白虎汤证辨析及应用

Discrimination and application of Baihu Decoction

白虎汤是出自《伤寒论》的名方。为临床更好的运用其治疗多种外感和内伤杂病,文章就其适应证、类方鉴别和禁忌证进行探讨。白虎剂可用于阳明经热之四大证,郁热昏厥证以及太阳中热证。外感邪热伤及气阴,以致口大渴、背微恶寒;四大证兼见心下痞;汗吐下后见四大证;暑入阳明;内伤热伤气阴之消渴,乃为白虎汤与白虎加人参汤之辨析要点。应用白虎剂仍应注意其四大禁、二阳少阴禁、用寒远寒禁等禁忌要点。

To provide a reference for the treatment of exogenous disease as well internal damage diseases, the indication, differentiation and contraindication of Baihu Decoction, a famous recipe in Shanghan Lun were discussed in this paper. Baihu Decoction was applicable to treat syndrome of the excessive heat in the Yangming channel, syndrome of syncope caused by stasis heat, and syndrome of the excessive heat striking in the Taiyang channel. The differentiation points of Baihu Decoction and Baihu Decoction modified ginseng should attach importance to the symptoms of qi and yin damaged by pathogenic heat, including extreme thirst and chilly feeling in back, the four severe symptoms coupled with epigastric fullness, the four severe symptoms caused by excessive diaphoresis, emetic and purgative therapy, and extreme thirst caused by qi and yin damaged by pathogenic heat, syndrome of Yangming meridian after diaphoresis, vomiting and purgation, hotness and thirst caused by internal injury. It should also be stressed in its contraindications such as most four contraindications, Taiyang, Yangming, and Shaoyin meridians contraindication and preventing using the cold when cold weather.