小青龙汤加减法“若喘去麻黄”之辨析

Discussion on Xiaoqinglong Decoction of Removing Ephedrae for Asthma

结合历代医家观点,对《伤寒论》中小青龙汤加减法"若喘去麻黄"是否"仲景意"进行了讨论,并结合《金匮要略》中的相关条文进行了理论分析。根据仲景的辨证论治精神,小青龙汤使用麻黄平喘与否需要在具体临床时辨别正邪关系:在寒邪甚体质好,适合汗法解表时可使用;若里饮重而喘,表邪不重或伴有虚证的患者则不宜使用。

Combining with the viewpoints of the past doctors,this paper discusses the addition and subtraction of Xiaoqinglonng Decoction in the Treatise on Febrile Diseases,which"Removing Ephedra for asthma"is"in accordance with the meaning of ZHANG Zhongjing".And combing the relevant provisions in the Essentials from the Golden Cabinet to carry out a theoretical analysis and believes that it is excessively pursued and has no practical significance.According to Zhongjing's spirit of differentiation and treatment syndrome,Xiaoqinglong Decoction needs to distinguish between healthy qi and pathogenic qi relationship in specific clinical application.It can be used for patients with cold and good constitution,suitable for sweat method;if the patients with fluid retention and asthma,mild cold exterior or accompanied with deficiency syndrome,it should not be used.