處方 : 黃耆(qi)9克(ke)(ke) 芍藥9克(ke)(ke) 桂(gui)枝9克(ke)(ke) 生姜18克(ke)(ke) 大棗12枚(mei)(一方有人參)
功能主治 : 補氣通陽,養血(xue)(xue)除(chu)痹。治血(xue)(xue)痹,脈寸口關上微、尺中小緊,外證身體不(bu)仁,如(ru)風痹狀。
用法用量 : 上五味,以水(shui)1.2升,煮取400毫升,分(fen)三(san)次溫服。
備注 : 方中黃耆(qi)補(bu)氣、桂枝(zhi)通陽(yang)為君(jun);,芍(shao)藥養血除痹為臣;大棗、生(sheng)姜調和營衛為佐、使(shi)。合(he)用以奏補(bu)氣通陽(yang),養血除痹之效。
摘錄 : 《金匱要略》卷上
處方 : 黃耆3兩(liang),芍藥3兩(liang),桂枝3兩(liang),生姜(jiang)6兩(liang),大棗12枚(一方(fang)有人參)。
功能主治 : 調養榮(rong)衛,祛(qu)風散邪。主血痹(bi)。陰陽俱微(wei),寸口關上微(wei),尺中(zhong)小緊,外證(zheng)身體不仁,如風痹(bi)狀。
臨床應用 : 1.痹(bi):張,形寒(han)(han)(han),手(shou)足(zu)痛(tong)(tong),肌肉(rou)漸腫,勞(lao)力行走,陽(yang)氣(qi)受傷(shang),客邪(xie)內侵(qin),營(ying)衛失和。仿《局方(fang)》“痹(bi)在四肢,汗(han)出陽(yang)虛者(zhe)(zhe),與黃(huang)(huang)(huang)(huang)(huang)耆(qi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯”。黃(huang)(huang)(huang)(huang)(huang)耆(qi)、桂(gui)(gui)枝(zhi)(zhi)、茯(fu)苓、炙草(cao)、當歸、煨姜(jiang)、南棗(zao)(zao)。2.真中風(feng)(feng):診(zhen)(zhen)得兩(liang)手(shou)脈(mo)(mo)厚(hou)而(er)長(chang),惟左(zuo)手(shou)略兼弦象,兩(liang)寸(cun)稍緊(jin),脈(mo)(mo)厚(hou)者(zhe)(zhe),得土之(zhi)(zhi)(zhi)(zhi)敦氣(qi),厚(hou)道足(zu)以載福,為(wei)(wei)長(chang)壽之(zhi)(zhi)(zhi)(zhi)征。但弦為(wei)(wei)風(feng)(feng)脈(mo)(mo),緊(jin)為(wei)(wei)痛(tong)(tong)脈(mo)(mo),今緊(jin)在兩(liang)寸(cun),主上(shang)半(ban)身(shen)(shen)有痹(bi)痛(tong)(tong)之(zhi)(zhi)(zhi)(zhi)患,據稱手(shou)腕(wan)及臂上(shang)痛(tong)(tong),時(shi)(shi)(shi)愈時(shi)(shi)(shi)作,已(yi)閱五(wu)年(nian)(nian)(nian)(nian)之(zhi)(zhi)(zhi)(zhi)久,且指尖(jian)時(shi)(shi)(shi)苦麻(ma)(ma)木,昔(xi)年(nian)(nian)(nian)(nian)尤(you)甚,近(jin)(jin)年(nian)(nian)(nian)(nian)略減,細(xi)察此癥(zheng)(zheng),系風(feng)(feng)在關節而(er)作痛(tong)(tong),至其所以痛(tong)(tong)者(zhe)(zhe),乃(nai)氣(qi)血(xue)(xue)與風(feng)(feng)邪(xie)相抗拒,非同偏枯者(zhe)(zhe)之(zhi)(zhi)(zhi)(zhi)全(quan)不覺(jue)痛(tong)(tong),其妙在于痛(tong)(tong)處(chu),不難扶正(zheng)以屏邪(xie),書稱中指麻(ma)(ma)木,三年(nian)(nian)(nian)(nian)內防患中風(feng)(feng),以中指屬手(shou)心(xin)經(jing)故也。今幸麻(ma)(ma)木之(zhi)(zhi)(zhi)(zhi)處(chu)以食(shi)指、拇指為(wei)(wei)甚,系肺(fei)與大(da)(da)腸(chang)氣(qi)之(zhi)(zhi)(zhi)(zhi)不調,尚無(wu)(wu)大(da)(da)害,然風(feng)(feng)善(shan)行而(er)變(bian)數,必須及早治(zhi)之(zhi)(zhi)(zhi)(zhi),然斯(si)時(shi)(shi)(shi)若(ruo)肥風(feng)(feng)藥以預防中風(feng)(feng),是適招風(feng)(feng)取(qu)(qu)中,無(wu)(wu)異借(jie)寇兵而(er)齊盜糧(liang),宜出諸鄭(zheng)重,切勿孟浪以圖(tu)一逞,宜用(yong)(yong)(yong)黃(huang)(huang)(huang)(huang)(huang)耆(qi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯。黃(huang)(huang)(huang)(huang)(huang)耆(qi)2錢,桂(gui)(gui)枝(zhi)(zhi)尖(jian)2錢,生(sheng)白(bai)芍2錢,生(sheng)姜(jiang)4錢,大(da)(da)棗(zao)(zao)2枚,同煎服(fu)。3.腦(nao)血(xue)(xue)管意外后(hou)遺(yi)癥(zheng)(zheng):一老嫗,證見右半(ban)身(shen)(shen)癱(tan)瘓,口(kou)眼斜,手(shou)足(zu)麻(ma)(ma)木,肌肉(rou)不仁,右半(ban)身(shen)(shen)自(zi)(zi)(zi)汗(han)出。血(xue)(xue)壓:150/100毫米汞(gong)柱(zhu)。此乃(nai)營(ying)衛氣(qi)血(xue)(xue)虛虧(kui),陽(yang)氣(qi)阻閉,經(jing)脈(mo)(mo)失于營(ying)養之(zhi)(zhi)(zhi)(zhi)證。予(yu)黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯治(zhi)之(zhi)(zhi)(zhi)(zhi)。共(gong)服(fu)15劑(ji)(ji),血(xue)(xue)壓:140/90毫米汞(gong)柱(zhu),脈(mo)(mo)舌(she)正(zheng)常。諸癥(zheng)(zheng)蠲(juan)(juan)除(chu),一如常人。四年(nian)(nian)(nian)(nian)后(hou)追訪(fang),終未再作。4.血(xue)(xue)痹(bi):劉某,患四肢麻(ma)(ma)木一年(nian)(nian)(nian)(nian)余(yu)(yu),夜晚尤(you)甚。用(yong)(yong)(yong)維生(sheng)素B12與維生(sheng)素B1;肌肉(rou)注射60余(yu)(yu)日(ri),療效(xiao)不明顯。后(hou)改為(wei)(wei)針(zhen)灸(jiu)治(zhi)療,初(chu)針(zhen)有小(xiao)效(xiao),繼(ji)之(zhi)(zhi)(zhi)(zhi)無(wu)(wu)效(xiao)。證見氣(qi)虛懶言(yan),疲乏(fa)無(wu)(wu)力,四肢麻(ma)(ma)木以上(shang)肢較甚,臀部(bu)發(fa)涼。脈(mo)(mo)雙沉(chen)細(xi),舌(she)質淡嫩,苔薄(bo)白(bai)。取(qu)(qu)黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯治(zhi)之(zhi)(zhi)(zhi)(zhi)。服(fu)15劑(ji)(ji),諸證俱(ju)蠲(juan)(juan)。5.自(zi)(zi)(zi)汗(han):患者(zhe)(zhe),女(nv),31歲(sui)(sui)。工人。痢后(hou)繼(ji)見汗(han)出,已(yi)兩(liang)年(nian)(nian)(nian)(nian)余(yu)(yu)。動則大(da)(da)汗(han)淋漓,乍(zha)冷乍(zha)熱(re),時(shi)(shi)(shi)時(shi)(shi)(shi)惡風(feng)(feng),并(bing)(bing)出現腸(chang)鳴(ming),進食(shi)不慎即瀉,頭暈無(wu)(wu)力,舌(she)淡苔薄(bo)白(bai),脈(mo)(mo)無(wu)(wu)力寸(cun)浮大(da)(da)。經(jing)某醫院診(zhen)(zhen)為(wei)(wei)“植物(wu)(wu)(wu)(wu)(wu)(wu)神經(jing)功能紊亂”,屢治(zhi)罔效(xiao)。遂用(yong)(yong)(yong)黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯加(jia)(jia)白(bai)術(shu)、五(wu)味子,水(shui)煎4劑(ji)(ji),服(fu)后(hou)自(zi)(zi)(zi)汗(han)明顯改善(shan),將桂(gui)(gui)枝(zhi)(zhi)減量,白(bai)術(shu)增制,使(shi)之(zhi)(zhi)(zhi)(zhi)外助黃(huang)(huang)(huang)(huang)(huang)耆(qi)以固表,內達健(jian)脾以收(shou)功。繼(ji)進6劑(ji)(ji),腸(chang)鳴(ming)消(xiao)失。再進3劑(ji)(ji),諸癥(zheng)(zheng)悉(xi)除(chu)。6.胸(xiong)痹(bi):患者(zhe)(zhe),女(nv),51歲(sui)(sui),干(gan)部(bu)。病初(chu)自(zi)(zi)(zi)覺(jue)胸(xiong)悶(men)氣(qi)短(duan),繼(ji)則胸(xiong)前區(qu)時(shi)(shi)(shi)感隱痛(tong)(tong),并(bing)(bing)向左(zuo)肩背放射,遇(yu)(yu)寒(han)(han)(han)痛(tong)(tong)甚,已(yi)2年(nian)(nian)(nian)(nian)余(yu)(yu)。心(xin)電(dian)圖(tu)診(zhen)(zhen)為(wei)(wei)“冠狀(zhuang)(zhuang)動脈(mo)(mo)供血(xue)(xue)不足(zu)”。予(yu)黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯加(jia)(jia)薤白(bai)、炙甘(gan)草(cao),共(gong)服(fu)30余(yu)(yu)劑(ji)(ji),胸(xiong)痛(tong)(tong)諸證得以控制,心(xin)電(dian)圖(tu)近(jin)(jin)于正(zheng)常。7.胃(wei)脘(wan)痛(tong)(tong):患者(zhe)(zhe),女(nv),42歲(sui)(sui),工人。胃(wei)脘(wan)時(shi)(shi)(shi)感隱痛(tong)(tong),逢(feng)勞(lao)遇(yu)(yu)寒(han)(han)(han)尤(you)甚,已(yi)5年(nian)(nian)(nian)(nian)許,鋇餐透視診(zhen)(zhen)為(wei)(wei)“胃(wei)竇炎”。曾(ceng)屢服(fu)大(da)(da)劑(ji)(ji)辛熱(re)理(li)氣(qi)之(zhi)(zhi)(zhi)(zhi)品,漸致腹脹納呆(dai),大(da)(da)便時(shi)(shi)(shi)溏,周身(shen)(shen)乏(fa)力,舌(she)淡潤(run),脈(mo)(mo)沉(chen)弦遲(chi)。方(fang)用(yong)(yong)(yong)黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯加(jia)(jia)炙甘(gan)草(cao)、干(gan)姜(jiang),服(fu)藥后(hou),胃(wei)痛(tong)(tong)頓解。酌去干(gan)姜(jiang),加(jia)(jia)腹皮與茯(fu)苓交替使(shi)用(yong)(yong)(yong),予(yu)以健(jian)脾,因(yin)病陳(chen)久,宜緩緩圖(tu)治(zhi)。繼(ji)服(fu)20余(yu)(yu)劑(ji)(ji),諸證漸愈。8.低熱(re):朱某某,女(nv).35歲(sui)(sui),教師。低熱(re)2年(nian)(nian)(nian)(nian)余(yu)(yu),體溫常在37.5℃左(zuo)右,偶爾(er)達38℃。伴(ban)有怯風(feng)(feng)怕(pa)冷,自(zi)(zi)(zi)汗(han)津津,聲(sheng)低氣(qi)短(duan),納谷(gu)不香,大(da)(da)便溏薄(bo),周身(shen)(shen)乏(fa)力等證。舌(she)苔薄(bo)白(bai),舌(she)質淡紅而(er)胖,脈(mo)(mo)細(xi)緩無(wu)(wu)力。證屬氣(qi)虛身(shen)(shen)熱(re)。擬取(qu)(qu)甘(gan)溫除(chu)熱(re)法,黃(huang)(huang)(huang)(huang)(huang)耆(qi)桂(gui)(gui)枝(zhi)(zhi)五(wu)物(wu)(wu)(wu)(wu)(wu)(wu)湯加(jia)(jia)焦(jiao)白(bai)術(shu)、炙甘(gan)草(cao)。服(fu)上(shang)方(fang)12劑(ji)(ji)后(hou),癥(zheng)(zheng)狀(zhuang)(zhuang)基本消(xiao)失。改用(yong)(yong)(yong)補(bu)中益氣(qi)丸調服(fu)半(ban)月以善(shan)后(hou),隨訪(fang)至今未發(fa)。
用法用量 : 黃(huang)(huang)耆湯(《圣濟(ji)總錄》卷(juan)十(shi)九)、黃(huang)(huang)耆五物(wu)湯(《三(san)因》卷(juan)三(san))、桂枝(zhi)五物(wu)湯(《赤水玄珠》卷(juan)十(shi)二)、五物(wu)湯(《東醫(yi)寶鑒(jian)·雜(za)病篇》卷(juan)二)。
各家論述 : 《金鑒(jian)》:以黃耆固衛(wei);芍藥養(yang)陰;桂枝調和(he)營衛(wei),托實表里,驅邪(xie)外出(chu);佐以生姜宣胃;大棗益脾,為至(zhi)當不易之(zhi)治也。
摘錄 : 《金匱》卷上
用法 : 水煎服。
功效 : 溫陽行痹。
主治 : 主治(zhi)血痹(bi),肌膚麻(ma)木不仁,脈微而澀緊。
臨床應用 : 臨(lin)床主要用于治(zhi)(zhi)(zhi)療(liao)(liao)糖(tang)尿(niao)病(bing)周(zhou)圍(wei)神(shen)(shen)經(jing)病(bing)變、頸(jing)椎病(bing)、奧沙(sha)利鉑的(de)周(zhou)圍(wei)神(shen)(shen)經(jing)毒(du)性、IgA腎(shen)病(bing)及皮膚瘙(sao)癢等病(bing)癥(zheng)。1.糖(tang)尿(niao)病(bing)周(zhou)圍(wei)神(shen)(shen)經(jing)病(bing)變:將(jiang)符合診(zhen)斷標(biao)準的(de)DPN患者(zhe)(zhe)(zhe)40例(li),隨機(ji)分為(wei)治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)和對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu)各20例(li)。在控(kong)制(zhi)血糖(tang)、血壓、血脂的(de)基礎(chu)上,治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)給(gei)(gei)予口服(fu)加(jia)(jia)味黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang)治(zhi)(zhi)(zhi)療(liao)(liao),對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu)給(gei)(gei)予口服(fu)甲鈷胺(彌可保(bao))治(zhi)(zhi)(zhi)療(liao)(liao),8周(zhou)為(wei)1個療(liao)(liao)程。結(jie)果:治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)總(zong)有(you)(you)效(xiao)(xiao)(xiao)率(lv)為(wei)90%,對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu)總(zong)有(you)(you)效(xiao)(xiao)(xiao)率(lv)為(wei)65%;治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)對(dui)患者(zhe)(zhe)(zhe)臨(lin)床癥(zheng)狀,兩側(ce)脛(jing)運動(dong)神(shen)(shen)經(jing)、感(gan)覺神(shen)(shen)經(jing)傳(chuan)導(dao)速度的(de)改善均優于對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu),治(zhi)(zhi)(zhi)療(liao)(liao)過程中(zhong)(zhong)未見明顯(xian)不良反應。(南京中(zhong)(zhong)醫藥(yao)大(da)學, 2010年第5期)2.頸(jing)椎病(bing):以黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang)治(zhi)(zhi)(zhi)療(liao)(liao)96例(li)頸(jing)椎病(bing)患者(zhe)(zhe)(zhe),結(jie)果:總(zong)治(zhi)(zhi)(zhi)療(liao)(liao)有(you)(you)效(xiao)(xiao)(xiao)率(lv)達91.7%。且遇勞累加(jia)(jia)重(zhong)(zhong)者(zhe)(zhe)(zhe),以本方加(jia)(jia)人參10克(ke)(ke)(ke);疼(teng)劇(ju)烈(lie)者(zhe)(zhe)(zhe)以本方加(jia)(jia)元胡、川芎各10克(ke)(ke)(ke),乳香、沒藥(yao)各6克(ke)(ke)(ke);遇寒(han)加(jia)(jia)重(zhong)(zhong)者(zhe)(zhe)(zhe),加(jia)(jia)蜀椒、干姜各6克(ke)(ke)(ke);頸(jing)項強疼(teng)加(jia)(jia)葛根10克(ke)(ke)(ke);手(shou)臂麻木嚴(yan)重(zhong)(zhong),加(jia)(jia)雞血藤、桑(sang)枝(zhi)(zhi)、桑(sang)寄生(sheng)各30克(ke)(ke)(ke),木瓜15克(ke)(ke)(ke);心急失(shi)眠者(zhe)(zhe)(zhe)加(jia)(jia)酸(suan)(suan)棗(zao)仁、柏(bo)子仁各30克(ke)(ke)(ke);頭暈劇(ju)烈(lie)者(zhe)(zhe)(zhe)加(jia)(jia)天(tian)麻、勾藤、石(shi)決明各10克(ke)(ke)(ke);胸(xiong)悶氣(qi)短(duan)者(zhe)(zhe)(zhe)加(jia)(jia)瓜蔞10克(ke)(ke)(ke),丹參30克(ke)(ke)(ke);惡心欲吐者(zhe)(zhe)(zhe)加(jia)(jia)半(ban)夏12克(ke)(ke)(ke);耳鳴耳聾加(jia)(jia)磁石(shi)15克(ke)(ke)(ke);腰酸(suan)(suan)腿疼(teng)加(jia)(jia)山芋、山藥(yao)各30克(ke)(ke)(ke),療(liao)(liao)效(xiao)(xiao)(xiao)顯(xian)著。(北(bei)京中(zhong)(zhong)醫藥(yao)大(da)學,2005年第6期)3.奧沙(sha)利鉑的(de)周(zhou)圍(wei)神(shen)(shen)經(jing)毒(du)性:共納(na)入6個隨機(ji)對(dui)照(zhao)(zhao)(zhao)買驗研究368例(li)患者(zhe)(zhe)(zhe)。Meta分析結(jie)果:化療(liao)(liao)時使用黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang)的(de)試(shi)驗組(zu)(zu)(zu)(zu)對(dui)比常規治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)或甲鈷胺片(pian)治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)在神(shen)(shen)經(jing)毒(du)性的(de)發(fa)生(sheng)率(lv)、嚴(yan)重(zhong)(zhong)神(shen)(shen)經(jing)毒(du)性的(de)發(fa)生(sheng)率(lv)及感(gan)覺神(shen)(shen)經(jing)傳(chuan)導(dao)速度(SNCV)等方面(mian)具有(you)(you)統計學差異;安全(quan)性分析納(na)入黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang)治(zhi)(zhi)(zhi)療(liao)(liao)奧沙(sha)利鉑引起的(de)外周(zhou)神(shen)(shen)經(jing)毒(du)性的(de)所有(you)(you)類(lei)型的(de)臨(lin)床研究。結(jie)果未發(fa)現嚴(yan)重(zhong)(zhong)的(de)不良事件(ADR/AE)。(《中(zhong)(zhong)國(guo)實驗方劑學雜志》2013年第22期)4.IgA腎(shen)病(bing):將(jiang)60例(li)IgA腎(shen)病(bing)屬脾(pi)腎(shen)陽(yang)(氣(qi))虛證(zheng)的(de)患者(zhe)(zhe)(zhe)采用隨機(ji)對(dui)照(zhao)(zhao)(zhao)按2:1的(de)比例(li),分為(wei)治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)(黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang))40例(li)和對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu)(雙嘧(mi)達莫)20例(li),治(zhi)(zhi)(zhi)療(liao)(liao)2個月。結(jie)果:治(zhi)(zhi)(zhi)療(liao)(liao)組(zu)(zu)(zu)(zu)總(zong)有(you)(you)效(xiao)(xiao)(xiao)率(lv)為(wei)72.5%,對(dui)照(zhao)(zhao)(zhao)組(zu)(zu)(zu)(zu)為(wei)50%,黃(huang)芪(qi)桂(gui)(gui)(gui)枝(zhi)(zhi)五(wu)(wu)(wu)(wu)物(wu)湯(tang)(tang)(tang)(tang)(tang)對(dui)降低IgA腎(shen)病(bing)脾(pi)腎(shen)陽(yang)(氣(qi))虛證(zheng)患者(zhe)(zhe)(zhe)蛋白尿(niao)及血尿(niao)均有(you)(you)效(xiao)(xiao)(xiao),對(dui)改善臨(lin)床疲倦(juan)乏力、腰背(bei)酸(suan)(suan)痛、面(mian)肢浮腫、畏(wei)寒(han)肢冷等癥(zheng)狀有(you)(you)明顯(xian)療(liao)(liao)效(xiao)(xiao)(xiao)。(《上海(hai)中(zhong)(zhong)醫藥(yao)大(da)學學報》2008年第3期)
方解 : 黃(huang)芪(qi)桂枝五(wu)物湯出自張(zhang)仲景《金匱要略(lve)》,原(yuan)用于(yu)(yu)(yu)(yu)(yu)(yu)治療(liao)血痹癥,后世醫家多用于(yu)(yu)(yu)(yu)(yu)(yu)治療(liao)風(feng)(feng)(feng)濕(shi)關節炎(yan)及類風(feng)(feng)(feng)濕(shi)關節炎(yan)等病證。方(fang)中黃(huang)芪(qi)益(yi)(yi)氣固表(biao);桂枝散風(feng)(feng)(feng)寒而溫經通痹;芍(shao)藥(yao)(yao)養(yang)血和營而通血痹,與桂枝合(he)用,調和營衛而和表(biao)里;生姜(jiang)(jiang)辛(xin)溫,疏散風(feng)(feng)(feng)邪,以(yi)助(zhu)桂枝之(zhi)(zhi)力;大棗甘溫,養(yang)血益(yi)(yi)氣以(yi)資黃(huang)芪(qi)、芍(shao)藥(yao)(yao)之(zhi)(zhi)功,全方(fang)配(pei)伍(wu)精(jing)當,療(liao)效確切(qie)。但本(ben)方(fang)主要用于(yu)(yu)(yu)(yu)(yu)(yu)治療(liao)血痹肌膚(fu)麻木。臨床應(ying)用以(yi)局部(bu)肌膚(fu)麻木不仁為辨證要點。臨床如見病發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)頭部(bu),加(jia)(jia)川芎、蒼耳(er)子(zi);發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)面部(bu),加(jia)(jia)白附子(zi)、白僵蠶(can);發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)胸部(bu),加(jia)(jia)白芥子(zi);發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)腹部(bu),加(jia)(jia)木香、大腹皮;發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)背部(bu),加(jia)(jia)羌(qiang)活;發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)腰部(bu),加(jia)(jia)補骨脂、續斷(duan);發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)四肢(zhi),加(jia)(jia)桑枝、雞血藤(teng);發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)上(shang)肢(zhi),加(jia)(jia)姜(jiang)(jiang)黃(huang)、羌(qiang)活;發(fa)于(yu)(yu)(yu)(yu)(yu)(yu)下(xia)肢(zhi),加(jia)(jia)牛膝、蒼術(shu)。
現代研究 : 現在藥理研究表明,黃芪在機體免疫、代謝、心(xin)腦血管系統、消化系統、泌尿系統等(deng)方(fang)面作用(yong)顯著(zhu)(zhu)。桂(gui)枝(zhi)抗病(bing)原微生物、抗驚厥、心(xin)血管等(deng)方(fang)面療效顯著(zhu)(zhu)。因此此方(fang)在臨床上的應用(yong)范圍(wei)要比其功能主(zhu)治范圍(wei)更加廣泛(fan)。
方歌 : 黃(huang)芪桂枝五物湯,芍藥大棗(zao)與生姜,益氣(qi)溫(wen)經和營衛,血痹(bi)風痹(bi)功效良。
摘錄 : 漢·《金匱要略》
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