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叶天士应用甘麦大枣汤医案探微

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甘麦大枣汤出自张机(字仲景)《金匮要略》,主要用于治疗脏躁.该方组方精良,药仅三味,结构简单精巧,药简效宏,应用广泛.叶桂(字天士)根据此方所治之病以心为重点脏腑的特点,化裁以治疗心神之病.此外,叶桂抓住此方所寓之法为甘缓法的特点,遵照《素问·脏气法时论篇》中"肝苦急,急食甘以缓之"的理论,以此方缓肝之急,治疗肝之体用失调的病证.叶氏临证采用甘麦大枣汤治疗以心脾不足为病因的疾病,大大开拓了甘麦大枣汤的应用范围.本研究对叶氏运用甘麦大枣汤的部分医案进行浅析与探索,归纳总结叶桂对甘麦大枣汤的临证应用特点,领会叶氏应用甘麦大枣汤的学术思想,以期为临床拓展甘麦大枣汤的应用提供新的思路.
A study on the application of the Ganmai Dazao decoction by YE Tianshi
The Ganmai Dazao decoction(甘麦大枣汤)comes from ZHANG Ji's Jingui Yaolue(《金匮要略》),which is mainly used to treat hysteria.The prescription has excellent composition,and only consists of three Chinese medicines.The structure is simple and exquisite,the medicine used is simple and effective,and the application is extensive.According to the characteristics of heart as the focus viscera of the disease treated with this prescription,YE Gui made this prescription to treat mental illness.In addition,YE Gui firmly grasped the characteristics of the method contained in this prescription as using sweet TCM medicine to relieve contracture,and followed the relevant theory in Suwen(《素问),so as to relieve liver urgency and treat hepatic dysfunction.YE's clinically used the Ganmai Dazao decoction to treat disease caused by heart and spleen deficiency,greatly expanding the application scope of the Ganmai Dazao decoction.This paper analyzes and explores some medical cases about the application of the Ganmai Dazao decoction by YE's,summarizes the clinical application characteristics of the Ganmai Dazao decoction,and understands the academic thought of YE Gui about the application of the Ganmai Dazao decoction,so as to provide new ideas for the clinical application of the Ganmai Dazao decoction.

The Ganmai Dazao decoctionMedical caseClinical experience

金虹、张丽艳

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辽宁中医药大学,辽宁 沈阳,110847

甘麦大枣汤 医案 临床经验

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(31)