伤寒论评话 第9章 谨查兼证病机,活用桂枝汤剂——太阳中风兼证的治疗

目的：探讨《伤寒论》关于太阳中风兼证的治疗。方法：对《伤寒论.辨太阳病脉证并治上》中第14条、第15条、第18条、第20条、第21条、第22条、第43条及第62条,并参成无己的注释,进行分析。结果：①太阳中风＂项背强几几＂（读作qing jīji）,是邪阻经脉和汗多伤津,筋脉失养共同导致的结果,故用桂枝加葛根汤解表养津,舒缓筋脉。②如果人体阳气不足,津液过盛,筋脉受到浸滋,柔韧过度,弹性不足,就会出现瘫软乏力,湿气盛的病人即会如此,和动物皮筋浸泡后失去弹性一个道理。如果阳气过盛,阴津匮乏,则筋脉失于濡润,刚性有余,柔韧不足,就会出现拘急痉挛,就像动物皮筋风干太过有如干柴一般缩紧坚硬。③漏汗症用桂枝加附子汤,桂枝汤是纠正气津损伤的原因,加用附子是弥补汗出过多的结果,前者是＂急则治其标＂,后者是＂缓则治其本＂。④桂枝去芍药汤证是手少阴心阳受损,桂枝去芍药加附子汤证是手、足少阴心、肾阳气均受损伤。⑤＂喘家作桂枝汤,加厚朴杏子佳＂并非是太阳中风兼证,而是喘家罹患太阳中风的治疗措施。结论：《伤寒论》关于太阳中风兼证治疗的条文对临床有重要指导意义。

Chapter 9. Accompanied Symptoms and Signs of Pathogenesis,Usage of Guizhi Decoction --Treatment of Taiyang Wind Stroke

Objective：To study the treatment of Taiyang wind stroke by ＂Treatise on Febrile Diseases＂. Methods：Analyze the article 14, article 15 and article 18, article 20, article 21, article 22, article 43 and article 62. Results ： ① Taiyang wind stroke caused by meridians lock,body fluid consumption and fiber dystrophy, so use ramuli cinnamomi decoction added with puerariae to relieve superficies and easy fiber. ②Yang qi deficiency and body fluid luxus induce weak and limp. Yangqi luxus and body fluid lack induce limb spasm. ③ Guizhi added with aconiti praeparatae decoction is used in the treatment of leakage hyperhidrosis. The former rectifys healthy atmosphere and the latter redeems perspiration. （~）Ramuli cinnamomi decoction is a hand to the hand-shao yin and heart yang damage, guizhi added with aconiti praeparatae decoction without penoy is a hand to both hand-shao yin and foot-shao yin damage and kidney yang damage. ④ ＂Guizhi decoction add houpu and apricot fruit＂ is the therapeutic measure for taiyang wind stroke. Conclusion：The treatment of taiyang wind stroke by ＂treatise on febrile diseases＂ has important clinical guiding significance.