處方 : 黃耆4.5克(ke) 桂枝(zhi)9克(ke)(去皮)甘(gan)草6克(ke)(炙)大棗(zao)12枚 芍藥(yao)18克(ke) 生姜9克(ke) 膠飴30克(ke)
功能主治 : 溫中(zhong)補(bu)氣,和(he)里緩急。治虛勞里急,諸(zhu)不足,小(xiao)腹急痛(tong)(tong),臍下虛滿,面(mian)色萎(wei)黃,唇口干燥(zao),胸中(zhong)煩(fan)悸,少力身重(zhong),骨肉酸痛(tong)(tong),行(xing)動喘乏,食欲不振,病(bing)后虛弱(ruo),自(zi)汗(han)盜汗(han)。
用法用量 : 上(shang)七味,以水1.4升,煮(zhu)取600毫升,入(ru)膠飴(yi),更上(shang)微火消解(jie)。每(mei)次溫服200毫升,日三服。氣短胸(xiong)滿,加生姜,腹滿,去棗(zao),加茯苓(ling)4.5克。
摘錄 : 《金匱要略》卷上
處方 : 小建(jian)中湯加黃耆2兩,人參2兩。
功能主治 : 男女因積(ji)勞(lao)虛損,或大病后不復常,若四肢(zhi)沉滯,骨肉疼酸,吸吸少氣,行動喘惙,或小腹拘急,腰背強痛(tong),心中虛悸(ji),咽干(gan)唇燥,面體少色,或飲食無味,陰陽(yang)廢弱,悲憂慘戚,多臥少起。久者積(ji)年;輕者才百日(ri),漸至瘦(shou)削,五臟氣竭,則(ze)難可振復。
用法用量 : 黃(huang)耆(qi)湯(《圣濟總錄》卷一七九)。若(ruo)患痰滿及(ji)溏(tang)泄,可(ke)除飴。
摘錄 : 方(fang)出《肘后(hou)方(fang)》卷(juan)四,名見《千(qian)金(jin)》卷(juan)十七
處方 : 小建中湯加(jia)黃耆1兩半。
藥理作用 : ①抗潰瘍作(zuo)(zuo)用(yong)(yong)《藥學(xue)學(xue)報》(1965;7:440):以(yi)黃耆(qi)建(jian)中(zhong)(zhong)湯煎(jian)劑給大白(bai)鼠(shu)(shu)皮(pi)下注(zhu)射(she)10g/kg時,可(ke)防止結扎幽門所致胃潰瘍發生,并抑制胃液分泌,減(jian)(jian)少(shao)游離酸(suan)及總酸(suan)度,使胃液PH值(zhi)上升。另以(yi)本(ben)(ben)方減(jian)(jian)去甘草的(de)(de)(de)煎(jian)劑皮(pi)下注(zhu)射(she),同樣(yang)也有(you)抗潰瘍作(zuo)(zuo)用(yong)(yong),但作(zuo)(zuo)用(yong)(yong)較(jiao)弱。說明黃耆(qi)建(jian)中(zhong)(zhong)湯除甘草外,尚有(you)其他抗潰瘍的(de)(de)(de)成分。②中(zhong)(zhong)樞(shu)鎮靜(jing)作(zuo)(zuo)用(yong)(yong)《北京(jing)中(zhong)(zhong)醫學(xue)院學(xue)報》(1960;3:208):加(jia)味(wei)黃耆(qi)建(jian)中(zhong)(zhong)湯(本(ben)(ben)方加(jia)當(dang)歸)對(dui)中(zhong)(zhong)樞(shu)神(shen)經(jing)系統有(you)明顯的(de)(de)(de)鎮靜(jing)作(zuo)(zuo)用(yong)(yong),可(ke)使小白(bai)鼠(shu)(shu)自由活動(dong)減(jian)(jian)少(shao)。但沒有(you)催(cui)眠(mian)和中(zhong)(zhong)樞(shu)的(de)(de)(de)鎮痛作(zuo)(zuo)用(yong)(yong),對(dui)平滑肌(ji)的(de)(de)(de)正(zheng)常運動(dong)有(you)抑制作(zuo)(zuo)用(yong)(yong),尤其在異(yi)常興奮狀(zhuang)態下更為顯著,有(you)較(jiao)弱對(dui)抗由組織胺引起的(de)(de)(de)胃酸(suan)增高現象。認為本(ben)(ben)方的(de)(de)(de)主要作(zuo)(zuo)用(yong)(yong)是(shi)(shi)對(dui)中(zhong)(zhong)樞(shu)神(shen)經(jing)的(de)(de)(de)鎮靜(jing)及對(dui)胃腸平滑肌(ji)的(de)(de)(de)解痙作(zuo)(zuo)用(yong)(yong),抗酸(suan)作(zuo)(zuo)用(yong)(yong)可(ke)能不是(shi)(shi)主要的(de)(de)(de)。
功能主治 : 溫養中氣。主(zhu)虛(xu)(xu)勞病,陰陽氣血俱虛(xu)(xu),里急腹(fu)痛(tong),喜溫喜按(an),形體(ti)羸瘦,面色無(wu)華,心(xin)悸短氣,自汗盜汗。現用于胃、心(xin)、肺等(deng)慢性(xing)消耗性(xing)疾患。
臨床應用 : ①虛(xu)勞(lao)《臨證指南醫(yi)(yi)(yi)案(an)》:汪,三九。此(ci)勞(lao)力傷陽之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)勞(lao),非(fei)酒色傷陽之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)勞(lao)也。胃(wei)口消憊,生(sheng)(sheng)氣日奪,豈治(zhi)(zhi)(zhi)嗽(sou)(sou)藥(yao)可(ke)以(yi)奏功(gong)?黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)去姜(jiang)。《種福(fu)堂方(fang)(fang)》:何,三一(yi)(yi)。臍流穢水,咳(ke)嗽(sou)(sou),腹痛欲瀉(xie)(xie)(xie)。詢(xun)知勞(lao)動太過(guo)(guo),陽氣受傷。三年(nian)(nian)(nian)久恙,大(da)忌清寒(han)(han)(han)治(zhi)(zhi)(zhi)嗽(sou)(sou),法(fa)當(dang)(dang)甘(gan)(gan)溫(wen)(wen)(wen)以(yi)治(zhi)(zhi)(zhi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)去姜(jiang)。②咳(ke)嗽(sou)(sou)《南雅(ya)堂醫(yi)(yi)(yi)案(an)》:診(zhen)得(de)(de)脈(mo)左細右虛(xu),咳(ke)嗽(sou)(sou)日久,吸短如喘(chuan),肌表(biao)微熱(re)(re),形容漸致(zhi)憔淬,慮(lv)成內(nei)損怯癥(zheng)(zheng),奈胃(wei)納漸見減(jian)(jian)少(shao),便亦帶溏,若投以(yi)寒(han)(han)(han)涼滋潤之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)品,恐嗽(sou)(sou)疾(ji)未必(bi)能治(zhi)(zhi)(zhi),而(er)脾(pi)胃(wei)先(xian)受損傷,豈云(yun)妥全,昔(xi)賢謂(wei)上(shang)損過(guo)(guo)脾(pi),下損及關胃(wei),均(jun)稱難治(zhi)(zhi)(zhi),自(zi)述近(jin)來背寒(han)(han)(han)忽熱(re)(re),似慮(lv)先(xian)理營(ying)衛(wei)為(wei)(wei)主,宗仲師元氣受損,甘(gan)(gan)藥(yao)調之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)例(li)(li),用(yong)(yong)(yong)(yong)建(jian)(jian)中(zhong)(zhong)加(jia)減(jian)(jian)法(fa)。桂(gui)(gui)(gui)枝1錢(qian)(qian),白(bai)芍(shao)藥(yao)3錢(qian)(qian),炙甘(gan)(gan)草8分(fen),炙黃(huang)(huang)(huang)耆(qi)(qi)1錢(qian)(qian),飴(yi)糖2錢(qian)(qian),加(jia)大(da)棗3枚,同煎(jian)服(fu)。③吐(tu)血《臨證指南醫(yi)(yi)(yi)案(an)》:許,四八。勞(lao)倦傷陽,形寒(han)(han)(han),失血,咳(ke)逆,中(zhong)(zhong)年(nian)(nian)(nian)不(bu)(bu)(bu)比少(shao)壯火亢之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)嗽(sou)(sou)血。黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)。④傷寒(han)(han)(han)《印機草》:病(bing)經(jing)一(yi)(yi)月(yue)(yue)(yue),兩脈(mo)虛(xu)浮,自(zi)汗(han)(han)惡氣,此(ci)衛(wei)虛(xu)陽弱(ruo)(ruo)。人(ren)身(shen)(shen)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)表(biao),衛(wei)氣主之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。凡所以(yi)溫(wen)(wen)(wen)分(fen)肉(rou),肥腠理,司(si)開(kai)闔者,皆此(ci)衛(wei)氣之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)用(yong)(yong)(yong)(yong),故《經(jing)》曰:陽者衛(wei)外而(er)為(wei)(wei)固也。今衛(wei)氣一(yi)(yi)虛(xu),則(ze)(ze)分(fen)肉(rou)不(bu)(bu)(bu)溫(wen)(wen)(wen),腠理不(bu)(bu)(bu)密(mi),周身(shen)(shen)毛竅,有(you)(you)開(kai)無合(he)(he),由是風(feng)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)外入(ru),汗(han)(han)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)內(nei)出,其(qi)孰從而(er)拒之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),用(yong)(yong)(yong)(yong)黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)以(yi)建(jian)(jian)立中(zhong)(zhong)氣,而(er)溫(wen)(wen)(wen)衛(wei)實(shi)表(biao)也。桂(gui)(gui)(gui)枝、生(sheng)(sheng)姜(jiang)、芍(shao)藥(yao)、甘(gan)(gan)草、大(da)棗、飴(yi)糖、黃(huang)(huang)(huang)耆(qi)(qi)。⑤泄(xie)瀉(xie)(xie)(xie)不(bu)(bu)(bu)食(shi)《得(de)(de)心集(ji)醫(yi)(yi)(yi)案(an)》:胡曉鶴孝(xiao)廉尊堂,素體(ti)虛(xu)弱(ruo)(ruo),頻年(nian)(nian)(nian)咳(ke)嗽(sou)(sou),眾(zhong)稱老癆不(bu)(bu)(bu)治(zhi)(zhi)(zhi)。今春咳(ke)嗽(sou)(sou)大(da)作(zuo),時(shi)發(fa)(fa)(fa)潮(chao)熱(re)(re),泄(xie)瀉(xie)(xie)(xie)不(bu)(bu)(bu)食(shi),諸(zhu)醫(yi)(yi)(yi)進(jin)參、術之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)劑(ji)(ji),則(ze)(ze)潮(chao)熱(re)(re)愈(yu)增(zeng),用(yong)(yong)(yong)(yong)地黃(huang)(huang)(huang)、鹿(lu)、膠之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)藥(yao),而(er)泄(xie)瀉(xie)(xie)(xie)胸緊(jin)尤甚。延醫(yi)(yi)(yi)數手,無非(fei)脾(pi)腎(shen)兩補,迨至弗效,便引勞(lao)損咳(ke)瀉(xie)(xie)(xie)不(bu)(bu)(bu)治(zhi)(zhi)(zhi)辭(ci)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。時(shi)值六(liu)月(yue)(yue)(yue),始邀予(yu)診(zhen),欲卜逝(shi)期,非(fei)求(qiu)治(zhi)(zhi)(zhi)也。診(zhen)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)脈(mo)俱遲(chi)軟,時(shi)多(duo)歇止(zhi),如徐行而(er)怠,偶羈一(yi)(yi)步之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)象,知為(wei)(wei)結代(dai)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)脈(mo),獨左關肝(gan)部弦大(da)不(bu)(bu)(bu)歇,有(you)(you)土(tu)敗木(mu)(mu)賊之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)勢。因(yin)思諸(zhu)虛(xu)不(bu)(bu)(bu)足(zu)者,當(dang)(dang)補之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)以(yi)味,又(you)勞(lao)者溫(wen)(wen)(wen)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),損者益之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),但補脾(pi)腎(shen)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)法(fa),前(qian)轍可(ke)鑒,然(ran)舍補一(yi)(yi)著(zhu),又(you)無他法(fa)可(ke)施,因(yin)悟各(ge)(ge)臟俱虛(xu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)脈(mo),獨肝(gan)臟自(zi)盛,忽記(ji)潔(jie)古云(yun),假令五臟勝(sheng)(sheng),則(ze)(ze)各(ge)(ge)刑(xing)已(yi)勝(sheng)(sheng),法(fa)當(dang)(dang)補其(qi)不(bu)(bu)(bu)勝(sheng)(sheng),而(er)瀉(xie)(xie)(xie)其(qi)勝(sheng)(sheng),重實(shi)其(qi)不(bu)(bu)(bu)勝(sheng)(sheng),微瀉(xie)(xie)(xie)其(qi)勝(sheng)(sheng)。此(ci)病(bing)肝(gan)木(mu)(mu)自(zi)盛,脾(pi)土(tu)不(bu)(bu)(bu)勝(sheng)(sheng),法(fa)當(dang)(dang)補土(tu)制(zhi)肝(gan),直取黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)與之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。蓋方(fang)(fang)中(zhong)(zhong)桂(gui)(gui)(gui)、芍(shao),微瀉(xie)(xie)(xie)肝(gan)木(mu)(mu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)勝(sheng)(sheng);甘(gan)(gan)、糖味厚,重實(shi)脾(pi)土(tu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)不(bu)(bu)(bu)勝(sheng)(sheng);久病(bing)營(ying)衛(wei)行澀(se),正宜姜(jiang)、棗通(tong)調,而(er)姜(jiang)以(yi)制(zhi)木(mu)(mu),棗能扶(fu)土(tu)也;用(yong)(yong)(yong)(yong)黃(huang)(huang)(huang)耆(qi)(qi)補肺者,蓋恐脾(pi)胃(wei)一(yi)(yi)虛(xu),肺氣先(xian)絕。連進(jin)數劑(ji)(ji),果獲起死(si)回生(sheng)(sheng),但掌心微熱(re)(re)不(bu)(bu)(bu)除,且(qie)口苦不(bu)(bu)(bu)寐,咳(ke)瀉(xie)(xie)(xie)雖止(zhi),肝(gan)木(mu)(mu)猶強(qiang),原(yuan)方(fang)(fang)加(jia)入(ru)丹(dan)皮重瀉(xie)(xie)(xie)肝(gan)木(mu)(mu)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)勝(sheng)(sheng)再勝(sheng)(sheng)而(er)安。⑥潰瘍(yang)(yang)(yang)病(bing)《廣西(xi)中(zhong)(zhong)醫(yi)(yi)(yi)藥(yao)》(1981;4:45):用(yong)(yong)(yong)(yong)黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)略作(zuo)加(jia)減(jian)(jian),治(zhi)(zhi)(zhi)療(liao)胃(wei)、十二指腸(chang)球(qiu)部潰瘍(yang)(yang)(yang)43例(li)(li),治(zhi)(zhi)(zhi)愈(yu)22例(li)(li),好轉17例(li)(li),無效4例(li)(li)。用(yong)(yong)(yong)(yong)藥(yao)最(zui)長者為(wei)(wei)55天(tian)(tian),最(zui)短者為(wei)(wei)25天(tian)(tian),平均(jun)30.3天(tian)(tian)。《湖(hu)北(bei)中(zhong)(zhong)醫(yi)(yi)(yi)雜(za)志(zhi)》(1982;3:21):用(yong)(yong)(yong)(yong)黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)或黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)片(黃(huang)(huang)(huang)耆(qi)(qi)、炙甘(gan)(gan)草、白(bai)芍(shao)、云(yun)苓各(ge)(ge)9g,肉(rou)桂(gui)(gui)(gui)1g,煅瓦(wa)楞3g,制(zhi)成浸膏片)治(zhi)(zhi)(zhi)療(liao)72例(li)(li)胃(wei)、十二指腸(chang)球(qiu)部潰瘍(yang)(yang)(yang)患者,治(zhi)(zhi)(zhi)愈(yu)55例(li)(li),好轉14例(li)(li),無效3例(li)(li),總有(you)(you)效率(lv)為(wei)(wei)95.8%。平均(jun)潰瘍(yang)(yang)(yang)愈(yu)合(he)(he)天(tian)(tian)數為(wei)(wei)28.9天(tian)(tian)。⑦陣(zhen)(zhen)發(fa)(fa)(fa)性(xing)室(shi)上(shang)性(xing)心動過(guo)(guo)速、早搏(bo)《江(jiang)蘇中(zhong)(zhong)醫(yi)(yi)(yi)雜(za)志(zhi)》(198O;6:15):顧某(mou)(mou)(mou)(mou)(mou)某(mou)(mou)(mou)(mou)(mou),男,41歲(sui)。1967年(nian)(nian)(nian)運動時(shi)突發(fa)(fa)(fa)心速,數分(fen)鐘自(zi)行緩(huan)(huan)解(jie),后(hou)每(mei)年(nian)(nian)(nian)有(you)(you)多(duo)次(ci)類似發(fa)(fa)(fa)病(bing)。EKG示:陣(zhen)(zhen)發(fa)(fa)(fa)性(xing)室(shi)上(shang)性(xing)心動過(guo)(guo)速。每(mei)發(fa)(fa)(fa)心率(lv)均(jun)>200次(ci)/分(fen),發(fa)(fa)(fa)病(bing)前(qian)先(xian)有(you)(you)頻繁早搏(bo)。1978年(nian)(nian)(nian)4月(yue)(yue)(yue)初診(zhen),予(yu)益氣建(jian)(jian)中(zhong)(zhong),養心益陰之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)合(he)(he)生(sheng)(sheng)脈(mo)散主之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),治(zhi)(zhi)(zhi)療(liao)一(yi)(yi)月(yue)(yue)(yue)余,諸(zhu)癥(zheng)(zheng)緩(huan)(huan)解(jie),一(yi)(yi)般良好,患者要求(qiu)配成丸(wan)藥(yao),乃將(jiang)前(qian)方(fang)(fang)15帖劑(ji)(ji)量,飴(yi)糖煉丸(wan),日服(fu)2次(ci),每(mei)次(ci)6丸(wan),以(yi)作(zuo)較長時(shi)間調治(zhi)(zhi)(zhi)鞏(gong)固,半(ban)年(nian)(nian)(nian)后(hou)隨(sui)訪未再復(fu)發(fa)(fa)(fa)。⑧自(zi)汗(han)(han)盜(dao)汗(han)(han)《江(jiang)蘇中(zhong)(zhong)醫(yi)(yi)(yi)》(1965;4:31):范某(mou)(mou)(mou)(mou)(mou)某(mou)(mou)(mou)(mou)(mou),男,18歲(sui)。患者身(shen)(shen)體(ti)素弱(ruo)(ruo),形體(ti)蒼瘦,面(白(bai)光)欠(qian)華,近(jin)來眠則(ze)(ze)遍身(shen)(shen)汗(han)(han)出,衣衫(shan)皆濕,脈(mo)濡細,此(ci)衛(wei)陽失固之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)候,治(zhi)(zhi)(zhi)擬(ni)扶(fu)正實(shi)表(biao)。予(yu)生(sheng)(sheng)黃(huang)(huang)(huang)耆(qi)(qi)4錢(qian)(qian),川(chuan)桂(gui)(gui)(gui)枝1錢(qian)(qian),大(da)白(bai)芍(shao)4錢(qian)(qian),炙甘(gan)(gan)草1錢(qian)(qian),老生(sheng)(sheng)姜(jiang)1錢(qian)(qian),大(da)紅棗4錢(qian)(qian),糯稻根須3錢(qian)(qian)。上(shang)方(fang)(fang)連服(fu)5劑(ji)(ji)。汗(han)(han)泄(xie)得(de)(de)止(zhi)。⑨小兒慢性(xing)支氣管(guan)炎(yan)《上(shang)海中(zhong)(zhong)醫(yi)(yi)(yi)藥(yao)雜(za)志(zhi)》(1984;1:22):張某(mou)(mou)(mou)(mou)(mou)某(mou)(mou)(mou)(mou)(mou),女(nv),6歲(sui)。1977年(nian)(nian)(nian)12月(yue)(yue)(yue)10初診(zhen)。咳(ke)嗽(sou)(sou)、喉鳴(ming)時(shi)輕時(shi)重反復(fu)發(fa)(fa)(fa)作(zuo)4年(nian)(nian)(nian)余。兩月(yue)(yue)(yue)前(qian)感寒(han)(han)(han)而(er)發(fa)(fa)(fa),發(fa)(fa)(fa)燒、咳(ke)嗽(sou)(sou)、喘(chuan)鳴(ming),某(mou)(mou)(mou)(mou)(mou)醫(yi)(yi)(yi)院診(zhen)為(wei)(wei)慢性(xing)支氣管(guan)炎(yan)急性(xing)發(fa)(fa)(fa)作(zuo),給予(yu)青(qing)、鏈霉素及麻杏石(shi)甘(gan)(gan)湯(tang)等(deng),藥(yao)后(hou)燒退(tui),咳(ke)喘(chuan)不(bu)(bu)(bu)愈(yu),來院求(qiu)診(zhen)。擬(ni)黃(huang)(huang)(huang)耆(qi)(qi)建(jian)(jian)中(zhong)(zhong)湯(tang)加(jia)半(ban)夏、白(bai)術,服(fu)6劑(ji)(ji)后(hou)諸(zhu)癥(zheng)(zheng)緩(huan)(huan)解(jie),囑以(yi)原(yuan)方(fang)(fang)加(jia)紫河車(che)粉,3日1劑(ji)(ji),計進(jin)28劑(ji)(ji)停藥(yao)觀(guan)察,追訪3年(nian)(nian)(nian)未見復(fu)發(fa)(fa)(fa)。
用法用量 : 黃耆(qi)湯(《外臺》卷(juan)十(shi)七(qi)引《古今(jin)錄驗(yan)》)。本方(fang)改為丸(wan)劑,名“黃耆(qi)建中丸(wan)”(見《全國中藥(yao)成(cheng)藥(yao)處方(fang)集》南昌方(fang))。
注意 : 忌(ji)海藻、菘菜、生蔥(cong)。
各家論述 : ①《金匱要略論注》:小(xiao)(xiao)建中(zhong)湯(tang)本取(qu)化脾中(zhong)之(zhi)(zhi)氣(qi)(qi),而(er)肌肉乃(nai)脾之(zhi)(zhi)所生(sheng)也,黃耆能(neng)走肌肉而(er)實胃氣(qi)(qi),故加之(zhi)(zhi)以(yi)(yi)補(bu)不足(zu)(zu),則(ze)桂(gui)、芍所以(yi)(yi)補(bu)一身之(zhi)(zhi)陰陽,而(er)黃耆、飴(yi)糖(tang)又所以(yi)(yi)補(bu)脾中(zhong)之(zhi)(zhi)陰陽也。②《金匱要略心典》:里急(ji)者(zhe),里虛(xu)脈急(ji),腹中(zhong)當引痛(tong)也。諸不足(zu)(zu)者(zhe),陰陽諸脈并俱(ju)不足(zu)(zu),而(er)眩、悸、喘(chuan)、喝、失(shi)精(jing)、亡血等證相因而(er)至也。急(ji)者(zhe)緩之(zhi)(zhi)必(bi)(bi)以(yi)(yi)甘,不足(zu)(zu)者(zhe)補(bu)之(zhi)(zhi)必(bi)(bi)以(yi)(yi)溫,充虛(xu)塞空(kong),則(ze)黃耆尤有(you)專(zhuan)長也。③《金匱要略方義(yi)》:此(ci)方乃(nai)小(xiao)(xiao)建中(zhong)湯(tang)加黃耆而(er)成。黃耆為補(bu)氣(qi)(qi)扶弱之(zhi)(zhi)品,得飴(yi)糖(tang)則(ze)甘溫以(yi)(yi)益(yi)氣(qi)(qi),得桂(gui)枝則(ze)溫陽以(yi)(yi)化氣(qi)(qi),得白芍又有(you)益(yi)氣(qi)(qi)和營之(zhi)(zhi)效。綜合全方,其補(bu)虛(xu)益(yi)氣(qi)(qi)之(zhi)(zhi)功優于(yu)小(xiao)(xiao)建中(zhong)湯(tang)。
摘錄 : 《金匱》卷上
功能主治 : 陽(yang)明病(bing)汗(han)多或反無汗(han),如蟲(chong)行皮(pi)中狀者。痘(dou)瘡遍身(shen)起(qi)發(fa),惟(wei)四肢不(bu)起(qi)者;痘(dou)瘡發(fa)熱腹痛(tong),大便自利者。
用法用量 : 水1盞半,煎(jian)7分,加生姜3片,大棗1枚,煎(jian)8分,稍熱(re)服,不拘(ju)時候。
摘錄 : 《證(zheng)治要訣類方(fang)》卷(juan)一
功能主治 : 汗(han)多亡(wang)陽,尺脈虛弱者。
用法用量 : 加生(sheng)姜,水煎服。元氣虛甚,加人參(can);熱,加柴胡(hu)。
摘錄 : 《傷寒全生集》卷二
制法 : 上為粗末。
功能主治 : 虛勞有熱(re),胸中煩,手足熱(re),心怔忡(chong),口苦(ku)咽干,咳嗽潮熱(re)等。
用法用量 : 本方方名,《普濟方》引作“十七味(wei)大建中湯”。
摘錄 : 《百一》卷(juan)四引陸彥安方
功能主治 : 傷寒汗(han)后身痛,脈遲(chi)弱者。
各家論述 : 黃耆、甘(gan)(gan)草之(zhi)甘(gan)(gan),補中(zhong)(zhong)氣(qi)(qi)也,然桂中(zhong)(zhong)有辛,同(tong)(tong)用之(zhi)足以(yi)益衛氣(qi)(qi)而實表;芍藥之(zhi)酸,收(shou)陰氣(qi)(qi)也,桂中(zhong)(zhong)有熱,同(tong)(tong)用之(zhi)足以(yi)利榮(rong)血而補虛(xu)。此方以(yi)建中(zhong)(zhong)名者,建立中(zhong)(zhong)氣(qi)(qi),使其生(sheng)育榮(rong)衛,通行(xing)津液(ye),則表不虛(xu)而身痛(tong)自愈矣(yi)。
摘錄 : 《醫方考》卷一
制法 : 上銼細。
功能主治 : 里虛,腹中痛。
用法用量 : 加生姜(jiang)3片,大棗(zao)兩(liang)枚,水1盞,煎5分,去滓,溫(wen)服。
摘錄 : 《痘疹(zhen)心(xin)法》卷二十二
功能主治 : 血氣不足,常自汗。
用法用量 : 入黑砂糖,煎服。
摘錄 : 《嵩崖尊生》卷八
功能主治 : 痘(dou)自7-8朝以后,內毒(du)已(yi)解,而余毒(du)未盡,如(ru)中虛腹(fu)響,肢(zhi)冷汗出,精神倦者(zhe)。
各家論述 : 參、芪、菊、芍獨(du)補中州,用(yong)桂枝以溫走四肢。
摘錄 : 《痘學真傳》卷七
制法 : 上切。
功能主治 : 虛勞(lao)。下焦虛冷(leng),不(bu)甚渴,小便(bian)數。
用法用量 : 以水1斗,煮7味(wei),取3升,去(qu)滓(zi),下飴烊(yang)銷(xiao),分3服。若失精(jing),加龍骨1兩,白蘞1兩。
注意 : 忌生蔥。
摘錄 : 《外臺》卷十七引《必效(xiao)方(fang)》
用法 : 水煎服(fu),各藥用量需(xu)根據目(mu)前(qian)常規劑量酌減。
功效 : 溫中補氣。
主治 : 主治虛(xu)勞不足,腹(fu)中拘(ju)急,自汗(han)或盜汗(han),短氣,肢(zhi)體困倦,脈(mo)虛(xu)大。
臨床應用 : 臨床(chuang)(chuang)(chuang)主要用于(yu)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)反(fan)(fan)流蘭食(shi)管炎(yan)、慢(man)(man)性(xing)(xing)(xing)萎縮(suo)(suo)性(xing)(xing)(xing)胃(wei)(wei)(wei)炎(yan)、胃(wei)(wei)(wei)潰(kui)瘍、慢(man)(man)性(xing)(xing)(xing)阻(zu)塞性(xing)(xing)(xing)肺(fei)病穩(wen)定期(qi)(qi)(qi)(qi)、胃(wei)(wei)(wei)癌等病癥。1.反(fan)(fan)流性(xing)(xing)(xing)食(shi)管炎(yan):應(ying)用黃芪(qi)建(jian)中(zhong)(zhong)(zhong)湯(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)老年(nian)脾胃(wei)(wei)(wei)虛(xu)寒(han)型(xing)反(fan)(fan)流性(xing)(xing)(xing)食(shi)管炎(yan)44例(li)(li),與(yu)鹽酸法(fa)莫替丁(ding)、多潘立酮治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)44例(li)(li)作(zuo)對(dui)(dui)照(zhao),療(liao)(liao)程(cheng)1個月(yue).以食(shi)道黏膜充血水腫、潰(kui)爛面積縮(suo)(suo)小50%及以上(shang)(shang)(全部癥狀幾乎消失(shi))為顯效標(biao)準。結果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)總(zong)有(you)(you)效率86.4%,對(dui)(dui)照(zhao)組(zu)(zu)63.6%。(《中(zhong)(zhong)(zhong)醫(yi)臨床(chuang)(chuang)(chuang)研究》2013年(nian)第2期(qi)(qi)(qi)(qi))2.慢(man)(man)性(xing)(xing)(xing)萎縮(suo)(suo)性(xing)(xing)(xing)胃(wei)(wei)(wei)炎(yan):應(ying)用黃芪(qi)建(jian)中(zhong)(zhong)(zhong)湯(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)慢(man)(man)性(xing)(xing)(xing)萎縮(suo)(suo)性(xing)(xing)(xing)胃(wei)(wei)(wei)炎(yan)30例(li)(li),與(yu)維酶素片治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)30例(li)(li)作(zuo)對(dui)(dui)照(zhao),療(liao)(liao)程(cheng)8周(zhou)。以臨床(chuang)(chuang)(chuang)癥狀和(he)體(ti)在消失(shi),胃(wei)(wei)(wei)鏡復(fu)(fu)查(cha)(cha)黏膜慢(man)(man)性(xing)(xing)(xing)炎(yan)癥明(ming)顯好(hao)轉,病理(li)檢(jian)查(cha)(cha)證實腺體(ti)萎縮(suo)(suo)、腸上(shang)(shang)皮化生和(he)異(yi)型(xing)增生復(fu)(fu)常(chang)或(huo)消失(shi)為臨床(chuang)(chuang)(chuang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)愈標(biao)準。結果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)總(zong)有(you)(you)效率90%。對(dui)(dui)照(zhao)組(zu)(zu)63.33%。(《中(zhong)(zhong)(zhong)醫(yi)雜志(zhi)》2013年(nian)第18期(qi)(qi)(qi)(qi))3.胃(wei)(wei)(wei)潰(kui)瘍:應(ying)用黃芪(qi)建(jian)中(zhong)(zhong)(zhong)湯(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)脾胃(wei)(wei)(wei)虛(xu)寒(han)型(xing)胃(wei)(wei)(wei)潰(kui)瘍45例(li)(li),與(yu)常(chang)規西(xi)(xi)藥治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)45例(li)(li)作(zuo)對(dui)(dui)照(zhao),療(liao)(liao)程(cheng)2周(zhou)。以癥狀、體(ti)征均(jun)完全消失(shi).胃(wei)(wei)(wei)鏡撿(jian)查(cha)(cha)示(shi)潰(kui)瘍面愈合、周(zhou)圍炎(yan)癥完全消失(shi)為治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)愈標(biao)準。結果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)總(zong)有(you)(you)效率97.78%,對(dui)(dui)照(zhao)組(zu)(zu)84.44%。(《河南中(zhong)(zhong)(zhong)醫(yi)》2013年(nian)第3期(qi)(qi)(qi)(qi))4.慢(man)(man)性(xing)(xing)(xing)阻(zu)塞性(xing)(xing)(xing)肺(fei)病穩(wen)定期(qi)(qi)(qi)(qi):應(ying)用黃芪(qi)建(jian)中(zhong)(zhong)(zhong)湯(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)慢(man)(man)性(xing)(xing)(xing)阻(zu)塞性(xing)(xing)(xing)肺(fei)病穩(wen)定期(qi)(qi)(qi)(qi)30例(li)(li),與(yu)金(jin)水寶膠囊治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)30例(li)(li)作(zuo)對(dui)(dui)照(zhao),療(liao)(liao)程(cheng)2個月(yue)。觀察(cha)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)前后肺(fei)功能及呼吸機疲勞指標(biao)、血氣分析(xi)。結果(guo):兩(liang)組(zu)(zu)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)后PaO?明(ming)顯上(shang)(shang)升,PaCO?明(ming)顯下降,治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)改(gai)善大于(yu)對(dui)(dui)照(zhao)組(zu)(zu);治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)FEV1(%)、FVC的改(gai)善優于(yu)對(dui)(dui)照(zhao)組(zu)(zu)。(《中(zhong)(zhong)(zhong)國中(zhong)(zhong)(zhong)醫(yi)急(ji)癥》2011年(nian)第1期(qi)(qi)(qi)(qi))5.胃(wei)(wei)(wei)癌:應(ying)用黃芪(qi)建(jian)中(zhong)(zhong)(zhong)湯(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)脾胃(wei)(wei)(wei)虛(xu)寒(han)型(xing)胃(wei)(wei)(wei)癌40例(li)(li),與(yu)西(xi)(xi)沙比利(li)、乳酸菌素或(huo)雙八(ba)面體(ti)蒙脫石治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)40例(li)(li)作(zuo)對(dui)(dui)照(zhao),療(liao)(liao)程(cheng)2周(zhou)。疼(teng)痛療(liao)(liao)效評價(jia)總(zong)有(you)(you)效率=完全緩(huan)解(jie)(CR)+部分緩(huan)解(jie)(PR)。結果(guo):治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)總(zong)有(you)(you)效率為57.3%,對(dui)(dui)照(zhao)組(zu)(zu)34.1%。(《長(chang)春中(zhong)(zhong)(zhong)醫(yi)藥大學學報》2013年(nian)第1期(qi)(qi)(qi)(qi))
方解 : 本方(fang)為張仲景(jing)治(zhi)療“虛(xu)勞(lao)里急,諸不(bu)足(zu)”所(suo)創,方(fang)以黃芪、大棗、甘草補(bu)脾(pi)益氣,掛枝、生(sheng)姜(jiang)溫陽散寒,白芍緩急止痛,飴糖補(bu)脾(pi)緩急。甘溫以建中,旺脾(pi)以生(sheng)精;建中又固(gu)表(biao),陰陽共調補(bu),是治(zhi)療虛(xu)寒性胃(wei)痛的主方(fang)。
現代研究 : 臨(lin)床報道也見(jian)于治療慢性(xing)(xing)肝(gan)炎、白(bai)細胞(bao)減少、便(bian)秘、陽虛(xu)(xu)感冒、潰瘍(yang)性(xing)(xing)結腸炎、慢性(xing)(xing)盆(pen)腔炎、不(bu)孕癥(zheng)、子(zi)宮內膜(mo)異位癥(zheng)、原發性(xing)(xing)痛(tong)經、肌萎縮側索硬化等證屬脾胃虛(xu)(xu)寒的(de)病癥(zheng)。實驗研究表明,黃芪建中湯具有鎮靜解痙、抑制(zhi)胃液和胃酸(suan)分泌、促進(jin)潰瘍(yang)愈(yu)合、止血、調節胃黏膜(mo)組(zu)織代(dai)謝(xie)、調節免疫功能、降血糖等作用。
方歌 : 黃(huang)芪(qi)建中補中虛,小建中湯加黃(huang)芪(qi),能治虛勞里急病,益(yi)氣固表最有力。
摘錄 : 漢·《金匱要略》
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