麻黄在荨麻疹治疗中的应用体会

The Application of Ephedra in the Treatment of Urticaria

[目的]从病因病机出发探讨麻黄治疗荨麻疹的临床体会。[方法]结合中医古籍、近现代医者经验以及笔者临床经验,从荨麻疹病因病机、麻黄主要功效等方面阐述麻黄在荨麻疹治疗中的思路及经验,并列举验案加以佐证。[结果]荨麻疹多由诸邪侵袭腠理,致营卫不和、玄府郁闭而发,卫闭营郁是其病机关键,治疗上当开宣腠理,驱邪外出;麻黄功善发汗解表,临床上常以麻黄辨治荨麻疹。所举医案为外邪袭表、卫闭营郁、郁久入里化热伤津所致之荨麻疹,辨为表闭里热证,治宜开郁解表兼清里热,以麻黄桂枝各半汤为主方,随证加减,疗效甚佳。[结论]麻黄辛温,善于开腠理、逐外邪,临床上巧用此味中药治疗荨麻疹,临证加减,疗效可观。

[Objective] To discuss the clinical experience of Ephedra in the treatment of urticaria starting from etiology and pathogenesis. [Methods]Combined with the ancient books of TCM,the experience of modern doctors and the author’s clinical experience,the thinking and experience of Ephedra in the treatment of urticaria from the aspects of the pathogenesis of urticaria,the main efficacy of Ephedra were expounded and one clinical medical case was presented as proof.[Results] Urticaria is mainly caused by the invasion of various pathogens,which lead to the disharmony between Ying and Wei and the closing of sweat pore. The key of the pathogenesis of urticaria is stagnation of Ying and Wei. The treatment of urticaria is to open striae and expel evils. Ephedra is good at inducing diaphoresis,and often used to treat urticaria. The medical case was urticaria caused by the exogenous pathogen attacking the exterior,stagnation of Ying and Wei,conversion into heat and consumption of the body fluid. The patient was syndrome differentiated as the stasis in exterior and thermal in interior. The appropriate treatment was to relieve depression through diaphoresis,and clear out stagnated heat the interior,Mahuang Guizhi Geban decocton was chosen as the main prescription,modifided according to symptoms,and led to good effect. [Conclusion]Ephedra’s properties are pungent-warm,which is good at opening striae and expelling evils. It can be used skillfully in clinic,and the clinical effect is considerable.