摘要:目的(de):觀察定喘(chuan)(chuan)(chuan)湯(tang)加減治療哮喘(chuan)(chuan)(chuan)病(bing)的(de)臨床療效(xiao)。方法:將57例哮喘(chuan)(chuan)(chuan)病(bing)患者給予定喘(chuan)(chuan)(chuan)湯(tang)加減口(kou)服治療,7天(tian)為(wei)1個療程,4個療程后觀察臨床療效(xiao)。結果:顯效(xiao)35例,占(zhan)61.4%,有(you)效(xiao)17例,占(zhan)29.8%,無效(xiao)5例,占(zhan)8.8%,總有(you)效(xiao)率(lv)為(wei)91.2%。結論:定喘(chuan)(chuan)(chuan)湯(tang)加減治療支(zhi)氣管哮喘(chuan)(chuan)(chuan)療效(xiao)確切,毒副作用(yong)小,值得臨床推廣應(ying)用(yong)。
哮(xiao)喘是發(fa)作(zuo)(zuo)性(xing)(xing)的(de)痰鳴氣(qi)喘疾(ji)病(bing)(bing)(bing)(bing),發(fa)作(zuo)(zuo)時喉中哮(xiao)鳴有聲(sheng),呼(hu)吸困難(nan),呼(hu)吸短(duan)促急(ji)(ji)迫,甚則喘息不能平臥(wo)為主要臨床表(biao)現,支氣(qi)管哮(xiao)喘屬于痰飲病(bing)(bing)(bing)(bing)的(de)“伏(fu)飲”證(zheng)(zheng),是因(yin)于宿(su)痰伏(fu)肺(fei),遇到(dao)寒冷,粉塵(chen),食物,感染等不良刺激,導(dao)致痰阻氣(qi)道(dao),氣(qi)道(dao)攣急(ji)(ji),肺(fei)失肅降(jiang),肺(fei)氣(qi)上逆所致的(de)發(fa)作(zuo)(zuo)性(xing)(xing)痰鳴氣(qi)喘疾(ji)患(huan),中醫治(zhi)療(liao)本(ben)病(bing)(bing)(bing)(bing)有顯著(zhu)療(liao)效(xiao),可(ke)以(yi)緩(huan)解癥狀(zhuang),減(jian)少發(fa)病(bing)(bing)(bing)(bing)次數,且通過緩(huan)解調(diao)理,達到(dao)祛除病(bing)(bing)(bing)(bing)根減(jian)少復發(fa)的(de)目的(de)。本(ben)病(bing)(bing)(bing)(bing)包括(kuo)西醫學的(de)支氣(qi)管哮(xiao)喘,喘息性(xing)(xing)支氣(qi)管炎,嗜酸性(xing)(xing)粒細胞增(zeng)多(duo)癥,或其他急(ji)(ji)性(xing)(xing)肺(fei)部過敏性(xing)(xing)疾(ji)病(bing)(bing)(bing)(bing)引(yin)起的(de)哮(xiao)喘。均可(ke)參(can)考本(ben)病(bing)(bing)(bing)(bing)辯證(zheng)(zheng)范圍(wei),若因(yin)肺(fei)系其他多(duo)種(zhong)疾(ji)病(bing)(bing)(bing)(bing)引(yin)起的(de)痰鳴氣(qi)喘癥狀(zhuang)者(zhe)屬于喘證(zheng)(zheng),肺(fei)脹等疾(ji)病(bing)(bing)(bing)(bing)的(de)范圍(wei),臨床上也可(ke)與本(ben)病(bing)(bing)(bing)(bing)辯證(zheng)(zheng)論治(zhi)內容相互參(can)照(zhao)應用(yong)。近(jin)年來,隨著(zhu)氣(qi)候(hou)變化無常(chang),本(ben)病(bing)(bing)(bing)(bing)發(fa)病(bing)(bing)(bing)(bing)率(lv)逐年上升,尤(you)為女性(xing)(xing)發(fa)病(bing)(bing)(bing)(bing)率(lv)加重。西醫學治(zhi)療(liao)本(ben)病(bing)(bing)(bing)(bing)療(liao)效(xiao)欠佳,而且易成癮(yin),副作(zuo)(zuo)用(yong)大。筆(bi)者(zhe)自2010年3月至2014年3月以(yi)來采用(yong)定喘湯加減(jian)治(zhi)療(liao)哮(xiao)喘病(bing)(bing)(bing)(bing)取得了顯著(zhu)療(liao)效(xiao),現總結如下。
1 臨床資料
1.1一般資料
57例患(huan)者均來自(zi)我(wo)院門診及住院患(huan)者,其中(zhong)男性(xing)23例,女性(xing)34,年(nian)(nian)(nian)(nian)齡最(zui)(zui)小(xiao)為(wei)(wei)19歲,年(nian)(nian)(nian)(nian)齡最(zui)(zui)大為(wei)(wei)70歲,平均年(nian)(nian)(nian)(nian)齡為(wei)(wei)47,病(bing)床最(zui)(zui)短為(wei)(wei)2周,病(bing)床最(zui)(zui)長為(wei)(wei)1年(nian)(nian)(nian)(nian)。
2 診斷標準
參照《中醫(yi)內科學》[1]哮喘病(bing)的診斷(duan)標準(zhun).1.發(fa)作(zuo)時呼吸困難(nan),呼吸短促急迫,喉(hou)中有(you)(you)(you)哮鳴(ming)音(yin),甚(shen)則張(zhang)口(kou)抬(tai)肩,不(bu)(bu)能平臥,或口(kou)唇,指甲發(fa)紺。2.具有(you)(you)(you)“夙根”臨床表(biao)現呈反(fan)復(fu)性(xing)發(fa)作(zuo),反(fan)復(fu)性(xing),頑固性(xing)。常(chang)因氣(qi)候突變,飲(yin)食(shi)不(bu)(bu)當,情(qing)志失調,勞累,吸入異味,煙霧,花粉,粉塵等因素(su)而誘發(fa),發(fa)作(zuo)前多(duo)有(you)(you)(you)鼻癢,噴嚏,咳嗽,胸悶等前兆。3.哮喘病(bing)常(chang)有(you)(you)(you)過敏(min)史(shi),家族史(shi)。4.經查(cha)體,胸部聽診兩肺可(ke)聞及哮鳴(ming)音(yin)及大量的濕(shi)羅音(yin)。5. 血是酸粒細(xi)胞(bao)計數,痰液涂片(pian),胸部X線可(ke)輔助診斷(duan)及其(qi)排除(chu)其(qi)他肺部疾病(bing)。
3 治療方法
給予定喘湯加減(jian)治療(liao)。基本方:白果10g,麻黃10g,蘇(su)子10g,甘草(cao)6g,款冬花10g,杏仁15g,桑(sang)白皮10g,黃芩10g,半夏(xia)10g。加減(jian):若痰(tan)(tan)稠難咳,可(ke)加膽南星10g,海蛤殼10g,瓜蔞(lou)10g以增強清熱(re)(re)化(hua)痰(tan)(tan)之(zhi)力(li),若肺(fei)熱(re)(re)較甚,可(ke)加入魚腥草(cao)10g,生(sheng)石(shi)膏(先(xian)煎)15g金銀花10g,知母10g以清肺(fei)熱(re)(re),若胸悶明顯可(ke)加枳(zhi)殼10g,厚樸10g以寬中(zhong)行(xing)氣(qi),若表寒(han)明顯,證見惡寒(han),無(wu)汗,配(pei)以桂枝8g,生(sheng)姜(jiang)5片(pian)以增強解表散(san)寒(han)之(zhi)力(li),若內熱(re)(re)壅(yong)盛,大便秘結者,可(ke)加大黃(后(hou)下)10g,冬瓜仁15g以通(tong)臟腑宣肺(fei),肺(fei)氣(qi)壅(yong)實,痰(tan)(tan)鳴息涌不(bu)得臥,加葶藶子15g,廣地龍(long)10g清痰(tan)(tan)瀉壅(yong)平喘。水煎服取(qu)汁600ml,分3次口服,每日1劑(ji),7天為(wei)1個療(liao)程,4個療(liao)程后(hou)觀察(cha)療(liao)效(xiao),若病情較重,喘息不(bu)得臥,可(ke)一次頓(dun)服。治療(liao)期間禁止煙(yan)酒,辛辣刺(ci)(ci)激(ji)性食物,避免精(jing)神刺(ci)(ci)激(ji),過度緊張,孤獨勞累(lei),避免寒(han)冷,花粉,粉塵等刺(ci)(ci)激(ji)因素。
4 結果
a)療效標準
參照《中醫(yi)內科學》[1]制(zhi)定(ding)。顯效治(zhi)療7---28天(tian)(tian)后,呼(hu)(hu)吸(xi)困難,呼(hu)(hu)吸(xi)短促急(ji)迫(po),喉中有(you)哮鳴(ming)音(yin),甚則(ze)張口抬(tai)肩(jian),不能(neng)平(ping)臥(wo),或口唇,指甲發(fa)紺等癥狀基本消失,查體雙肺哮鳴(ming)音(yin)及其濕(shi)羅音(yin)已無。有(you)效治(zhi)療7---28天(tian)(tian)后,呼(hu)(hu)吸(xi)困難,呼(hu)(hu)吸(xi)短促急(ji)迫(po),喉中有(you)哮鳴(ming)音(yin),甚則(ze)張口抬(tai)肩(jian),不能(neng)平(ping)臥(wo),或口唇,指甲發(fa)紺有(you)所(suo)緩解,查體雙肺哮鳴(ming)音(yin)已無,有(you)少量(liang)的(de)濕(shi)羅音(yin)。無效治(zhi)療7---28呼(hu)(hu)吸(xi)困難,呼(hu)(hu)吸(xi)短促急(ji)迫(po),喉中有(you)哮鳴(ming)音(yin),甚則(ze)張口抬(tai)肩(jian),不能(neng)平(ping)臥(wo),或口唇,指甲發(fa)紺等癥狀無改善,查體雙肺布滿(man)哮鳴(ming)音(yin)及其大量(liang)的(de)濕(shi)羅音(yin),個別患者加重,無效的(de)送往市級醫(yi)院專(zhuan)科治(zhi)療。
b)治療結果
顯效(xiao)(xiao)35例,占(zhan)61.4%,有效(xiao)(xiao)17例,占(zhan)29.8%,無效(xiao)(xiao)5例,占(zhan)8.8%,總有效(xiao)(xiao)率為91.2%。
5 典型病例
患者(zhe),王某(mou),女,39歲,農(nong)民,2012年4月21日就診,患者(zhe)自訴以(yi)往有(you)反復(fu)發(fa)作性(xing)呼(hu)吸(xi)(xi)(xi)困難(nan)(nan)病史,近(jin)幾日由(you)于油菜花(hua)的(de)刺激,感覺呼(hu)吸(xi)(xi)(xi)困難(nan)(nan),沒在意在加上昨(zuo)晚受涼(liang),自己感覺鼻塞,呼(hu)吸(xi)(xi)(xi)困難(nan)(nan)喉(hou)中哮(xiao)鳴(ming)聲如吼,氣(qi)粗息涌,胸高(gao)肋脹,咳促陣(zhen)發(fa),咳痰色黃(huang)或色白,痰粘(zhan)稠,咳痰不爽,煩躁,汗出,面赤,口(kou)苦(ku)咽干,口(kou)渴欲飲,查(cha)體,雙(shuang)肺布滿哮(xiao)鳴(ming)音及其大(da)量的(de)濕羅(luo)音,舌(she)紅苔(tai)黃(huang),脈(mo)象滑數。急查(cha)胸部X 線片(pian)提示,兩肺透(tou)亮度增(zeng)加,呈(cheng)過度充氣(qi)狀(zhuang)態,可見肺紋理(li)增(zeng)粗及炎性(xing)浸(jin)潤(run)陰影。辯(bian)證(zheng)類(lei)型屬于熱(re)性(xing)哮(xiao)喘證(zheng),病及概要:由(you)于痰熱(re)壅(yong)盛,壅(yong)滯(zhi)氣(qi)道,肺失(shi)清肅,而肺氣(qi)上逆導致肺部大(da)量哮(xiao)鳴(ming)音及濕羅(luo)音。治(zhi)療(liao)方(fang)法(fa)為:宣(xuan)肺降氣(qi),祛痰平喘,給予定喘湯加減(jian)(jian)(jian)治(zhi)療(liao),方(fang)藥:白果(guo)10g,麻(ma)黃(huang)10g,蘇(su)子10g,甘草(cao)(cao)6g,款冬(dong)花(hua)10g,杏(xing)仁(ren)(ren)15g,桑白皮10g,黃(huang)芩(qin)10g,半夏10g。膽(dan)南星10g,海蛤(ha)殼10g,瓜(gua)蔞10g,魚(yu)腥草(cao)(cao)10g,生石(shi)膏(先煎)15g金(jin)銀花(hua)10g,知母10g,大(da)黃(huang)(后下)10g,冬(dong)瓜(gua)仁(ren)(ren)15g,葶藶子15g,廣(guang)地龍10g。服藥7天后,呼(hu)吸(xi)(xi)(xi)困難(nan)(nan),呼(hu)吸(xi)(xi)(xi)短促急迫,喉(hou)中有(you)哮(xiao)鳴(ming)音,甚則張口(kou)抬(tai)肩(jian),不能(neng)平臥,或口(kou)唇(chun)(chun),指(zhi)甲(jia)(jia)發(fa)紺(gan)明顯(xian)減(jian)(jian)(jian)輕,連服2個療(liao)程(cheng)后呼(hu)吸(xi)(xi)(xi)困難(nan)(nan),呼(hu)吸(xi)(xi)(xi)短促急迫,喉(hou)中有(you)哮(xiao)鳴(ming)音,甚則張口(kou)抬(tai)肩(jian),不能(neng)平臥,或口(kou)唇(chun)(chun),指(zhi)甲(jia)(jia)發(fa)紺(gan)等癥狀(zhuang)基本消失(shi),之后按原方(fang)加減(jian)(jian)(jian)服用3個療(liao)程(cheng)后,呼(hu)吸(xi)(xi)(xi)困難(nan)(nan),呼(hu)吸(xi)(xi)(xi)短促急迫,喉(hou)中有(you)哮(xiao)鳴(ming)音,甚則張口(kou)抬(tai)肩(jian),不能(neng)平臥,或口(kou)唇(chun)(chun),指(zhi)甲(jia)(jia)發(fa)紺(gan)等癥狀(zhuang)完(wan)全消失(shi),病情(qing)明顯(xian)好轉,隨訪至今未復(fu)發(fa)。
6 討論
哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)是(shi)經常反復發(fa)作(zuo)性的疾病,乃(nai)宿(su)痰(tan)(tan)(tan)伏于(yu)肺(fei)(fei)(fei)(fei),復因(yin)(yin)外(wai)感(gan)(gan),情志,飲(yin)(yin)食(shi),勞(lao)倦等因(yin)(yin)素(su),以(yi)(yi)致痰(tan)(tan)(tan)阻(zu)氣(qi)(qi)(qi)道,肺(fei)(fei)(fei)(fei)失肅降(jiang),肺(fei)(fei)(fei)(fei)氣(qi)(qi)(qi)上(shang)逆而(er)(er)發(fa),病因(yin)(yin)一(yi)般有主(zhu)(zhu)因(yin)(yin)與誘(you)因(yin)(yin)之(zhi)(zhi)(zhi)(zhi)分,主(zhu)(zhu)因(yin)(yin)為(wei)(wei)(wei)宿(su)痰(tan)(tan)(tan)內(nei)(nei)于(yu)肺(fei)(fei)(fei)(fei),屢感(gan)(gan)風寒(han),失于(yu)解(jie)表,則寒(han)邪(xie)深入肺(fei)(fei)(fei)(fei)系,或(huo)常飲(yin)(yin)食(shi)生(sheng)(sheng)冷(leng),傷(shang)(shang)及肺(fei)(fei)(fei)(fei)氣(qi)(qi)(qi),津液不(bu)布(bu),凝(ning)(ning)結(jie)(jie)成(cheng)寒(han)痰(tan)(tan)(tan),內(nei)(nei)伏于(yu)肺(fei)(fei)(fei)(fei),或(huo)飲(yin)(yin)食(shi)酸咸肥甘太(tai)過,助熱(re)生(sheng)(sheng)痰(tan)(tan)(tan),或(huo)寒(han)痰(tan)(tan)(tan)內(nei)(nei)郁,日久(jiu)化熱(re),或(huo)病后傷(shang)(shang)陰及素(su)體(ti)陽盛(sheng)者,痰(tan)(tan)(tan)熱(re)膠固,內(nei)(nei)伏于(yu)肺(fei)(fei)(fei)(fei),凝(ning)(ning)集(ji)成(cheng)痰(tan)(tan)(tan),痰(tan)(tan)(tan)的產生(sheng)(sheng)責之(zhi)(zhi)(zhi)(zhi)于(yu)肺(fei)(fei)(fei)(fei)不(bu)能宣降(jiang)津液,脾不(bu)能轉輸(shu)精(jing)微,腎不(bu)能氣(qi)(qi)(qi)化津液,以(yi)(yi)致津液凝(ning)(ning)聚成(cheng)痰(tan)(tan)(tan),伏藏于(yu)肺(fei)(fei)(fei)(fei),成(cheng)為(wei)(wei)(wei)哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)證發(fa)生(sheng)(sheng)的“夙(su)根”。誘(you)因(yin)(yin)為(wei)(wei)(wei)本病以(yi)(yi)宿(su)痰(tan)(tan)(tan)為(wei)(wei)(wei)主(zhu)(zhu)因(yin)(yin),為(wei)(wei)(wei)“夙(su)根”而(er)(er)誘(you)因(yin)(yin)則較為(wei)(wei)(wei)復雜,多(duo)與外(wai)邪(xie),飲(yin)(yin)食(shi),煙(yan)霧(wu),異味刺激,花粉,粉塵(chen)吸入,勞(lao)倦,精(jing)神因(yin)(yin)素(su)等皆有關(guan)聯(lian)。每遇(yu)氣(qi)(qi)(qi)候變化,外(wai)邪(xie)侵犯,飲(yin)(yin)食(shi)不(bu)當,飲(yin)(yin)食(shi)失調(diao)(diao),勞(lao)累等誘(you)因(yin)(yin)的影響,均可(ke)(ke)誘(you)導“夙(su)根”引起哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)發(fa)作(zuo),其(qi)病機(ji)主(zhu)(zhu)要(yao)(yao)是(shi)誘(you)因(yin)(yin)觸發(fa)宿(su)痰(tan)(tan)(tan),痰(tan)(tan)(tan)隨氣(qi)(qi)(qi)升(sheng),氣(qi)(qi)(qi)因(yin)(yin)痰(tan)(tan)(tan)阻(zu),相互(hu)搏(bo)結(jie)(jie),阻(zu)塞氣(qi)(qi)(qi)道,肺(fei)(fei)(fei)(fei)管狹(xia)窄,通(tong)(tong)暢不(bu)利,痰(tan)(tan)(tan)氣(qi)(qi)(qi)搏(bo)擊(ji),而(er)(er)出現(xian)呼吸急促,喉(hou)中哮(xiao)(xiao)(xiao)(xiao)鳴之(zhi)(zhi)(zhi)(zhi)聲(sheng)(sheng)。《素(su)問.陰陽別論(lun)篇》曰(yue):“起則熏肺(fei)(fei)(fei)(fei),使人(ren)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)鳴”,僅有哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)病的發(fa)作(zuo)特點(dian)的描(miao)述(shu)。《金(jin)貴要(yao)(yao)略.肺(fei)(fei)(fei)(fei)痿(wei)肺(fei)(fei)(fei)(fei)癰咳嗽上(shang)氣(qi)(qi)(qi)篇》:“咳而(er)(er)上(shang)氣(qi)(qi)(qi),喉(hou)中水雞(ji)聲(sheng)(sheng),定喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)湯(tang)主(zhu)(zhu)之(zhi)(zhi)(zhi)(zhi)。”描(miao)述(shu)了哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)病發(fa)作(zuo)時(shi)的典(dian)型癥狀,提出治(zhi)(zhi)療方法。《丹(dan)溪心(xin)法.哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)》曰(yue):“哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)必用薄滋味,專注(zhu)于(yu)痰(tan)(tan)(tan)。”元朱丹(dan)溪首創哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)之(zhi)(zhi)(zhi)(zhi)名(ming)。明虞博《醫學正傳.哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)》曰(yue):“哮(xiao)(xiao)(xiao)(xiao)以(yi)(yi)聲(sheng)(sheng)響名(ming),喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)以(yi)(yi)氣(qi)(qi)(qi)息名(ming)。”“夫喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)促喉(hou)中如水雞(ji)聲(sheng)(sheng)者,謂(wei)之(zhi)(zhi)(zhi)(zhi)哮(xiao)(xiao)(xiao)(xiao),氣(qi)(qi)(qi)促而(er)(er)連續不(bu)能以(yi)(yi)息者,謂(wei)之(zhi)(zhi)(zhi)(zhi)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)。”始終把哮(xiao)(xiao)(xiao)(xiao)證與喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)證區分為(wei)(wei)(wei)二證。張景(jing)岳在《景(jing)岳全書.喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)促》曰(yue):“喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)有夙(su)根,遇(yu)寒(han)即(ji)發(fa),或(huo)遇(yu)熱(re)發(fa)著(zhu)為(wei)(wei)(wei)熱(re)性哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)。未發(fa)時(shi)扶正為(wei)(wei)(wei)主(zhu)(zhu),既(ji)發(fa)時(shi)以(yi)(yi)攻邪(xie)為(wei)(wei)(wei)主(zhu)(zhu)”。強(qiang)調(diao)(diao)緩解(jie)時(shi)治(zhi)(zhi)其(qi)本,以(yi)(yi)扶正為(wei)(wei)(wei)主(zhu)(zhu),發(fa)作(zuo)時(shi)治(zhi)(zhi)其(qi)表,以(yi)(yi)祛邪(xie)為(wei)(wei)(wei)主(zhu)(zhu)。而(er)(er)本方定喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)湯(tang)治(zhi)(zhi)當宣肺(fei)(fei)(fei)(fei)以(yi)(yi)散(san)(san)外(wai)邪(xie),降(jiang)氣(qi)(qi)(qi)祛痰(tan)(tan)(tan)以(yi)(yi)平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)咳。方中麻黃(huang)宣肺(fei)(fei)(fei)(fei)平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan),散(san)(san)風寒(han),白(bai)果斂肺(fei)(fei)(fei)(fei)定喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan),化痰(tan)(tan)(tan)濁,二藥(yao)(yao)配伍,一(yi)散(san)(san)一(yi)收,既(ji)可(ke)(ke)加強(qiang)平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)之(zhi)(zhi)(zhi)(zhi)功(gong),又可(ke)(ke)防止麻黃(huang)發(fa)散(san)(san)太(tai)過,耗散(san)(san)肺(fei)(fei)(fei)(fei)氣(qi)(qi)(qi),共(gong)為(wei)(wei)(wei)君藥(yao)(yao),蘇子,杏(xing)仁,款冬花,半(ban)夏降(jiang)氣(qi)(qi)(qi)平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan),化痰(tan)(tan)(tan)止咳,同為(wei)(wei)(wei)臣藥(yao)(yao),黃(huang)芩,桑(sang)白(bai)皮清(qing)肺(fei)(fei)(fei)(fei)泄(xie)熱(re),降(jiang)氣(qi)(qi)(qi)平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan),為(wei)(wei)(wei)佐藥(yao)(yao),甘草調(diao)(diao)和諸藥(yao)(yao),為(wei)(wei)(wei)使藥(yao)(yao)。膽(dan)南星,海蛤殼,瓜蔞以(yi)(yi)增強(qiang)清(qing)熱(re)化痰(tan)(tan)(tan)之(zhi)(zhi)(zhi)(zhi)力(li),魚腥草,生(sheng)(sheng)石(shi)膏,金(jin)銀花,知(zhi)母以(yi)(yi)清(qing)肺(fei)(fei)(fei)(fei)熱(re),大黃(huang),冬瓜仁以(yi)(yi)通(tong)(tong)臟(zang)(zang)腑(fu)宣肺(fei)(fei)(fei)(fei),葶(ting)藶子,廣(guang)地(di)龍清(qing)痰(tan)(tan)(tan)瀉(xie)壅平(ping)(ping)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)。諸藥(yao)(yao)合用,散(san)(san)中有升(sheng),降(jiang)中有宣,使臟(zang)(zang)腑(fu)之(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi)外(wai)散(san)(san),,痰(tan)(tan)(tan)熱(re)內(nei)(nei)清(qing),肺(fei)(fei)(fei)(fei)氣(qi)(qi)(qi)得以(yi)(yi)宣降(jiang),則哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)可(ke)(ke)平(ping)(ping)。為(wei)(wei)(wei)治(zhi)(zhi)療哮(xiao)(xiao)(xiao)(xiao)喘(chuan)(chuan)(chuan)(chuan)(chuan)(chuan)之(zhi)(zhi)(zhi)(zhi)要(yao)(yao)方,療效顯著(zhu),毒副作(zuo)用小,值得臨床推廣(guang)應用。
參考文獻
[1] 姚軍漢,陳兆修,程桂(gui)真. 中醫(yi)內科(ke)學【M】.1版(ban).西安(an):第四軍醫(yi)大學出(chu)版(ban)社,2005.08:48-52.
[2] 吳紅彥,周天(tian)寒,汪 欣(xin).方劑(ji)學【M】.1版.北京:高等教育出版社,2006.01:157-158
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