半夏泻心汤辨证要点及应用发挥探讨

Discussion of Differentiation and Application of Banxia Xiexin Decoction

半夏泻心汤为历代医家公认的治疗胃肠疾病的有效方剂。但从伤寒论原文来看,对其使用的辨证要点较为模糊,为后世医家临床应用带来难度。另外,原文的适应证是痞证,痞证的症状只是心下痞胀。该文对半夏泻心汤进行了初步探讨,在辨证上,认为其辨证要点为胃脘痞胀而无嗳气,也是与气滞型胃瘅鉴别的关键点;在适应证上,除了治疗痞证外,也可发挥应用于治疗胃痛一类的病证。只要掌握好辨证要点和药物剂量,多能收到较好效果。

Banxia Xiexin Decoction is an effective prescription used for the treatment of gastrointestinal disease. However, the key point of its differentiation in the Shanghan Theory was not clear which made some difficulties in the application for clinical medicine. Additionally, the only one indication in Shanghan Theory was the feeling of fullness in the chest and upper abdomen. In this literature, we discussed Banxia Xiexin Decoction, and we considered the key point of differentiation was the feeling of fullness in the chest and upper abdomen without belching, which was the key point for differentiating from Qi stagnation and gastritis. Also we considered the indication might include stomachache. Different accurate and appropriate dosages are essential for achieving a good curative effect.