蒋家道临证运用麻黄连翘赤小豆汤经验

蒋家道主任医师 ,临证善用经方治疗疑难杂证。现将其运用仲景之麻黄连翘赤小豆汤临证经验介绍如下。1　鼻衄患者 ,男 ,32岁。 1997年 4月 2 0日就诊。既往患有肝炎病史。近 1年来 ,体检发现ＨＢｓＡｇ阳性 ,肝功能 :谷丙转氨酶偏高 ( 6 0～ 72ｕ) ,其余各项指标正常。 5ｄ前 ,无明显诱因而鼻中出血 ,色鲜红 ,无血块 ,无鼻腔干燥热感 ,无口干、口臭、口苦 ,无烦渴引饮 ,无心悸、头晕 ,经在其他医院运用冷敷、鼻腔填塞及中医凉血止血、疏肝解郁、清泄肝胆湿热之剂合保肝药物治疗后 ,疗效不显 ,遂来就诊。刻诊 :鼻中出血 ,色鲜红 ,时有牙龈出…     

心律失常经方方证对应论治体悟

在方证对应原则指导下,运用经方治疗心悸取得良好疗效。并举验案2则以说明。     

加味麻黄连翘赤小豆汤治疗皮肤病临床举隅

麻黄连翘赤小豆汤出自《伤寒论》262条：“伤寒,瘀热在里,身必黄,麻黄连翘赤小豆汤主之。”由麻黄、连翘、杏仁、赤小豆、大枣、生梓白皮、生姜、甘草组成,现在常以桑白皮代生梓自皮,此方能解表散邪,清热除湿退黄,在《伤寒论》、《金匮要略》中用治外有表邪,内有湿热的黄疸、水肿等病。笔者在临床用之于皮肤科疾病,举隅如下。     

麻黄连翘赤小豆汤治疗皮肤病经验及其方证归纳

<正>麻黄连翘赤小豆汤的条文在《伤寒论》中仅一条(第262):"伤寒瘀热在里,身必发黄,麻黄连翘赤小豆主之。"该条为承接第259条起论述黄疸病之阳黄证之一。一般黄疸病因责之湿,无湿不成黄,黄色为土之主色,病位核心是脾胃。湿去途径无非气化后从汗走或从尿利。湿邪亦为皮肤病的常见病因,故该方在皮肤病治疗中运用广泛。据聂惠民先生主编的《长沙方歌括白话解》引证,后世麻黄连翘赤小豆汤的运用一般在内科的肾系、肝系病谱上。笔者从事中医皮肤病临床     

麻黄连翘赤小豆汤应用于荨麻疹的理论探讨与临床体会

麻黄连翘赤小豆汤出自《伤寒论》,广泛应用于临床各种疾病,尤其是皮肤病的治疗.本文对其应用于荨麻疹的理论进行了较为详尽的论述,并阐述了临床应用的经验与体会,其临床疗效有待规范的前瞻性临床研究进一步评价.     

麻黄连翘赤小豆汤治疗皮肤瘙痒症2例

皮肤瘙痒症是一种自觉瘙痒而临床上无原发损害的皮肤病,属中医“痒风”的范畴。麻黄连翘赤小豆汤中麻黄含有的麻黄碱有拟肾上腺素样效应,可以抑制组胺的释放,具有明显的抗过敏作用。张焱等利用外源性组胺和右旋糖酐诱导释放内源性组胺的动物瘙痒模型也证实了本方有显著的止痒作用。刘公望教授临床运用本方收效良验,现摘录两则报告如下。     

李萍运用麻黄连翘赤小豆汤加味治疗皮肤病医案举隅

麻黄连翘赤小豆汤源自张仲景《伤寒论》262条,文中云[1]:"伤寒瘀热在里,身必黄,麻黄连翘赤小豆汤主之。"在《伤寒论》中用于阳黄兼表不解者。临床上凡见身目俱黄,黄色鲜明如橘色者,小便黄而短少,并兼有恶寒发热,无汗身痒,舌苔白或黄腻,脉浮数者,即可选用麻黄连翘赤小豆汤治     

刘爱民教授妙用麻黄连翘赤小豆汤治疗皮肤病验案举隅

刘爱民教授从医30余年,治疗皮肤病效果卓著。麻黄连翘赤小豆汤在皮肤病的治疗中应用颇为广泛,然导师刘教授辨证施治,不拘于病,对麻黄连翘赤小豆汤的应用更是有其独到之处。笔者有幸侍诊于旁,时常有所感悟,现将刘教授使用麻黄连翘赤小豆汤治疗皮肤病的验案整理如下。1红皮病型银屑病案王某,男,62岁,2013年2月18日收治入院。主诉:全身反复红斑、鳞屑30年,加重1周,以红皮病型银屑病为     

《伤寒论》麻黄连翘赤小豆汤之湿热兼表与瘀热在里证辨析

辨析《伤寒论》麻黄连翘赤小豆汤证湿热兼表与瘀热在里的病机特点及药物配伍规律,阐述其理论内涵。     

麻黄连翘赤小豆汤治疗皮肤病验案举隅

麻黄连翘赤小豆汤出自《伤寒论·辨阳明病脉证并治》第262条：“伤寒瘀热在里,身必黄,麻黄连轺赤小豆汤主之。”湿热发黄无表里证,热者清之,小便不利者利之,里实者下之,表实者汗之,皆无非为病求去路也。方中以麻黄汤开其表,使黄从外而散;去桂枝者,避其热也;佐姜、枣者,和其营卫也;加连轺、桑白皮以泻其热,赤小豆以利其湿,共成治表实发黄之效也。连轺,即连翘根。无桑白皮则以茵陈代之。笔者临床将麻黄连翘赤小豆汤用于治疗荨麻疹、湿疹、日光性皮炎、多形红斑等,每获佳效。现结合案例介绍如下。     

麻黄连翘赤小豆汤加减治疗急性肾小球肾炎临床观察

目的:观察中药治疗急性肾小球肾炎(AGN)的临床疗效。方法:将符合标准的84例患者分为两组,对照组(41例)采用西医治疗,观察组(43例)加用麻黄连翘赤小豆汤加减治疗。结果:观察组和对照组治愈率分别为88.37%、70.73%,总有效率分别为100%、90.24%,组间比较,差异均有统计学意义(P<0.05)。观察组水肿、血尿、蛋白尿消失时间均少于对照组,组间比较,差异均有统计学意义(P<0.05)。结论:麻黄连翘赤小豆汤加减联合西药治疗AGN,临床疗效优于单纯西医治疗。     

麻黄连翘赤小豆汤对特应性皮炎小鼠皮肤组织PAR-2、TRPA1表达的影响

目的:探讨麻黄连翘赤小豆汤对特应性皮炎(AD)小鼠皮损修复及PAR-2、TRPA1的表达的影响.方法:选用SPF级雄性BALB/c小鼠48只,随机分为正常组、模型组、激素组、中药组.除正常组外,各组用2,4二硝基氟苯(DNFB)诱导AD模型.造模后模型组给予皮炎平外抹,中药组给予麻黄连翘赤小豆汤灌胃,其余均给予等量蒸馏...     

采用网络药理学和分子对接技术研究麻黄连翘赤小豆汤治疗湿疹的作用机制

通过网络药理学和分子对接的方法研究麻黄连翘赤小豆汤治疗湿疹(eczema)的作用机制.首先利用TCMSP数据库挖掘麻黄连翘赤小豆汤中各个药物的活性成分并预测其作用靶点,借用Uniprot数据库将靶点蛋白名称标准化.然后通过GeneCards,OMIM,PharmGkb,DrugBank等数据库获得湿疹的疾病靶点.取药物...     

麻黄连翘赤小豆汤加味治疗慢性肾炎的临床观察

目的观察麻黄连翘赤小豆汤加味治疗慢性肾炎的临床疗效。方法将91例慢性肾炎患者随机分为2组,治疗组51例采用麻黄连翘赤小豆汤加味治疗,对照组40例服用黄葵胶囊治疗,疗程3个月。结果治疗组临床总疗效显著优于对照组(P<0.01):治疗组24h尿蛋白定量、血浆白蛋白、免疫球蛋白IgG、IgA、补体C_3改善优于对照组(P<0.05,P<0.01)。结论麻黄连翘赤小豆汤加味能够显著改善慢性肾炎患者的临床症状,减少尿蛋白,提高血浆白蛋白和体液免疫。     

麻黄连翘赤小豆汤结合针灸治疗变应性鼻炎61例临床观察

目的:观察麻黄连翘赤小豆汤结合针灸治疗变应性鼻炎(allergic rhinitis,AR)的临床疗效及对血清Thl/Th2的调节作用和对Ig E水平的影响。方法:将121例中、重度持续性AR患者采用随机按数字表法分为对照组60例和观察组61例。对照组采用布地奈德气雾剂,200~1 600μg·d-1,可于早晨1次喷入或早晚分2次喷入,和口服地氯雷他定片,10 mg·d-1;观察组采用麻黄连翘赤小豆汤联合针灸治疗。两组疗程均为14 d。评价治疗前后鼻塞、鼻痒、喷嚏、流涕4个主要症状及相关伴随症状评分;采用鼻黏膜炎生命质量调查问卷(RQLQ)评价患者生活质量;检测治疗前后血清总Ig E水平(T Ig E),γ-干扰素(IFN-γ),细胞介素-2(IL-2),白细胞介素-4(IL-4),白细胞介素-5(IL-5)水平。结果:治疗后观察组鼻塞、喷嚏、流涕和伴随症状评分低于对照组(P0.05,P0.01);治疗后观察组非鼻眼症状、鼻部症状、眼部症状及RQLQ量表总分均低于对照组(P0.05,P0.01);治疗后观察组IFN-γ和IL-2水平高于对照组,IL-5和T Ig E水平低于对照组(P0.01)。结论:麻黄连翘赤小豆汤结合针灸能有效控制中-重度持续性AR患者的临床症状,提高患者生活质量,其作用机制可能通过调节Thl/Th2细胞因子,降低血清Ig E水平来实现的。     

Intervention of the Mahuang Lianqiao Chixiaodou decoction on immune imbalance in atopic dermatitis-like model mice

ObjectiveTo explore the potential mechanism of intervention on the immune imbalance of atopic dermatitis (AD) by studying the effects of Mahuang Lianqiao Chixiaodou decoction (MLCD) on skin damage and inflammation factors in an AD-like mouse model.MethodsNinety-six male BALB/c mice were divided into normal, model, positive control (mometasone furoate), and traditional Chinese medicine treatment (MLCD) groups by a random number table. 2,4-dinitrofluorobenzene was used to induce AD-like mice in all groups except the normal group. The treatment or intervention was administered for seven consecutive days on days 4, 18, 32, and 39. The mRNA relative expressions of interleukin-4 (IL-4), IL-10, interferon-γ (IFN-γ), thymic stromal lymphopoietin (TSLP), and the TSLP receptor (TSLPR) were measured using quantitative real-time polymerase chain reaction, and the serum immunoglobulin E, IL-4, IL-10, and IFN-γ levels were detected using enzyme-linked immunosorbent assay.ResultsCompared with the normal group, the hematoxylin-eosin staining of the skin lesions of the mice in the model group was significantly thickened on days 11, 25, and 39. Compared with the model group, the epidermal thickness of the positive control group was significantly alleviated on day 39 (P < .001), and that of the MLCD group was significantly improved on days 25 and 39 (P < .001). Compared with the four observation time points, MLCD had the best treatment effect on day 39 of the experiment and significantly improved the skin damage performance and relieved pathological lesions. On day 39, compared with the model group, MLCD downregulated the skin mRNA relative expressions of IL-4 (P = .009), TSLP (P = .030), and TSLPR (P < .001), and reduced the mouse serum levels of IL-4 (P = .003). For other serum indicators, no significant difference was observed between the model and MLCD groups.ConclusionMLCD improved AD-like mice skin damage by regulating the Th1/Th2 immune imbalance.     

高松寿教授化裁麻黄连翘赤小豆汤辨治杂病

高松寿教授,主任医师,硕士研究生导师,从事中医临床工作30余年,对各种内科疾病的治疗都有独到见解。     

麻黄连翘赤小豆汤对5-HT所致瘙痒模型大鼠与不同细胞系中5-HT1A及GRPR表达的影响＊

目的 通过建立大鼠瘙痒模型结合体外细胞培养，探讨麻黄连翘赤小豆汤止痒效果及对5-HT1a受体（5-羟色胺1a受体，Serotonin 1a receptor）、GRPR（胃泌素释放肽受体，Gastrin-releasing peptide receptor）表达的影响。方法 以40只雄性SD大鼠为研究对象，随机分为空白组、模型组、麻黄连翘赤小豆汤低、中、高剂量组，每组8只。除正常组外，其余各组均采取颈背部部皮下注射12%5-羟色胺（5-hydroxytryptamine，5-HT）溶液建立大鼠瘙痒模型。造模完成1天后，药物干预组大鼠分别用浓度为4.3 g·kg^-1、8.6 g·kg^-1、17.2 g·kg^-1的麻黄连翘赤小豆汤灌胃治疗14天，正常组和模型组灌胃等量等体积的生理盐水，观察并记录大鼠造模当天、治疗第7天、治疗第14天各组大鼠搔抓次数。治疗14天后取大鼠脊髓，采用蛋白免疫印迹法（Western Blot，WB）和免疫组化法检测5-HT1a受体和GRPR的表达水平及组织内分布情况。同时选用2种不同类型细胞系，分别分为空白组，对照组与干预组，对照组与干预组采用生理盐水与麻黄连翘赤小豆汤处理，48h后采用实时荧光定量PCR技术（Quantitative real-time PCR，qPCR）检测5-HT1a受体与GRPR mRNA的表达情况。结果 麻黄连翘赤小豆汤对瘙痒模型大鼠有止痒作用（P < 0.05），其抑制5-HT1a受体及GRPR的表达水平（P < 0.05），在细胞层面也下调5-HT1a受体及GRPR的表达。结论 麻黄连翘赤小豆汤可通过抑制5-HT1a与GPRP的表达进而达到止痒作用。     

Mechanism of improving skin barrier function in a mouse model of atopic dermatitis using Mahuang Lianqiao Chixiaodou decoction and its disassembled formula

ObjectiveTo reveal the mechanism of Mahuang Lianqiao Chixiaodou decoction and its disassembled formula for improving the skin barrier function in a mouse model of atopic dermatitis (AD).MethodsSixty specific-pathogen free male BALB/c mice were randomly divided into the control group, model group, whole formula group (WF), exterior-releasing formula group (ERF), interior-clearing formula group (ICF), and positive control group (PC). A mouse model of AD was established using the semi-antigen 2,4-dinitrofluorobenzene induction method. The lesion scores, transepidermal water loss and pH, and skin histopathology of mice in each group were observed. The expressions of filaggrin, loricrin, and involucrin were detected by the streptavidin peroxidase immunohistochemical method and western blotting, and their mRNA expressions were detected by quantitative polymerase chain reaction.ResultsMice in the WF, ERF, ICF, and PC groups showed reduced skin lesion performance, improved histopathology, decreased skin lesion score, transepidermal water loss and pH, and upregulated expressions of proteins including filaggrin, loricrin, and involucrin, and their mRNAs. The most obvious regulatory effect was observed in the WF group, followed by the ICF, ERF, and PC groups, accordingly.ConclusionsMahuang Lianqiao Chixiaodou decoction and its disassembled formula can improve the skin barrier function in a mouse model of AD by upregulating filaggrin, loricrin, and involucrin, and their mRNA expressions, and the most optimal effect was noted in the WF group, followed by the ICF and ERF groups, which suggests that the effect of clearing heat and resolving dampness in improving the skin barrier function of AD is more obvious and is one of the key treatments for AD.