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桂枝加葛根汤主治及临床应用探析

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桂枝加葛根汤方由"葛根四两、芍药二两、生姜三两(切)、甘草二两(炙)、大枣十二枚(擘)、桂枝二两(去皮)"等6味药物组成,具有解肌发表,宣通经气,调和营卫之功效,主治"项背强几几",临床多用于风寒客于太阳经输,营卫不和所致的发热、恶风、汗出、项背强而不舒等证."项背强几几"是指从后头部至后腰部的肌肉拘急疼痛感,有时范围可达到腰部,同时多伴有头痛、眩晕等.后世医家基于《伤寒杂病论》桂枝加葛根汤原方,将其用于风寒引起的颈背疼痛、痘疹、斑疹等.现代医家进一步拓展其临床应用,认为凡是辨证为营卫失和、气血阻滞、筋脉失养者均可使用该方治疗,包括感冒、颈椎病、落枕、肩关节周围炎等,还包括冠状动脉粥样硬化性心脏病的胸背疼痛、高血压动脉硬化所引起的后脑部疼痛等疾病,师古而不泥古.
An Analysis of the Main Indications and Clinical Applications of Cinnamon Twig Decoction Plus Pueraria
Cinnamon Twig Decoction Plus Pueraria,composed of six ingredients-Gegen(Radix Puerariae Lobatae)4 liang,Shaoyao(Radix Paeoniae Alba seu Rubra)2 liang,Shengjiang(Rhizoma Zingiveris Recens)3 liang(cut),Zhigancao(Radix Glycyrrhizae Pra-eparata)2 liang,Dazao(Fructus Jujubae)12 pieces(split),and Guizhi(Cinnamon Twig)2 liang(peeled)-functions to release the flesh to relieve the exterior,promote the circulation of qi in the channels,regulate and harmonize the nutrient qi and defense qi,and.It primarily treats"stiffness and tension of the nape and back"associated with external wind-cold invasion in the greater yang meridian and disharmony between the nutrient qi and defense qi,manifesting in symptoms such as fever,aversion to wind,sweating,and stiffness in the nape and back."Stiffness and tension of the nape and back"refers to a feeling of tightness and pain in the muscles from the back of the head to the lower back,sometimes extending to the waist,often accompanied by headache and dizziness.Later generations of phy-sicians,based on Zhang Zhongjing's original formula from Treatise on Cold Damage and Miscellaneous Diseases,applied the formula to wind-cold-induced neck and back pain,measles,and rashes.Modern practitioners have further expanded its clinical applications,finding it effective for conditions involving disharmony between the nutrient qi and defense qi,qi and blood stagnation,and muscle and tendon malnutrition.It is used to treat ailments such as common cold,cervical spondylosis,stiff neck,periarthritis of the shoulder,as well as chest and back pain caused by coronary atherosclerotic heart disease,and occipital pain due to hypertensive arteriosclerosis,while adhering to but not rigidly following classical principles.

Cinnamon Twig Decoction Plus Pueraria"stiffness and tension of the nape and back"Treatise on Cold Damage and Miscel-laneous DiseasesZhang Zhongjing

谭王琪、田苗芳、王兴丽、田岳凤

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山西中医药大学,山西太原 030024

山西省针灸医院,山西太原 030006

桂枝加葛根汤 "项背强几几" 《伤寒杂病论》 张仲景

2024

河南中医
河南省中医药学会 河南中医学院

河南中医

影响因子:0.968
ISSN:1003-5028
年,卷(期):2024.44(11)