功能主治 : 溫(wen)中(zhong)散寒(han),回陽救逆。治寒(han)邪宜中(zhong)陰經,惡寒(han),四(si)肢冷厥,戰栗腹疼,吐瀉不渴,蜷臥沉重,或手(shou)指甲唇(chun)青,或口吐涎沫,或脈來沉遲(chi)無(wu)力。
用法用量 : 上(shang)藥(yao)用水400毫(hao)升(sheng)(sheng),加(jia)生姜3片煎,臨臥入麝香0.1克調服。嘔吐涎沫或小腹痛,加(jia)鹽(yan)炒吳萸;無脈者,加(jia)豬膽汁5毫(hao)升(sheng)(sheng);泄瀉不止(zhi),加(jia)升(sheng)(sheng)麻(ma)、黃耆(qi);嘔吐不止(zhi),加(jia)姜汁。
摘錄 : 《傷寒六書》卷三
處方 : 熟附子5分(fen)(fen),干(gan)姜5分(fen)(fen),人(ren)參(can)5分(fen)(fen),甘草1錢,白術1錢,肉(rou)桂、陳皮、五味子、茯(fu)苓、半夏。
功能主治 : 寒邪直中陰經真(zhen)寒證。
用法用量 : 回陽(yang)急救湯(《壽(shou)世(shi)保元(yuan)》卷二(er))、回陽(yang)返本(ben)湯(《鎬(hao)京直指》)。方(fang)(fang)中肉(rou)桂(gui)、陳皮、五味子、茯苓、半夏(xia)用量原缺。《壽(shou)世(shi)保元(yuan)》本(ben)方(fang)(fang)用大附子(制)八(ba)(ba)分,干姜八(ba)(ba)分,人參(can)二(er)錢(qian)(qian),肉(rou)桂(gui)五分,半夏(xia)二(er)錢(qian)(qian),五味子四(si)分,白茯苓三錢(qian)(qian),甘草(炙(zhi))八(ba)(ba)分,陳皮錢(qian)(qian)半。方(fang)(fang)中白術,《壽(shou)世(shi)保元(yuan)》作(zuo)白米(炒)一撮。嘔吐涎(xian)沫,或小腹(fu)痛,加(jia)鹽炒吳萸;無脈者,加(jia)豬膽汁1匙(chi);泄瀉不(bu)止(zhi),加(jia)升麻、黃耆;嘔吐不(bu)止(zhi),加(jia)姜汁。
各家論述 : 1.《醫方(fang)(fang)集(ji)解(jie)》:此(ci)足三(san)陰(yin)(yin)藥(yao)也(ye)。寒中(zhong)三(san)陰(yin)(yin),陰(yin)(yin)盛則(ze)陽(yang)(yang)微,故以(yi)(yi)(yi)附子(zi)、姜、桂辛熱(re)之(zhi)(zhi)(zhi)(zhi)藥(yao)祛其(qi)(qi)陰(yin)(yin)寒,而(er)(er)以(yi)(yi)(yi)六(liu)君子(zi)溫(wen)(wen)補之(zhi)(zhi)(zhi)(zhi)藥(yao)助其(qi)(qi)陽(yang)(yang)氣(qi)(qi);五味合人參(can)可(ke)以(yi)(yi)(yi)生(sheng)脈(mo)(mo)(mo);加(jia)麝(she)香(xiang)(xiang)(xiang)者(zhe)(zhe)(zhe),通(tong)(tong)(tong)其(qi)(qi)竅(qiao)也(ye)。2.《重訂通(tong)(tong)(tong)俗(su)傷(shang)寒論》何秀(xiu)山按:少陰(yin)(yin)病下利脈(mo)(mo)(mo)微,甚則(ze)利不(bu)止(zhi)(zhi),脈(mo)(mo)(mo)厥(jue)無脈(mo)(mo)(mo),干嘔心(xin)煩者(zhe)(zhe)(zhe),經(jing)方(fang)(fang)用白通(tong)(tong)(tong)加(jia)豬膽汁湯主之(zhi)(zhi)(zhi)(zhi)。然不(bu)及(ji)此(ci)方(fang)(fang)面面顧(gu)到。故俞氏每用之(zhi)(zhi)(zhi)(zhi)奏功(gong)。揣其(qi)(qi)方(fang)(fang)義,雖仍以(yi)(yi)(yi)四逆(ni)湯加(jia)桂溫(wen)(wen)補回陽(yang)(yang)為(wei)君;而(er)(er)以(yi)(yi)(yi)《千金》生(sheng)脈(mo)(mo)(mo)散為(wei)臣者(zhe)(zhe)(zhe),以(yi)(yi)(yi)參(can)能益氣(qi)(qi)生(sheng)脈(mo)(mo)(mo),麥(mai)(mai)冬能續胃絡脈(mo)(mo)(mo)絕,五味能引陽(yang)(yang)歸根(gen)也(ye);佐(zuo)以(yi)(yi)(yi)白術、二陳健(jian)脾和胃,上止(zhi)(zhi)干嘔,下止(zhi)(zhi)瀉痢;妙(miao)在使以(yi)(yi)(yi)些許麝(she)香(xiang)(xiang)(xiang),斬關直(zhi)入(ru),助參(can)、術、附、桂、麥(mai)(mai)、味等溫(wen)(wen)補收斂(lian)藥(yao)用,但(dan)顯其(qi)(qi)助氣(qi)(qi)之(zhi)(zhi)(zhi)(zhi)功(gong),而(er)(er)無散氣(qi)(qi)之(zhi)(zhi)(zhi)(zhi)弊矣。此(ci)為(wei)回陽(yang)(yang)固脫,益氣(qi)(qi)生(sheng)脈(mo)(mo)(mo)之(zhi)(zhi)(zhi)(zhi)第一良方(fang)(fang)。廉勘:此(ci)節庵老名醫得心(xin)應手之(zhi)(zhi)(zhi)(zhi)方(fang)(fang)。凡治少陰(yin)(yin)中(zhong)寒及(ji)夾陰(yin)(yin)傷(shang)寒,陽(yang)(yang)氣(qi)(qi)津液并虧(kui),及(ji)溫(wen)(wen)熱(re)病涼瀉太過,克(ke)伐之(zhi)(zhi)(zhi)(zhi)陽(yang)(yang),而(er)(er)陽(yang)(yang)虛神散者(zhe)(zhe)(zhe)多效。妙(miao)在參(can)、術、附、桂與麝(she)香(xiang)(xiang)(xiang)同用。世俗(su)皆知(zhi)麝(she)香(xiang)(xiang)(xiang)為(wei)散氣(qi)(qi)通(tong)(tong)(tong)竅(qiao)之(zhi)(zhi)(zhi)(zhi)藥(yao),而(er)(er)不(bu)知(zhi)麝(she)食各種香(xiang)(xiang)(xiang)藥(yao),含(han)莫咀華,蘊(yun)釀香(xiang)(xiang)(xiang)精(jing)而(er)(er)藏于(yu)丹田之(zhi)(zhi)(zhi)(zhi)間。配合于(yu)溫(wen)(wen)補回陽(yang)(yang)之(zhi)(zhi)(zhi)(zhi)中(zhong),殊有(you)卓識。吳鞠通(tong)(tong)(tong)輒詆其(qi)(qi)謬,亦未免(mian)所見不(bu)廣,信(xin)口雌黃(huang)者(zhe)(zhe)(zhe)矣。以(yi)(yi)(yi)余(yu)所驗,服此(ci)方(fang)(fang)后,脈(mo)(mo)(mo)漸(jian)漸(jian)緩出(chu)者(zhe)(zhe)(zhe)生(sheng),不(bu)出(chu)者(zhe)(zhe)(zhe)死,暴出(chu)者(zhe)(zhe)(zhe)亦死,手足不(bu)溫(wen)(wen)者(zhe)(zhe)(zhe)亦死。若舌卷囊縮,額汗(han)如珠不(bu)流,兩目(mu)直(zhi)視者(zhe)(zhe)(zhe)速死。
摘錄 : 《傷寒六書》卷三
組成 : 熟附(fu)子三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、干姜二(er)錢(qian)(qian)(qian)(qian)(qian)(6克(ke)(ke))、肉桂一錢(qian)(qian)(qian)(qian)(qian)(3克(ke)(ke))、人(ren)參三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、白術(shu)三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、茯苓三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、半(ban)夏三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、陳皮(pi)三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke))、甘草二(er)錢(qian)(qian)(qian)(qian)(qian)(6克(ke)(ke))、五味(wei)子三(san)(san)(san)錢(qian)(qian)(qian)(qian)(qian)(9克(ke)(ke)),麝香三(san)(san)(san)厘臨服時加入湯(tang)內調服(0.1克(ke)(ke)),生(sheng)姜三(san)(san)(san)片
用法 : 水煎服。
功效 : 回(hui)陽救逆,益氣復脈。
主治 : 主(zhu)治(zhi)寒邪(xie)直中三陰,真陽衰微,癥見(jian)四(si)肢厥冷,惡寒踡臥,吐(tu)瀉腹痛,口(kou)不渴,神衰欲(yu)寐(mei),或身(shen)寒戰栗,或指端(duan)口(kou)唇發紺,或口(kou)吐(tu)涎沫(mo),舌淡苔(tai)白滑,脈沉(chen)遲無(wu)力(li),甚或無(wu)脈。
臨床應用 : 臨床主要用(yong)于治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)心(xin)(xin)源(yuan)性休克(ke)、冠(guan)心(xin)(xin)病心(xin)(xin)絞(jiao)痛(tong)、慢(man)性心(xin)(xin)力(li)衰竭等病癥。1.心(xin)(xin)源(yuan)性休克(ke):在西(xi)醫(yi)常(chang)(chang)規(gui)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)的基(ji)(ji)礎(chu)上(shang)加用(yong)回陽救(jiu)急湯治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)心(xin)(xin)源(yuan)性休克(ke)30例(li),與(yu)常(chang)(chang)規(gui)西(xi)藥(yao)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)30例(li)作(zuo)對(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)24小時,連續觀(guan)察3個療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)。以血壓回升(sheng)(收(shou)(shou)縮(suo)壓較治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)前升(sheng)高20mmHg、收(shou)(shou)縮(suo)壓>80mmHg、脈(mo)壓差(cha)>20mmHg,厥脫改善(脈(mo)有力(li),肢(zhi)溫回升(sheng),尿量(liang)增(zeng)加;停藥(yao)后血壓癥狀穩(wen)定)為臨床治(zhi)(zhi)(zhi)(zhi)(zhi)愈標(biao)(biao)準(zhun)。結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)有效(xiao)(xiao)率(lv)(lv)為86.70%,對(dui)照(zhao)(zhao)組(zu)(zu)(zu)有效(xiao)(xiao)率(lv)(lv)為73.30%。(《遼(liao)寧(ning)中(zhong)(zhong)(zhong)醫(yi)雜志(zhi)》2010年(nian)第7期)2.冠(guan)心(xin)(xin)病心(xin)(xin)絞(jiao)痛(tong):在西(xi)醫(yi)常(chang)(chang)規(gui)基(ji)(ji)礎(chu)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)的基(ji)(ji)礎(chu)上(shang)加用(yong)回陽救(jiu)急湯加減治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)冠(guan)心(xin)(xin)病心(xin)(xin)絞(jiao)痛(tong)患者(zhe)30例(li),與(yu)單純西(xi)醫(yi)常(chang)(chang)規(gui)基(ji)(ji)礎(chu)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)30例(li)作(zuo)對(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)2周(zhou)。以心(xin)(xin)絞(jiao)痛(tong)癥狀消失(shi)或基(ji)(ji)本消失(shi),心(xin)(xin)電圖正常(chang)(chang)或大致正常(chang)(chang)為顯效(xiao)(xiao)標(biao)(biao)準(zhun),結(jie)果:治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總有效(xiao)(xiao)率(lv)(lv)為90%,對(dui)照(zhao)(zhao)組(zu)(zu)(zu)63.33%。(《中(zhong)(zhong)(zhong)國中(zhong)(zhong)(zhong)醫(yi)基(ji)(ji)礎(chu)醫(yi)學(xue)(xue)雜志(zhi)》2010年(nian)第10期)3.慢(man)性心(xin)(xin)力(li)衰竭:西(xi)藥(yao)常(chang)(chang)規(gui)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)法的基(ji)(ji)礎(chu)上(shang)加用(yong)回陽救(jiu)急湯治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)慢(man)性心(xin)(xin)力(li)衰竭120例(li),與(yu)單純西(xi)藥(yao)常(chang)(chang)規(gui)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)60例(li)作(zuo)對(dui)照(zhao)(zhao),療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)程(cheng)(cheng)2周(zhou)一治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)前后觀(guan)察中(zhong)(zhong)(zhong)醫(yi)證(zheng)候療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)和心(xin)(xin)功能療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)。結(jie)果:中(zhong)(zhong)(zhong)醫(yi)證(zheng)候療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總有效(xiao)(xiao)率(lv)(lv)為85.0%,對(dui)照(zhao)(zhao)組(zu)(zu)(zu)為73.4%;心(xin)(xin)功能療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)效(xiao)(xiao)治(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)(liao)組(zu)(zu)(zu)總有效(xiao)(xiao)率(lv)(lv)84.2%,對(dui)照(zhao)(zhao)組(zu)(zu)(zu)70.0%。(《中(zhong)(zhong)(zhong)國當代醫(yi)學(xue)(xue)》2011年(nian)第5期)
方解 : 本方由四逆湯(tang)合六君子(zi)湯(tang),再加肉桂(gui)、五味子(zi)、麝(she)香組成(cheng)。方中(zhong)附(fu)子(zi)除干(gan)姜外,與肉桂(gui)共舉(ju)溫壯(zhuang)元陽之功,以助祛寒破(po)陰之效;人參(can)與五味子(zi)相合有益(yi)氣生脈(mo)之功;麝(she)香走竄而(er)通竅醒神(shen),能(neng)使藥力四達(da)。
現代研究 : 臨床報道也見于治(zhi)療肺(fei)心病(bing)心力衰竭、老年難(nan)治(zhi)性(xing)肺(fei)炎、慢性(xing)泄瀉等證(zheng)屬陽(yang)虛的病(bing)癥。實驗研究表明,回陽(yang)救急湯具有強心、降(jiang)低外(wai)周血(xue)管阻(zu)力和降(jiang)壓,增(zeng)加(jia)冠脈流量(liang)(liang)和心排(pai)血(xue)量(liang)(liang),保護缺血(xue)心肌(ji),增(zeng)加(jia)尿量(liang)(liang),改(gai)善肢冷、發(fa)紺、出汗等癥狀,止痛、提高免疫力等作用。
方歌 : 回陽救急用六君,桂附(fu)干姜(jiang)五味群,加(jia)麝三(san)(san)厘與生姜(jiang),三(san)(san)陰寒厥建奇勛。
摘錄 : 明·《傷寒六書》
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上(shang)一篇: 回(hui)陽救急丹(dan)