张仲景治疗心悸的方证辨治探析

Decoction Syndrome Differentiation and Treatment of Palpitation by ZHANG Zhongjing

心悸是临床常见病症,张仲景在《伤寒论》和《金匮要略》中论述颇为广泛,其首提心悸病名,开本病辨证论治之先河。拟对仲景治疗心悸的方证,即治疗心阳不足证的桂枝甘草汤、桂枝甘草龙骨牡蛎汤、桂枝去芍药加蜀漆牡蛎龙骨救逆汤;心脾两虚证的小建中汤;阴阳两虚证的炙甘草汤;水饮凌心证的苓桂术甘汤、苓桂姜甘汤、苓桂枣甘汤、真武汤、小半夏加茯苓汤、半夏麻黄丸;以及肝郁气滞、枢机不利证的小柴胡汤加减、四逆散加味等方剂进行详实梳理,以期对临床辨治本病有所借鉴。

Palpitation is a common clinical symptom,it is widely discussed in ZHANG Zhongjing＇s Treatise on exogenous febrile disease and Synopsis of Golden Chamber,ZHANG Zhongjing first mentioned the name of palpitation and discussed diagnosis and treatment of palpitation. according to pathomechanism,palpitation will be divided into five syndrome,namely：Guizhi Gancao Decoction,Guizhi Gancao Longgu Muli Decoction treatment of deficiency of heart-yang syndrome,Xiaojianzhong Decoction treatment of asthenia of heart and spleen syndrome,Zhigancao Decoction treatment of deficiency of both Yin and Yang syndrome,Linggui Zhugan Decoction,Linggui Jianggan Decoction,Linggui Zaogan Decoction,Zhenwu Decoction,Xiaobanxiajiafuling decoction,Banxiamahuang pills treatment of fluid retention invading heart syndrome,and Xiaochaihu Decoction,Sini powders treatment of liver depression and Qi stagnation syndrome. This article systematicly introduces ZHANG Zhongjing＇s decoction syndrome,treatment characteristics,the use of prescription and herbs and so on,in order to provide an important reference for clinical treatment of palpitation.