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溫通復脈湯

醫案(an)日記 2023-06-15 07:19:50

組成:黨參10-15克(ke),黃(huang)芪10-15克(ke),柴胡10克(ke),干姜10克(ke),升麻(ma)10克(ke),肉桂1.5-3克(ke)(后下),白術10克(ke),當歸10克(ke),陳皮10克(ke),凈麻(ma)黃(huang)3-6克(ke),細辛3-6克(ke),制附(fu)子10克(ke),炙(zhi)甘草10克(ke)。

功能:益氣(qi)補陽,溫(wen)經散寒(han),提高脈率。

主治(zhi):緩慢性心(xin)律失常,包(bao)括以心(xin)動過(guo)緩為(wei)表現的病(bing)態竇(dou)房結綜合(he)征,可以加速傳導,提(ti)高脈率(lv),改善(shan)虛寒(han)證候。

用法:水煎(jian)服(fu),每日1劑;也(ye)可制成丸(wan)劑服(fu)用,每日3次(ci),每次(ci)3克。

加減(jian)運用:溫而(er)無燥,口干者可伍(wu)石斛(hu)30克(ke)、知(zhi)母(mu)、黃柏(bo)各6-10克(ke),以制其燥,欲其溫陽益氣而(er)不助火;有血瘀征象(xiang)者,可加雞(ji)血藤30克(ke)、川芎10克(ke)以活血通瘀;有咽干、牙痛“上火”征象(xiang),不宜用大辛(xin)大熱藥(yao)(yao)者,藥(yao)(yao)量(liang)酌減(jian)。或以巴戟天10克(ke)、仙靈脾30克(ke)、補骨脂12克(ke)溫潤藥(yao)(yao)取代肉桂(gui)、附(fu)子(zi)及麻黃。尤其久服者,更應(ying)注意陰(yin)陽寒熱消(xiao)長情況(kuang)。

經驗體會:眩暈(yun)或暈(yun)厥發作(zuo),心率減(jian)慢,可以(yi)“生脈、四逆濃縮煎劑”30毫升服用(相(xiang)當(dang)于常用量中藥一劑);畏冷(leng)明顯,脈沉者(zhe),肉(rou)桂末1.5克沖服,一日(ri)2-3次(ci);惡心、心悸等痰飲(yin)征象,可伍用苓桂術甘湯(tang);血壓(ya)高且(qie)有頭暈(yun)、頭痛(tong)、肢麻癥(zheng)狀者(zhe),可酌加珍珠母30克、葛(ge)根12克、菊花12克;心悸、腹(fu)脹(zhang)者(zhe),可配(pei)合灸上脘(wan)、中脘(wan)、足三里、三陰交等穴。

附:陳可冀簡介

陳(chen)可冀,男(nan),漢(han)族,1930年(nian)10月20日(ri)生(sheng),福建(jian)(jian)省福州市(shi)人;1954年(nian)畢業于(yu)(yu)福建(jian)(jian)醫(yi)(yi)(yi)(yi)學(xue)院,中(zhong)(zhong)國中(zhong)(zhong)醫(yi)(yi)(yi)(yi)研究院建(jian)(jian)院初(chu)期奉(feng)調來京(jing);曾(ceng)隨(sui)名醫(yi)(yi)(yi)(yi)冉雪(xue)峰、岳美中(zhong)(zhong)、趙錫武系統學(xue)習中(zhong)(zhong)醫(yi)(yi)(yi)(yi)和臨癥多(duo)年(nian),學(xue)而(er)有(you)成,融為一(yi)體;后(hou)畢業于(yu)(yu)北(bei)京(jing)市(shi)第一(yi)屆西(xi)(xi)醫(yi)(yi)(yi)(yi)學(xue)習中(zhong)(zhong)醫(yi)(yi)(yi)(yi)班,獲(huo)北(bei)京(jing)市(shi)在職(zhi)西(xi)(xi)醫(yi)(yi)(yi)(yi)學(xue)中(zhong)(zhong)醫(yi)(yi)(yi)(yi)一(yi)等獎,為我國第一(yi)代中(zhong)(zhong)西(xi)(xi)醫(yi)(yi)(yi)(yi)結合醫(yi)(yi)(yi)(yi)學(xue)家。

陳(chen)可冀院(yuan)士長期(qi)致(zhi)力于中(zhong)(zhong)西(xi)醫(yi)(yi)(yi)(yi)結(jie)(jie)合(he)防(fang)治心(xin)血(xue)管(guan)病及(ji)老(lao)年(nian)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)的臨(lin)床和(he)基礎研(yan)究(jiu),系我國(guo)(guo)(guo)著名(ming)心(xin)臟(zang)病學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)家(jia)(jia)和(he)老(lao)年(nian)病學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)家(jia)(jia)、中(zhong)(zhong)國(guo)(guo)(guo)中(zhong)(zhong)醫(yi)(yi)(yi)(yi)研(yan)究(jiu)院(yuan)首席研(yan)究(jiu)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)、西(xi)苑(yuan)醫(yi)(yi)(yi)(yi)院(yuan)內科(ke)教(jiao)授(shou),世界衛生(sheng)組織傳統醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)顧問,北京(jing)大學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)部(bu)兼職(zhi)(zhi)教(jiao)授(shou)、北京(jing)大學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)中(zhong)(zhong)醫(yi)(yi)(yi)(yi)藥現代研(yan)究(jiu)中(zhong)(zhong)心(xin)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)術委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)會(hui)(hui)主任;1991年(nian)當選為中(zhong)(zhong)國(guo)(guo)(guo)科(ke)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)院(yuan)院(yuan)士(學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)部(bu)委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan));現并(bing)任中(zhong)(zhong)央(yang)保(bao)健委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)會(hui)(hui)專(zhuan)家(jia)(jia)組成員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)、國(guo)(guo)(guo)務(wu)院(yuan)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)位委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)會(hui)(hui)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)科(ke)評議組成員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)、中(zhong)(zhong)國(guo)(guo)(guo)中(zhong)(zhong)西(xi)醫(yi)(yi)(yi)(yi)結(jie)(jie)合(he)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)會(hui)(hui)會(hui)(hui)長等職(zhi)(zhi);國(guo)(guo)(guo)家(jia)(jia)中(zhong)(zhong)醫(yi)(yi)(yi)(yi)藥管(guan)理局專(zhuan)家(jia)(jia)咨(zi)詢(xun)委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)會(hui)(hui)委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan),國(guo)(guo)(guo)家(jia)(jia)新藥協調領導小組顧問,國(guo)(guo)(guo)家(jia)(jia)藥典委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan),中(zhong)(zhong)國(guo)(guo)(guo)科(ke)協榮譽委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan),中(zhong)(zhong)國(guo)(guo)(guo)老(lao)年(nian)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)會(hui)(hui)名(ming)譽會(hui)(hui)長,中(zhong)(zhong)華醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)會(hui)(hui)常務(wu)理事(shi)及(ji)老(lao)年(nian)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)分會(hui)(hui)主任委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)。為第七、八屆全國(guo)(guo)(guo)政協委(wei)(wei)員(yuan)(yuan)(yuan)(yuan)(yuan)(yuan)。目(mu)前從事(shi)的研(yan)究(jiu)領域主要是心(xin)腦血(xue)管(guan)疾(ji)病和(he)老(lao)年(nian)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)的研(yan)究(jiu),以及(ji)中(zhong)(zhong)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)與西(xi)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)的結(jie)(jie)合(he)醫(yi)(yi)(yi)(yi)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)學(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)科(ke)建(jian)設研(yan)究(jiu)。

陳可(ke)冀(ji)院士(shi)在(zai)中(zhong)(zhong)(zhong)(zhong)(zhong)西醫(yi)結合治(zhi)療(liao)心血(xue)(xue)管(guan)病(bing)(bing)研(yan)(yan)(yan)(yan)究(jiu)(jiu)和(he)老(lao)年(nian)(nian)醫(yi)學(xue)研(yan)(yan)(yan)(yan)究(jiu)(jiu)方面取得卓著(zhu)(zhu)成就,成功研(yan)(yan)(yan)(yan)制了(le)冠心 II號方;在(zai)我國(guo)最(zui)(zui)早應(ying)用川芎嗪(Ligustrazine)治(zhi)療(liao)缺血(xue)(xue)性(xing)腦血(xue)(xue)管(guan)病(bing)(bing),并研(yan)(yan)(yan)(yan)究(jiu)(jiu)其(qi)抗血(xue)(xue)小(xiao)板及(ji)血(xue)(xue)栓素A2現代(dai)藥(yao)理,研(yan)(yan)(yan)(yan)究(jiu)(jiu)赤芍甙、去甲烏(wu)藥(yao)堿(jian)(jian)、元胡堿(jian)(jian)在(zai)心血(xue)(xue)管(guan)疾病(bing)(bing)治(zhi)療(liao)中(zhong)(zhong)(zhong)(zhong)(zhong)的應(ying)用;最(zui)(zui)近10年(nian)(nian)研(yan)(yan)(yan)(yan)究(jiu)(jiu)活血(xue)(xue)化(hua)淤方藥(yao)防治(zhi)冠脈(mo)介入治(zhi)療(liao)后(hou)(hou)(hou)再狹窄的作(zuo)用及(ji)其(qi)分子(zi)機(ji)理取得顯著(zhu)(zhu)進(jin)展;研(yan)(yan)(yan)(yan)究(jiu)(jiu)整理清代(dai)宮(gong)(gong)廷原始醫(yi)藥(yao)檔(dang)案(an)(an)3萬余(yu)件(jian),填補了(le)我國(guo)清代(dai)宮(gong)(gong)廷醫(yi)史研(yan)(yan)(yan)(yan)究(jiu)(jiu)的空白。先(xian)(xian)后(hou)(hou)(hou)獲(huo)(huo)國(guo)家(jia)級(ji)(ji)及(ji)部級(ji)(ji)成果獎(jiang)12項,1989年(nian)(nian)獲(huo)(huo)愛因(yin)斯坦世界(jie)科學(xue)獎(jiang),1994年(nian)(nian)獲(huo)(huo)立夫(fu)中(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)藥(yao)學(xue)術(shu)獎(jiang),2001年(nian)(nian)獲(huo)(huo)“求是”杰出(chu)(chu)貢獻優秀集體獎(jiang)(中(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)藥(yao)現代(dai)化(hua)研(yan)(yan)(yan)(yan)究(jiu)(jiu));2002年(nian)(nian)獲(huo)(huo)何梁何利科技進(jin)步獎(jiang);主編了(le)《心腦血(xue)(xue)管(guan)疾病(bing)(bing)研(yan)(yan)(yan)(yan)究(jiu)(jiu)》、《血(xue)(xue)瘀證(zheng)與活血(xue)(xue)化(hua)瘀研(yan)(yan)(yan)(yan)究(jiu)(jiu)》、《中(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)藥(yao)臨床驗案(an)(an)范(fan)例(li)》、《抗衰(shuai)老(lao)中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)學(xue)》、《老(lao)年(nian)(nian)醫(yi)學(xue)在(zai)中(zhong)(zhong)(zhong)(zhong)(zhong)國(guo)》、《中(zhong)(zhong)(zhong)(zhong)(zhong)國(guo)傳統康復醫(yi)學(xue)》及(ji)《清宮(gong)(gong)醫(yi)案(an)(an)研(yan)(yan)(yan)(yan)究(jiu)(jiu)》等(deng)10余(yu)種專(zhuan)著(zhu)(zhu),發(fa)表(biao)論(lun)文240余(yu)篇;為國(guo)家(jia)培養(yang)博士(shi)、博士(shi)后(hou)(hou)(hou)、碩士(shi)60人次,先(xian)(xian)后(hou)(hou)(hou)出(chu)(chu)國(guo)訪問(wen)及(ji)參加學(xue)術(shu)會議(yi)約40余(yu)次,為促進(jin)中(zhong)(zhong)(zhong)(zhong)(zhong)西醫(yi)結合、中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)走(zou)向世界(jie)作(zuo)出(chu)(chu)貢獻。

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