礞石滚痰丸的临床运用

Clinical Application of Mengshi Guntan Pill

礞石滚痰丸是中医泻火逐痰的著名方剂,为历代医家所推崇,被临床广泛应用。文章基于该方的现代研究与运用背景,围绕其主治、功效、剂型、用法、临床运用及加减变化等进行了系统评述。调查显示,原方所主病证有数十种之多,但以痰火壅、闭、窜、乱为其基本病机;汤、散、丸剂均可选用,但以丸剂为佳,且宜缓缓服用(药后宜静卧或少动),有利于消除陈积伏匿之痰。现代该方主要用于神经精神、呼吸、内分泌等系统的疾病,其中治疗精神神经系统疾病的疗效与西药大体相近,联合西药使用时或能提高其疗效及减轻其不良反应,但不少病例属于个案,确切疗效尚待评价。该方现代多用汤剂,随症加减中的配伍主要涉及化痰祛浊、凉血活血、行气解郁、祛风止痉等类药物,尤其与清半夏、天竺黄配用最为常见。

Mengshi Guntan pill is a famous formula for sputum syndrome,which is praised by the doctors in past dynasties and clinical widely used. This article reviews about its indications,efficacy,dosage,usage,clinical application and modified changes based on it＇s modern research and use. The investigation showed the original formula indications related dozens of disease in that the basic pathogenesis were sputum fire obstruct,closed, channeling, chaos. Dosages as decoction, powder and pill, can be selected, but the best to pill. It should be slowly taken and keep quiet or less moving after taking to eliminate deeply hidden old phlegm. It is mainly used for the diseases of neuropsyehiatry, respiratory and endocrine system. Its effect is similar with Western Medicine in treating neuropsyehiatry diseases. It combined with western medicine maybe improve the curative effect and reduce the adverse reaction. But definite clinical effect remains to be evaluated because some cases from a case report. In its addition and subtraction according to syndrome, the compatibility application of it mainly involves the medicines such as removing phlegm,cooling blood and activating circulation,promoting qi circulation and relieving depression,relieving convulsion and spasm, especially matched with prepared Rhizoma Pinelliae and concretio silicea bambusae.