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1、中华中医药杂志(原中国医药学报)2007年12月第22卷第12期CJTCMP,December2007,Vol.22,No.12829论著金匮要略泽漆汤证治法探讨庞德湘!(指导!连建伟)(浙江中医药大学附属第二医院,杭州310005)!!摘要:文章主要发掘金匮要略泽漆汤证的治法机理,探讨了泽漆汤证的治疗法则,揭示了泽漆汤治疗的病位、病机和疾病。同时结合临床经验和引证实验结果说明泽漆汤治疗肺癌的可行性。泽漆汤逐水通阳、消痰散结、健脾扶正、清化郁热,是寒热并用、攻补兼施之治法,临床主要治疗肺癌、转移性肺肿瘤病等。其治法重视对病位的脏器气机调理,顺应脏腑特性,疏
2、理肺脏气机。肿瘤病正气大虚,脾为后天之本,治当培本,是一大要义。泽漆先煎,去其毒性,为护正安胃之举,时时不忘顾护胃气之义。关键词:金匮要略;泽漆汤;肺癌;治疗法则InvestigationontherapyofZeQiDecoctionsyndromeinDiseases,SynopsisofGoldenChamberPANGDexiang!(Director!LIANJianwei)(TheSecondAffiliatedHospitalofZhejiangUniversityofTraditionalChineseMedicine,Hangzhou310005
3、,China)!!Abstract:ThisarticleexploresthetherapymechanismandprincipleofZeQiDecoctionsyndromeinDiseases,SynopsisofGoldenChamber.Theposition,pathogenesisanddiseasesaboutZeQiDecoctionsyndromearerevealed.ThefeasibilityofZeQiDecoctionintreatinglungcancerisproposedbyclinicalexperienceandexpe
4、rimentalresults.ThefourprinciplesofZeQiDecoction(removingwaterretentionandimprovingyang,dispersingphlegmandeliminatingstagnation,invigoratingthespleenandstrengtheningbodyresistance,clearingstagnatedheat)canbesummarizedascoldandheatincombination,reinforcementandeliminationincombination.T
5、hemainclinicalapplicationofZeQiDecoctionistotreatlungcancer,metastastictumoroflungandsoon.Thetreatmentmethodsfocusonregulatingtheactivitiesofqiintheorgans.Thespleenisthefoundationofacquiredconstitution;thetreatmengprincipalshouldbebasedonthespleen.HerbaEuphoribiaeHelioscopiaeshouldbe
6、decoctedfirsttoremovethetoxicitytoprotectthestomach.Keywords:SynopsisofGoldenChamber;ZeQiDecoction;Lungcancer;Treatmentprinciple!!金匮要略肺萎肺痈咳嗽上气病脉证中曰:半里和解膈气(徐彬)。形寒饮冷伤肺,化热耗津,瘀∀咳而脉沉者,泽漆汤主之。泽漆汤:半夏半升,紫参痰成痈:素日形寒饮冷伤肺,变热入里,耗其正津,瘀五两,泽漆三斤(以东流水五斗,煮取一斗五升),生其痰血,而欲成痈。以泽漆破瘀清热利水降气,佐姜五两,白前五两,甘草三两,黄芩三两,
7、人参三两,开、泄、润、升散、补益之品。预治肺痈,稍从急治(魏桂枝三两。上九味,咀,内泽漆汁中,煮取五升,温念庭)。脾衰肺逆:脾土衰败不能制水,水停于肺而服五合,至夜尽。#气逆。脉沉为水,泽漆为君,功专消痰行水,水性阴历代对泽漆汤证的见解寒,桂枝行阳气以导之。以停水者,脾土衰不能制里邪在荣,血结痰气:用泽漆破血为君,加入开水,肺气逆不能调水道,补脾顺肺,佐以辛散苦泄(医痰下气清热和荣诸药,参草扶正(喻昌、张璐)。邪在宗金鉴)。水邪上泛,相火壅阻:咳而脉沉,其病在肺家荣分,膈气不和:咳而脉沉,邪在肺家荣分,以泽下,是水邪上泛,相火壅阻,肺金伤克而不归也。
