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菖蒲郁金湯

中醫世家(jia) 2023-05-04 14:56:12

《溫病全書》:菖蒲郁金湯

處方 : 石(shi)菖蒲(pu)3錢(qian),炒(chao)梔(zhi)子3錢(qian),鮮(xian)竹葉(xie)3錢(qian),牡(mu)丹皮(pi)3錢(qian),郁金(jin)2錢(qian),連翹2錢(qian),燈心2錢(qian),木通1錢(qian)半,淡竹瀝(沖)5錢(qian),紫金(jin)片(沖)5分。

功能主治 : 清(qing)營透(tou)熱。主(zhu)伏邪風(feng)溫,辛涼發汗后,表邪雖解,暫時(shi)(shi)熱退身涼,而胸(xiong)腹(fu)之(zhi)熱不除,繼則灼熱自汗,煩躁不寐,神識(shi)時(shi)(shi)昏時(shi)(shi)清(qing),夜多譫語(yu),脈數舌絳(jiang),四肢厥而脈陷,癥情較輕(qing)者。

用法用量 : 水煎服。

摘錄 : 《溫病全書》

清·《溫病全書》:菖蒲郁金湯

組成 : 石菖蒲炒三錢(qian)(qian)(qian)(9克)、梔子(zi)三錢(qian)(qian)(qian)(9克)、鮮竹(zhu)葉三錢(qian)(qian)(qian)(9克)、牡丹皮三錢(qian)(qian)(qian)(9克)、郁金二錢(qian)(qian)(qian)(6克)、連翹二錢(qian)(qian)(qian)(6克)、燈心二錢(qian)(qian)(qian)(6克)、木通一錢(qian)(qian)(qian)半(4.5克)、竹(zhu)瀝沖五錢(qian)(qian)(qian)(15克)、玉(yu)樞丹半錢(qian)(qian)(qian)(1.5克)。

用法 : 水煎服。另一方(fang)無木通、燈(deng)心,有菊花、牛蒡子、滑石、生姜汁(zhi)。

功效 : 清營透熱,開竅辟(pi)穢。

主治 : 主(zhu)治(zhi)主(zhu)伏邪風(feng)溫,辛涼發汗后(hou),表邪雖解,暫時熱退身涼,而胸(xiong)腹之熱不除(chu),繼則灼熱自汗,煩躁不寐,神識時昏時清(qing),夜多譫(zhan)語,四肢厥而脈陷(xian),脈數舌絳。

臨床應用 : 臨(lin)(lin)床(chuang)主(zhu)要用于治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)急性一(yi)氧化碳(tan)中(zhong)(zhong)(zhong)毒(du)遲發腦(nao)(nao)病(bing)、失眠癥(zheng)(zheng)(zheng)(zheng)、腦(nao)(nao)卒中(zhong)(zhong)(zhong)后(hou)(hou)抑郁(yu)(yu)癥(zheng)(zheng)(zheng)(zheng)等病(bing)癥(zheng)(zheng)(zheng)(zheng)。1.急性一(yi)氧化碳(tan)中(zhong)(zhong)(zhong)毒(du)遲發腦(nao)(nao)病(bing):常(chang)規(gui)西(xi)(xi)(xi)醫(yi)(yi)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)的基礎上加(jia)用菖蒲郁(yu)(yu)金湯加(jia)減(jian)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)急性一(yi)氧化碳(tan)中(zhong)(zhong)(zhong)毒(du)遲發腦(nao)(nao)病(bing)20例(li),與(yu)單純(chun)西(xi)(xi)(xi)醫(yi)(yi)常(chang)規(gui)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)20例(li)作(zuo)對(dui)(dui)照(zhao)(zhao)。以意識(shi)清楚,臨(lin)(lin)床(chuang)癥(zheng)(zheng)(zheng)(zheng)狀(zhuang)及體征(zheng)消失,生活自理,能(neng)勝任(ren)日常(chang)工作(zuo),腦(nao)(nao)電圖(tu)恢(hui)(hui)復(fu)(fu)正(zheng)常(chang)為(wei)(wei)痊愈(yu)標(biao)(biao)準。結(jie)果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總(zong)(zong)有效(xiao)率(lv)90.0%,對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)70.0%。(《中(zhong)(zhong)(zhong)國醫(yi)(yi)藥導報》2010年第10期(qi))2.失眠癥(zheng)(zheng)(zheng)(zheng):應(ying)用加(jia)味(wei)菖蒲郁(yu)(yu)金湯聯合(he)艾(ai)司唑侖治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)失眠癥(zheng)(zheng)(zheng)(zheng)50例(li),與(yu)單純(chun)口服艾(ai)司唑侖治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)50例(li)作(zuo)對(dui)(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)程30日。以睡(shui)眠時(shi)間增加(jia),可≥6小時(shi),或睡(shui)眠恢(hui)(hui)復(fu)(fu)到正(zheng)常(chang)水(shui)平,睡(shui)眠質量良(liang)好,醒后(hou)(hou)無疲勞感(gan),不影(ying)響正(zheng)常(chang)工作(zuo)學習(xi)為(wei)(wei)臨(lin)(lin)床(chuang)痊愈(yu)標(biao)(biao)準。結(jie)果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總(zong)(zong)有效(xiao)率(lv)為(wei)(wei)94%,對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)84%。(《神(shen)經損傷與(yu)功能(neng)重建》2014年第1期(qi))3.腦(nao)(nao)卒中(zhong)(zhong)(zhong)后(hou)(hou)抑郁(yu)(yu)癥(zheng)(zheng)(zheng)(zheng):應(ying)用菖蒲郁(yu)(yu)金湯治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)腦(nao)(nao)卒中(zhong)(zhong)(zhong)后(hou)(hou)抑郁(yu)(yu)癥(zheng)(zheng)(zheng)(zheng)58例(li),與(yu)鹽酸帕羅(luo)西(xi)(xi)(xi)汀(ting)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)59例(li)作(zuo)對(dui)(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)程8周。以癥(zheng)(zheng)(zheng)(zheng)狀(zhuang)消失,情緒正(zheng)常(chang)。HAMD減(jian)分率(lv)≥75%為(wei)(wei)痊愈(yu)標(biao)(biao)準。結(jie)果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總(zong)(zong)有效(xiao)率(lv)75.86%,對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)74.58%。(《國醫(yi)(yi)論壇》2012年第3期(qi))4.出(chu)血性中(zhong)(zhong)(zhong)風伴意識(shi)障礙:應(ying)用西(xi)(xi)(xi)醫(yi)(yi)基礎治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)合(he)菖蒲郁(yu)(yu)金湯加(jia)減(jian)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)出(chu)血性中(zhong)(zhong)(zhong)風伴意識(shi)障礙120例(li),與(yu)單純(chun)西(xi)(xi)(xi)醫(yi)(yi)基礎治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)80例(li)作(zuo)對(dui)(dui)照(zhao)(zhao),治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)時(shi)間至意識(shi)改善(shan)為(wei)(wei)止。以癥(zheng)(zheng)(zheng)(zheng)狀(zhuang)及體征(zheng)消失,基本能(neng)獨立生活為(wei)(wei)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)愈(yu)標(biao)(biao)準。結(jie)果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總(zong)(zong)有效(xiao)率(lv)95.0%,對(dui)(dui)照(zhao)(zhao)組(zu)(zu)(zu)72.5%。(《中(zhong)(zhong)(zhong)西(xi)(xi)(xi)醫(yi)(yi)結(jie)合(he)實(shi)用臨(lin)(lin)床(chuang)急救》1998年第8期(qi))

方解 : 方中(zhong)石菖蒲辛溫方香,化濕(shi)(shi)痰(tan),開(kai)(kai)心竅(qiao);郁金辛寒(han),行氣(qi)(qi)(qi)開(kai)(kai)郁,二藥(yao)(yao)配伍(wu),相(xiang)輔相(xiang)成(cheng),共(gong)奏(zou)行氣(qi)(qi)(qi)化痰(tan),芳香開(kai)(kai)竅(qiao)之功;以連翹(qiao)配菊花、牛蒡(bang)子、竹(zhu)葉(xie)輕(qing)清宣(xuan)(xuan)透,宣(xuan)(xuan)泄濕(shi)(shi)熱邪氣(qi)(qi)(qi);以滑(hua)石配炒山(shan)梔(zhi)、竹(zhu)葉(xie)導濕(shi)(shi)熱從(cong)小便而驅;竹(zhu)瀝苦寒(han),清化痰(tan)熱而開(kai)(kai)其(qi)竅(qiao),加姜汁(zhi)可制竹(zhu)瀝之寒(han)涼,保護(hu)胃(wei)氣(qi)(qi)(qi);牡丹皮行血脈,瀉(xie)血中(zhong)伏熱;玉樞丹為成(cheng)藥(yao)(yao),研末沖于(yu)湯劑中(zhong)服用,有(you)避穢化濁之功。諸藥(yao)(yao)配伍(wu).芳化痰(tan)濕(shi)(shi),清利濕(shi)(shi)熱,共(gong)成(cheng)化濕(shi)(shi)清熱,芳香開(kai)(kai)竅(qiao)之劑。但其(qi)開(kai)(kai)竅(qiao)之力畢竟不足,故當配入蘇合香丸(wan)或至(zhi)寶丹同(tong)服。

現代研究 : 臨床(chuang)報道也見于治療肺性腦(nao)病、腦(nao)血(xue)管(guan)性癡呆、小兒(er)多發性抽動癥、偏(pian)頭痛、額顳葉癡呆、慢性重癥肝炎、瘀膽型肝炎、圍絕經期抑郁癥等證屬痰熱蒙蔽(bi)心(xin)包(bao)的病癥。實驗研究(jiu)表明,石菖(chang)蒲β-細(xi)辛醚對意識(shi)障礙有(you)效。

方歌 : 菖蒲(pu)郁金丹皮妙,竹葉竹瀝滑石要(yao),連翹牛蒡玉樞丹,姜汁菊花梔(zhi)子效。

摘錄 : 清·《溫病全書》

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