柴胡桂枝干姜汤方证辨析

柴胡桂枝干姜汤方出自《伤寒论》＂,伤寒五六日,已发汗而复下之,胸胁满微结,小便不利,渴而不呕,但头汗出,往来寒热,心烦者,此为未解也,柴胡桂枝汤主之＂;方证定位于少阳病兼证,属经腑同病兼津伤阳损证,原文对太阴虚寒症状未作明示,但结合后世医家补充及临床验案,太阴虚寒为必有兼证。刘渡舟定位于胆火内郁兼太阴脾寒更贴近临床实际。方证应无表证,邪已传入少阳,水饮内停并非其兼证。因柴胡黄芩用量与小柴胡汤相同,故归于柴胡剂已达成共识,争论焦点在栝楼根、牡蛎及桂枝干姜的作用,详辨结构,乃小柴胡汤理中汤、栝楼牡蛎散合方之意。多数医者认同该方证病机为少阳枢机不利、胆火内郁,兼津伤阳损,广泛应用于消化系统疾病。刘渡舟主张使用本方,论病机为胆热脾寒,抓主证须重视口苦便溏;断病在少阳,以口苦为准,便溏之证是判断太阴病主要依据,对临床使用影响很大,多按此原则使用,疗效确切,极大地扩大了此方的使用范围。

ChaiHuGuiZhiGanJiang Soup Fang Zheng differentiate and analyze

ChaiHuGuiZhiGanJiang soup stems from ShangHanLun,＂Fever for 5-6 typhoid,already sweatin g,under the chest side full knot,urination,thirst without emesia,but head sweat,fever,upset,this is not solu tion also,ChaiHu,GuiZhi,GanJiang soup are master＂;Positioning in shaoyang disease and syndrome,belon g to the inner parts with illness and injury,the original express has been made to too Yin deficiency cold sympto ms,but added that combining the later physicians and clinical cases,too Yin deficiency cold for it and will pass. LiuDuzhou positioning within the bravery fire liu yu and closer to the clinical actual lunar the spleen cold syndr ome. Zheng should have no table card,evil has been introduced to ShaoYang,and drink the water stop is not wit hin the disease. Because the amount of XiaoChaiHu soup as much as ChaiHu HuangChen,same reason to radix bupleuri agent have reached a consensus,contention on GualLou MuLi,oysters and cassia twig dried ginger,d etailed structure,is a XiaoChaiHu soup,GualLou MuLi oysters in tonga subtraction reasonable scattered Fang Zhiyi. Most doctors agree that party within a YangShuJi less adverse,bravery fire syndrome and pathogenesis of depression,and jin Yang loss,widely used in diseases of the digestive system. LiuDuzhou for using his own the ory of the spleen cold syndrome pathogenesis of gallbladder heat;Grasp the main card to mouth bitter loose stool;Disease in ShaoYang,will be subject to bitter mouth,loose stool of certificate is lunar disease,had a great infl uence on clinical use,according to its use,exact curative effect,greatly expanded the scope of this application.