摘要
大黄作为泻下类中药的代表,具有泻积热、下瘀血、涤肠胃、退黄疸、消痞满等多种功效,临床应用广泛,但其性沉降峻猛,用量多易伤正,用量不足又难达疗效。通过分析经典方剂发现,大黄用量主要与病邪性质、药物炮制和配伍有关。病邪性质方面,当大黄用于攻伐有形实邪时,用量较重;用于消减无形之邪时,用量较轻。炮制方面,若单纯取大黄炭止血之性、酒大黄清上焦热邪之功、熟大黄活血化瘀之能,三者用量由轻到重依次为大黄炭、酒大黄、熟大黄。配伍方面,大黄与泻下药、活血药配伍用量重;与和解药、温里药配伍用量轻;与清热药、理气药相配,则需根据病情深浅轻重、病邪寒热虚实决定用量。此外,大黄用量还与患者体质、年龄、地域及剂型等因素有关,临床需遵循三因制宜原则,灵活加减。
Dahuang(Rhei Radix et Rhizoma),as a representative medicine of purgative medicinals,has many effects such as discharging accumulated heat,resolving blood stasis,washing and cleaning the intestines and the stomach,treating jaundice and eliminating stuffiness and fullness,so it is widely used in clinic.It has the directional characteristic of sinking and is drastic and strong in strength,so it is easy to damage healthy qi with large dosage,and difficult to achieve therapeutic effect with small dosage.The author analyzed some classical formulas and found that the dosage of Dahuang were related to the property of pathogenic factors,its processing method and compatibility.In terms of the property of pathogenic factors,when Dahuang is used to attack excess pathogens which has its form,the dosage was larger than when it was used to eliminate pathogens which do not have any form.In the processed products of Dahuang,looking only at the following effects,stir-fried Dahuang for stopping bleeding,wine-processed Dahuang for clearing heat in the upper energizer,prepared Dahuang for promoting blood circulation and removing blood stasis,the order of the dosage from small to large is stir-fried Dahuang,wine-processed Dahuang and prepared Dahuang.In terms of compatibility,the dosage of Rhei Radix et Rhizoma is large when it is combined with purgative medicinals and blood-activating medicinals. However,when it is combined with harmonizing and releasing medicinals,or with interior-warming medicinals,the dosage is small. when it is combined with heat-clearing medicinals and qi-regulating medicinals,the dosage is determined by the severity of the disease and the property of the pathogen. In addition,the dosage of Dahuang should be changed flexibly according to the patients’ constitution and age,local condition and the preparation form. In clinic,the dosage of Dahuang should be modified according to time,local condition and individuality.
作者
王翰飞
潘孜文
朱向东
马尚贤
WANG Hanfei;PAN Ziwen;ZHU Xiangdong;MA Shangxian(Gansu University of Traditional Chinese Medicine,Lanzhou 730101,China;Hebei Medical University,Shijiazhuang 050017,China)
出处
《山东中医杂志》
2020年第6期550-553,559,共5页
Shandong Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(编号:8167150826)。
关键词
大黄
用量
病邪性质
炮制
配伍
体质
Dahuang(Rhei Radix et Rhizoma)
dosage
effect
processing
compatibility
constitution
