiao)(xiao)8例(li)(li)(li)(li)(li),兩組(zu)(zu)(zu)有(you)顯(xian)(xian)(xian)著差(cha)別。(《云(yun)南中醫中藥(yao)(yao)(yao)》2014年(nian)(nian)第(di)6期)4.急(ji)性(xing)(xing)腦(nao)出(chu)血:以(yi)(yi)(yi)本(ben)方(fang)(fang)(fang)隨(sui)證(zheng)加(jia)減(jian)(jian)(jian)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)60例(li)(li)(li)(li)(li),對(dui)(dui)癥(zheng)(zheng)(zheng)常規治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)20例(li)(li)(li)(li)(li)為(wei)(wei)(wei)(wei)(wei)對(dui)(dui)照(zhao)(zhao),均(jun)以(yi)(yi)(yi)15日(ri)(ri)為(wei)(wei)(wei)(wei)(wei)1個(ge)(ge)療(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)。以(yi)(yi)(yi)1995年(nian)(nian)全國(guo)第(di)4屆腦(nao)血管病(bing)會議(yi)制(zhi)定的(de)標準進行(xing)(xing)神經功(gong)能缺損及療(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)(xiao)(xiao)(xiao)評(ping)定。結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)基(ji)本(ben)痊(quan)愈(yu)(yu)13例(li)(li)(li)(li)(li),進步37例(li)(li)(li)(li)(li),無(wu)效(xiao)(xiao)(xiao)(xiao)(xiao)6例(li)(li)(li)(li)(li),惡化(hua)4例(li)(li)(li)(li)(li),優于(yu)對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)的(de)基(ji)本(ben)痊(quan)愈(yu)(yu)3例(li)(li)(li)(li)(li),進步9例(li)(li)(li)(li)(li),無(wu)效(xiao)(xiao)(xiao)(xiao)(xiao)5例(li)(li)(li)(li)(li),惡化(hua)3例(li)(li)(li)(li)(li)。(《中國(guo)中醫急(ji)癥(zheng)(zheng)(zheng)》2008年(nian)(nian)第(di)5期)5.糖(tang)尿(niao)病(bing)急(ji)性(xing)(xing)高(gao)血糖(tang):以(yi)(yi)(yi)白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)聯合胰島(dao)(dao)素(su)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)26例(li)(li)(li)(li)(li),與胰島(dao)(dao)素(su)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)26例(li)(li)(li)(li)(li)對(dui)(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)(xiao)(xiao)(xiao)評(ping)定標準:癥(zheng)(zheng)(zheng)狀(zhuang)、體(ti)征明(ming)(ming)顯(xian)(xian)(xian)改(gai)善,積(ji)分(fen)(fen)(fen)減(jian)(jian)(jian)少>80%為(wei)(wei)(wei)(wei)(wei)顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao);癥(zheng)(zheng)(zheng)狀(zhuang)、體(ti)征有(you)所改(gai)善,積(ji)分(fen)(fen)(fen)減(jian)(jian)(jian)少>30%為(wei)(wei)(wei)(wei)(wei)有(you)效(xiao)(xiao)(xiao)(xiao)(xiao)。結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)后(hou)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)TNF-α、IL-6、HS-CRP變化(hua)情況(kuang)優于(yu)對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu),治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)Leptin、APN變化(hua)情況(kuang)優于(yu)對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu);治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)中醫臨床(chuang)癥(zheng)(zheng)(zheng)狀(zhuang)積(ji)分(fen)(fen)(fen)改(gai)善情況(kuang)明(ming)(ming)顯(xian)(xian)(xian)。(《河南中醫》2014年(nian)(nian)第(di)2期)6.老年(nian)(nian)性(xing)(xing)癡(chi)呆:以(yi)(yi)(yi)白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)加(jia)減(jian)(jian)(jian)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)23例(li)(li)(li)(li)(li),與阿米三嗪(qin)-蘿巴新治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)20例(li)(li)(li)(li)(li)對(dui)(dui)照(zhao)(zhao)。將癥(zheng)(zheng)(zheng)狀(zhuang)嚴(yan)重程(cheng)(cheng)度(du)分(fen)(fen)(fen)為(wei)(wei)(wei)(wei)(wei)4個(ge)(ge)等(deng)級:0分(fen)(fen)(fen)表(biao)(biao)示無(wu)該(gai)(gai)項癥(zheng)(zheng)(zheng)狀(zhuang),1分(fen)(fen)(fen)表(biao)(biao)示癥(zheng)(zheng)(zheng)狀(zhuang)輕微,Ⅲ分(fen)(fen)(fen)表(biao)(biao)示癥(zheng)(zheng)(zheng)狀(zhuang)嚴(yan)重,Ⅱ分(fen)(fen)(fen)癥(zheng)(zheng)(zheng)狀(zhuang)嚴(yan)重程(cheng)(cheng)度(du)介于(yu)1分(fen)(fen)(fen)Ⅲ分(fen)(fen)(fen)之間。每次復診(zhen)詳細(xi)記錄(lu)分(fen)(fen)(fen)數等(deng)級。治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)前(qian)后(hou)計算累積(ji)積(ji)分(fen)(fen)(fen)。結(jie)果:該(gai)(gai)方(fang)(fang)(fang)能改(gai)善老年(nian)(nian)性(xing)(xing)癡(chi)呆的(de)癥(zheng)(zheng)(zheng)狀(zhuang),在失語(yu)失認、閱(yue)讀(du)書寫障礙等(deng)方(fang)(fang)(fang)面明(ming)(ming)顯(xian)(xian)(xian)優于(yu)對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)。(《陜西(xi)中醫》2003年(nian)(nian)第(di)8期)7.腎(shen)移植(zhi)術后(hou)感(gan)染高(gao)熱(re):以(yi)(yi)(yi)白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)加(jia)減(jian)(jian)(jian)聯合激素(su)、抗(kang)病(bing)毒(du)、抗(kang)細(xi)菌等(deng)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)15例(li)(li)(li)(li)(li),與單純激素(su)、抗(kang)病(bing)毒(du)、抗(kang)細(xi)菌等(deng)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)17例(li)(li)(li)(li)(li)對(dui)(dui)照(zhao)(zhao)。結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)痊(quan)愈(yu)(yu)14例(li)(li)(li)(li)(li),好(hao)(hao)轉1例(li)(li)(li)(li)(li),治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)愈(yu)(yu)率為(wei)(wei)(wei)(wei)(wei)93%;對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)痊(quan)愈(yu)(yu)9例(li)(li)(li)(li)(li),好(hao)(hao)轉1例(li)(li)(li)(li)(li),死亡(wang)7例(li)(li)(li)(li)(li),治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)愈(yu)(yu)率為(wei)(wei)(wei)(wei)(wei)53%。(《中國(guo)中西(xi)醫結(jie)合急(ji)救雜志》2004年(nian)(nian)第(di)3期)8.癌性(xing)(xing)發熱(re):以(yi)(yi)(yi)白(bai)(bai)虎(hu)(hu)(hu)湯(tang)(tang)(tang)為(wei)(wei)(wei)(wei)(wei)主治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)癌性(xing)(xing)發熱(re)42例(li)(li)(li)(li)(li),療(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)(xiao)(xiao)(xiao)評(ping)定以(yi)(yi)(yi)服(fu)藥(yao)(yao)(yao)1個(ge)(ge)療(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)內(nei)體(ti)溫降(jiang)至(zhi)正常范圍,停藥(yao)(yao)(yao)后(hou)體(ti)溫不再上升為(wei)(wei)(wei)(wei)(wei)顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao)。結(jie)果:顯(xian)(xian)(xian)效(xiao)(xiao)(xiao)(xiao)(xiao)27例(li)(li)(li)(li)(li),有(you)效(xiao)(xiao)(xiao)(xiao)(xiao)12侈ij,無(wu)效(xiao)(xiao)(xiao)(xiao)(xiao)3例(li)(li)(li)(li)(li)。總(zong)有(you)效(xiao)(xiao)(xiao)(xiao)(xiao)率為(wei)(wei)(wei)(wei)(wei)92.8%。(《廣東醫學》2004年(nian)(nian)第(di)11期)
現代研究 : 經(jing)現(xian)代(dai)藥理(li)研究證(zheng)明(ming),白虎湯有明(ming)顯的退熱作用,能(neng)增強腹腔(qiang)巨(ju)噬(shi)細胞(bao)的吞噬(shi)功能(neng),同時能(neng)提高血(xue)清溶菌酶(mei)的含量,促進淋巴細胞(bao)轉化(hua)。
注意 : 凡表證(zheng)未解的(de)無(wu)汗(han)發(fa)熱,口不(bu)渴者(zhe);血虛(xu)發(fa)熱,脈洪而(er)重按無(wu)力者(zhe);真寒(han)假熱的(de)陰盛格(ge)陽證(zheng)等均不(bu)可(ke)誤用。
方歌 : (一)白虎湯用生石(shi)膏,知(zhi)母甘草(cao)粳米熬,汗出身熱又煩(fan)躁,清陽(yang)明熱功勞髙(gao)。(二)白虎膏知(zhi)甘草(cao)粳,氣分大熱此(ci)方清,熱渴汗出脈(mo)洪大,加(jia)入人(ren)參氣津生。
摘錄 : 漢·《傷寒論》
正(zheng)句:若非他人(ren)母、定用白虎(hu)湯(tang)。說的是古時候的一個技藝(yi)精湛(zhan)的中醫、他自(zi)己的母親患了重疾(ji)、唯獨用了白虎(hu)湯(tang)才可能(neng)有(you)效、但是他自(zi)己知道(dao)白虎(hu)湯(tang)藥效重、擔心(xin)自(zi)己的老母親承受不了、意思是換作其它(ta)病人(ren)、他就會果斷選擇用白虎(hu)湯(tang)了。順便說下(xia)、白虎(hu)湯(tang)有(you)神奇療效、但也(ye)存在風(feng)險。
目錄1拼(pin)音2處方3功能主治4麻(ma)黃白虎湯(tang)的(de)用法用量5摘錄附:1古籍(ji)中的(de)麻(ma)黃白虎湯(tang) 1拼(pin)音 má huáng bái hǔ tāng
2處方麻黃、葛根、蘇(su)葉、防風(feng)、石膏(gao)、知母、杏仁、黃芩。
3功能主治疹已出,陽毒(du)熱甚(shen),煩躁(zao)口渴,齒槁出血,唇焦舌刺,不(bu)吐不(bu)瀉,壯熱無汗(han),鼻孔(kong)燥黑,喘急氣悶(men),鼻煽痰嘶(si)者。
4麻(ma)黃白(bai)虎湯的(de)用法用量(liang)水煎服。
5摘(zhai)錄《治疹全書》卷中(zhong)
古籍中(zhong)的麻(ma)黃白(bai)虎湯(tang) 《古今醫(yi)統大(da)全(quan)》:[卷之十(shi)四傷(shang)(shang)寒(han)藥方]傷(shang)(shang)寒(han)藥方評 石膏,故亦治(zhi)傷(shang)(shang)寒(han),不(bu)專于治(zhi)也(ye)。或問曰∶夏(xia)月若果見(jian)麻(ma)黃桂枝證,亦豈(qi)得不(bu)用(yong),而固用(yong)白(bai)虎湯(tang)也(ye)?曰∶此說尤妙...
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《祖劑》:[卷之一三黃湯]三黃石膏(gao)湯 即黃連解毒(du)湯合白虎湯加玄參一方加石膏(gao)麻黃豆豉無知母(mu)玄參治暑(shu)毒(du)深入熱(re)煩(fan)渴不(bu)欲近衣大便(bian)秘結小便(bian)赤澀(se)者《...
《傷寒(han)指掌》:[卷一]陽明總要述古 麻黃湯(tang)(tang)(tang)。桂枝湯(tang)(tang)(tang)。瓜蒂散(san)。梔(zhi)子豉湯(tang)(tang)(tang)。白(bai)虎湯(tang)(tang)(tang)。豬(zhu)苓湯(tang)(tang)(tang)。大(da)承氣(qi)湯(tang)(tang)(tang)。小(xiao)承氣(qi)湯(tang)(tang)(tang)。調(diao)胃承氣(qi)湯(tang)(tang)(tang)。茵陳蒿湯(tang)(tang)(tang)。《傷寒(han)...
《醫學綱目(mu)》:[卷之三(san)十二(er)·傷寒部合病并(bing)病汗(han)下吐后等病]身熱(re)惡(e)(e)寒身寒惡(e)(e)熱(re)
目錄1拼(pin)音(yin)2《王氏醫案》卷二 2.1方(fang)名(ming)2.2組成2.3功效2.4青龍白(bai)虎湯的用(yong)(yong)法(fa)用(yong)(yong)量2.5各家(jia)論述 附(fu):1古籍中的青龍白(bai)虎湯 1拼(pin)音(yin) qīng lóng bái hǔ tāng
2《王氏醫案》卷二
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