麻黄附子甘草汤作用浅识

A Brief Discussion of Effect of Mahuang Fuzi Gancao Tang

从《伤寒论》《金匮要略》中麻黄附子甘草汤条文及对方中麻黄、附子、甘草的认识入手,结合条文内容及前人研究的麻黄附子甘草汤进行深入探讨。在质疑麻黄归经、散寒等作用的基础上,对麻黄附子甘草汤证病机及作用进行分析。麻黄附子甘草汤证病机为肝胆枢机不利,中下二焦(即少阴心肾、足太阴脾)不足,外感风寒循经入里,方中甘草敛降浮阳,炮附子温补下焦,麻黄宣散肝胆气机,促阳气外达以祛风寒。本方的作用关键在于散寒不伤正气、敛降以防虚浮。通过对方中药物之间的配伍关系进行探索,深化了对经方以及对应条文的认识与理解,从而有助于指导临床应用。

Starting with the content of Mahuang Fuzi Gancao tang in Shanghan Lun and Jingui Yaolve as well as the understanding of Chinese herbal medicine in the prescription including Herba Ephedrae, Radix Aconiti Lateralis Praeparata and Radix et Rhizoma Glycyrrhizae,this paper made a further discussion of Mahuang Fuzi Gancao tang based on predecessors’ study combing with the content in the articles. Based on the query to the effect of Herba Ephedrae including meridian entry and dissipating cold, the pathogenesis and the effect of Mahuang Fuzi Gancao tang were analyzed. Mahuang Fuzi Gancao tang is for the dysfunction of the pivot in the liver and the gallbladder,insufficiency of middle energizer and lower energizer(namely heart meridian and kidney meridian, as well as spleen meridian), as well as wind-cold from external contraction entering the interior through meridians. In this prescription,Radix et Rhizoma Glycyrarhizae is for astringing and downbearing as well as floating yang,processed Radix Aconiti Lateralis Praeparata is for warming and tonifying the lower energizer,and Herba Ephedrae is for diffusing and dissipating the qi movement of the liver and the gallbladder,as well as inducing yang qi to the exterior so as to dispel wind-cold. The key of this prescription lies in dissipating cold without damaging healthy qi,and astringing and downbearing so as to prevent deficiency and superficiality. Through the study of the combination among Chinese herbal medicine in the prescription,the understanding of classical prescriptions and corresponding content were deepened,which contributed to the guidance of clinical application.