温胆汤方证刍议

Analysis of the Indication of Wendan Decoction

[目的]阐述温胆汤方证,拓展温胆汤在临床上的应用。[方法]通过讨论分析温胆汤的沿革、病机,归纳温胆汤所主之方证,分享其临床应用之验案,进一步总结温胆汤的临床运用规律。[结果]温胆汤起自《集验方》,其病机在于胆寒胆虚,痰饮内犯,全方治以温化寒痰,兼以清解郁热。温胆汤之方证可归纳于下:其人体型多中等强壮,面容多滋腻,且平素多有情志不畅表现;刻下多见有惊悸胆怯、失眠多梦、头晕头痛等精神神经症状,而恶心呕吐、腹胀纳差及嗳气痞满等消化系统症状常为其人的兼杂之证,其舌虽未必有厚腻之象,然脉多有弦、滑之征。每随此证而治之,常效如桴鼓。[结论]温胆汤为千古名方,正确理解温胆汤方证,能够启发、拓展温胆汤的临床运用,故值得后世医家学习探讨。

[Objective] To discuss the indication of Wendan Decoction and figure out its application pattern in modern medical field. [Method] Through discussing the pathogenesis and origin of Wendan Decoction, we summed up the main prescription, shared a case of clinical application and further summarized the clinical uses of it.[Result] Wendan Decoction originated in the Set Prescription. The pathogenesis of Wendan Decoction is gall-bladder cold and deficiency,leading to produce endogenous phlegmatic and fluid retention. Wendan Decoction is mainly used for warming and eliminating the phlegmatic and fluid retention, as well as clearing heat. It is effective to use Wendan Decoction clinically according to the indication of it, which is as described below： firstly, the somatotype of patients is mostly medium strong, the face of them is mostly oily, and they usually have poor emotional performance. Then, fear, insomnia, dizziness, headache and other mental neurological symptoms, as well as nausea, vomiting, abdominal distension and other digestive symptoms are often seen in them. Besides, most of them are taut pulse and slippery pulse but thick greasy fur of tongue image is not necessary.[Conclusion] Wendan Decoction is a famous prescription. The correct understanding of Wendan Decoction prescription is useful to expand the clinical application value of it, so it is worth exploring.