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清氣化痰丸組成與功效

道醫 2023-06-24 22:18:26

清氣化痰丸

出自《醫方考》

【組(zu)成】 陳皮(pi)去(qu)白 杏仁(ren)去(qu)皮(pi)尖 枳實麩炒(chao) 黃芩酒炒(chao) 瓜蔞仁(ren)去(qu)油 茯苓(ling)各一兩(liang)(各30g) 膽南(nan)星 制半夏各一兩(liang)半(各45g)

【用(yong)法】 姜(jiang)(jiang)汁為(wei)丸。每(mei)服6g,溫開水(shui)送下(xia)(現代用(yong)法:以上(shang)八味,除瓜蔞仁霜(shuang)外(wai),其余(yu)黃芩(qin)等七味粉碎(sui)成細(xi)粉,與瓜蔞仁霜(shuang)混(hun)勻,過篩。另取生姜(jiang)(jiang)100g,搗(dao)碎(sui)加水(shui)適量,壓榨取汁,與上(shang)述粉末泛(fan)丸,干燥,即得。每(mei)服6~9g,一(yi)日2次;小兒(er)酌減(jian)。亦可作湯劑,加生姜(jiang)(jiang)水(shui)煎(jian)服,用(yong)量按(an)原方比(bi)例酌減(jian))。

【功用】 清(qing)熱化痰,理氣止咳(ke)。

【主治(zhi)】 痰(tan)熱(re)咳嗽(sou)。咳嗽(sou)氣喘(chuan),咯痰(tan)黃稠,胸膈痞(pi)悶(men),甚則氣急嘔惡(e),煩躁(zao)不寧,舌質(zhi)紅(hong),苔(tai)黃膩,脈(mo)滑數。

【方(fang)解】 本方(fang)證(zheng)因痰(tan)(tan)(tan)阻氣(qi)(qi)(qi)(qi)滯(zhi),氣(qi)(qi)(qi)(qi)郁化(hua)(hua)火,痰(tan)(tan)(tan)熱(re)(re)互結(jie)所致。痰(tan)(tan)(tan)熱(re)(re)為患,壅肺(fei)則(ze)(ze)肺(fei)失(shi)清(qing)(qing)肅,故見咳嗽氣(qi)(qi)(qi)(qi)喘,咯痰(tan)(tan)(tan)黃(huang)(huang)稠;阻礙氣(qi)(qi)(qi)(qi)機,則(ze)(ze)胸(xiong)膈痞悶,甚則(ze)(ze)氣(qi)(qi)(qi)(qi)逆于(yu)(yu)上,發為氣(qi)(qi)(qi)(qi)急(ji)嘔惡;痰(tan)(tan)(tan)熱(re)(re)擾(rao)亂心神,可見煩躁不(bu)寧。治宜清(qing)(qing)熱(re)(re)化(hua)(hua)痰(tan)(tan)(tan),理氣(qi)(qi)(qi)(qi)止咳。方(fang)中膽南星苦涼,瓜(gua)蔞仁(ren)甘寒,均(jun)長于(yu)(yu)清(qing)(qing)熱(re)(re)化(hua)(hua)痰(tan)(tan)(tan),瓜(gua)蔞仁(ren)尚能導(dao)痰(tan)(tan)(tan)熱(re)(re)從大便而下,二(er)者(zhe)共為君藥。制半夏(xia)雖(sui)屬辛溫之(zhi)品,但與(yu)苦寒之(zhi)黃(huang)(huang)芩相配,一(yi)化(hua)(hua)痰(tan)(tan)(tan)散結(jie),一(yi)清(qing)(qing)熱(re)(re)降火,既相輔相成,又相制相成,共為臣藥。治痰(tan)(tan)(tan)者(zhe)當須降其(qi)火,治火者(zhe)必須順(shun)其(qi)氣(qi)(qi)(qi)(qi),故佐以(yi)杏仁(ren)降利肺(fei)氣(qi)(qi)(qi)(qi)以(yi)宣上,陳皮理氣(qi)(qi)(qi)(qi)化(hua)(hua)痰(tan)(tan)(tan)以(yi)暢中,枳實破氣(qi)(qi)(qi)(qi)化(hua)(hua)痰(tan)(tan)(tan)以(yi)寬(kuan)胸(xiong)。茯苓(ling)健(jian)脾滲濕,以(yi)杜生(sheng)痰(tan)(tan)(tan)之(zhi)源,亦(yi)為佐藥。使以(yi)姜汁為丸,用(yong)為開痰(tan)(tan)(tan)之(zhi)先導(dao)。諸(zhu)藥合(he)用(yong),化(hua)(hua)痰(tan)(tan)(tan)與(yu)清(qing)(qing)熱(re)(re)、理氣(qi)(qi)(qi)(qi)并進,俾(bi)氣(qi)(qi)(qi)(qi)順(shun)則(ze)(ze)火降,火清(qing)(qing)則(ze)(ze)痰(tan)(tan)(tan)消(xiao),痰(tan)(tan)(tan)消(xiao)則(ze)(ze)火無所附,諸(zhu)證(zheng)悉除。

 【運用】

1.辨(bian)證要(yao)點(dian)(dian):本(ben)方為(wei)(wei)治療痰熱咳嗽的常用方。臨床(chuang)應用以咯痰黃稠,胸膈痞悶,舌(she)紅苔(tai)黃膩,脈滑數為(wei)(wei)辨(bian)證要(yao)點(dian)(dian)。

2.加(jia)減(jian)運用:若痰多氣急者(zhe)(zhe),可(ke)(ke)加(jia)魚腥草、桑白(bai)皮(pi);痰稠膠粘難咯(ge)者(zhe)(zhe),可(ke)(ke)減(jian)半夏用量(liang),加(jia)青黛、蛤粉;惡(e)心(xin)嘔吐明顯者(zhe)(zhe),加(jia)竹茹(ru);煩躁不眠者(zhe)(zhe),可(ke)(ke)去黃(huang)芩,加(jia)清(qing)熱除煩之(zhi)黃(huang)連、山梔,并酌加(jia)琥珀(po)粉、遠志等(deng)寧心(xin)安神(shen)之(zhi)品。

3.現代運用(yong)(yong):本方可用(yong)(yong)于肺(fei)炎(yan)、急性支(zhi)氣(qi)管炎(yan)、慢(man)性支(zhi)氣(qi)管炎(yan)急性發作等(deng)屬痰熱內結者。

 【附方】

清金降火(huo)湯(《古(gu)今醫鑒》)陳皮(pi)一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)五分(4.5g) 半夏泡一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 茯苓(ling)一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 桔梗一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 枳(zhi)殼(ke)麩炒一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 貝(bei)母去心(xin)一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 前(qian)胡一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 杏仁去皮(pi)尖(jian)一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)半(4.5g) 黃芩炒一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 石膏一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 瓜蔞仁一(yi)錢(qian)(qian)(qian)(qian)(qian)(qian)(3g) 甘草炙(zhi)三分(1g) 上銼一(yi)劑。加生姜三片,水煎,食(shi)遠,臨臥服。功用:清金降火(huo),化痰止嗽。主治:熱痰咳嗽。

清(qing)氣(qi)化痰丸(wan)與(yu)本方均治痰熱(re)所致之咳嗽。但比較(jiao)而(er)言,前(qian)(qian)者以咯痰黃稠(chou)為(wei)主,后者以肺(fei)熱(re)咳嗽為(wei)重。故清(qing)氣(qi)化痰丸(wan)以膽星為(wei)君,清(qing)化痰熱(re)之功獨勝,更用枳實,則(ze)消痰行氣(qi)之力(li)亦強。而(er)清(qing)金降(jiang)火(huo)湯用石(shi)膏清(qing)熱(re)瀉火(huo)力(li)增,并伍(wu)貝母、前(qian)(qian)胡、桔梗等意(yi)在止(zhi)咳。

【文獻摘要】

1.原書主治

《醫方考》卷2:“此痰火通用之(zhi)方也。”

2.方論選錄

吳昆(kun)《醫方(fang)考》卷2:“氣(qi)之(zhi)不清(qing),痰(tan)(tan)(tan)之(zhi)故也(ye),能治其痰(tan)(tan)(tan),則(ze)(ze)氣(qi)清(qing)矣。是(shi)方(fang)也(ye),星、夏所(suo)以(yi)(yi)燥痰(tan)(tan)(tan)濕,杏、陳所(suo)以(yi)(yi)利痰(tan)(tan)(tan)滯,枳實所(suo)以(yi)(yi)攻痰(tan)(tan)(tan)積,黃芩所(suo)以(yi)(yi)消痰(tan)(tan)(tan)熱,茯苓之(zhi)用滲(shen)痰(tan)(tan)(tan)濕也(ye)。若(ruo)瓜(gua)蔞者,則(ze)(ze)下(xia)氣(qi)利痰(tan)(tan)(tan)云爾(er)。”

汪昂《醫方集解·除痰(tan)之(zhi)(zhi)(zhi)劑(ji)》:“此手足太(tai)陰之(zhi)(zhi)(zhi)藥(yao),治痰(tan)火(huo)之(zhi)(zhi)(zhi)通劑(ji)也。氣(qi)(qi)能發火(huo),火(huo)能役痰(tan),半夏、南星以(yi)(yi)燥濕氣(qi)(qi),黃芩、瓜蔞以(yi)(yi)平熱氣(qi)(qi),陳皮以(yi)(yi)順里氣(qi)(qi),杏仁以(yi)(yi)降逆氣(qi)(qi),枳實以(yi)(yi)破(po)積氣(qi)(qi),茯苓以(yi)(yi)行(xing)水(shui)氣(qi)(qi)。水(shui)濕火(huo)熱,皆生痰(tan)之(zhi)(zhi)(zhi)本(ben)也。蓋(gai)氣(qi)(qi)之(zhi)(zhi)(zhi)亢則為(wei)火(huo),火(huo)退(tui)則還(huan)為(wei)正氣(qi)(qi)而(er)安其位矣,故化痰(tan)必以(yi)(yi)清氣(qi)(qi)為(wei)先(xian)也。”

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