浅析麻黄汤治疗中风恢复期意识障碍

Analysis of Ephedra Decoction in the Treatment of Consciousness Disorder in Convalescent Stage of Apoplexy

麻黄汤是"八法"之中"汗法"的鼻祖,孙思邈《备急千金要方》称之为"还魂汤""追魂汤",汉唐时期多应用于中风后意识障碍,其演化出来的"千金小续命汤"和"《古今录验》"小续命汤"为宋代以前医家治疗中风病的重要方剂。从中医外科的角度和思维来看,无论是出血性脑血管病或是缺血性脑血管病,都可以视为"疮疡",由此而论,汗法应用于中风恢复期意识障碍,于理有据。但同时临床上应注意遵循张仲景原方剂量及《伤寒论》中所提出的"麻黄九禁",以确保患者临床疗效及用药安全。

Ephedra decoction is the predecessor of ＂ diaphoresis＂ among the eight treatment methods.Sun Simiao called this method as ＂ resurrection decoction＂ in his medial book Essential Recipes for Emergent Use Worth a Thousand Gold.In Han and Tang dynasties,it was mostly applied to postapoplectic disturbance of consciousness.＂ Small emergency decoction worth a thousand gold＂ evolved from this method and ＂ small emergency decoction＂ recorded in Ancient and Modern Recipes are important prescriptions for doctors before Song dynasty to cure stroke.From the perspective and theory of surgery of traditional Chinese medicine,both hemorrhagic cerebrovascular disease and ischemic cerebrovascular disease can be regarded as ＂ skin and external diseases＂.Based on this point of view,the application of diaphoresis for the treatment of disturbance of consciousness in the recovery period of apoplexy is well grounded theoretically.However,clinically,Zhang Zhongjing＇ s original prescription dose and ＂ nine contraindications for ephedra＂ brought forward in Treatise on Cold Pathogenic Diseases should be followed,so as to ensure clinical effect and medication safety.