从方药离合学说解读当归四逆汤的功效与主治

Interpretation of the Efficacy and Indications of Chinese Angelica Frigid Extremities Decoction from the Theory of Separation and Combination of Formula and Medicinal

当归四逆汤功效为温气养血,散寒除湿,祛邪止痛。主治气血亏虚,寒湿内侵,阻滞脏腑、九窍、肌肉、筋骨,气络与血络不畅所致的疼痛、麻木、肿胀等病证。按照当归四逆汤单味药物主治疾病进行归纳,当归四逆汤7味药物的主治病证共有33种。按照系统分类,所治病证包含呼吸系统、消化系统、神经系统、泌尿系统、风湿免疫系统、肝胆系统等。所治疾病中内科疾病有:寒热病(相当于外感病)、咳嗽、头痛、腹痛、便秘、肠澼、烦躁、短气、消渴、肺痈、关节痛(痹证)、癥瘕积聚、水肿、淋证、痞满、失眠、胁痛、心痛、胸闷、痉病。外科疾病有:瘘疮、疮疡。妇科疾病有:痛经、闭经、经期腰痛、乳汁不下、不孕、癥瘕。五官科疾病有:喉痹、口舌生疮、迎风流泪、风寒鼻塞、齿痛。以上疾病病机或偏于血瘀,或偏于寒凝,或偏于阳气不足,或偏于寒湿阻滞,均为在气血不足基础上,感受寒邪。治疗需标本兼治,充分考虑体质、疾病因素。

The efficacy of Chinese Angelica Frigid Extremities Decoction is warming qi and nourishing blood,dispersing cold and removing dampness,eliminating pathogenic factors and relieving pain.It is mainly used to treat pain,numbness and swelling caused by deficiency of qi and blood,invasion of cold and dampness blocking viscera,nine orifices,muscles,bones,qi and collaterals,and obstruction of blood collaterals.According to the single medicinal′s indications of Chinese Angelica Frigid Extremities Decoction,it can treat 33 kinds of main diseases and syndromes with 7 kinds of medicinals of it.According to the system classification,the treated diseases include respiratory system,digestive system,nervous system,urinary system,rheumatic immune system,liver and gallbladder system,etc.The internal medicine diseases treated include cold and heat disease(equivalent to exogenous diseases),cough,headache,abdominal pain,constipation,intestinal pain,irritability,shortness of breath,diabetes,lung carbuncle,arthralgia(arthralgia syndrome),abdominal mass,edema,drenching syndrome,stuffiness and fullness,insomnia,flank pain,heartache,chest tightness,spasm.Surgical diseases include fistula sores and sores.Gynecological diseases include dysmenorrhea,amenorrhea,low back pain during menstruation,agalactia,infertility,and abdominal mass.The diseases of five sense organs include throat obstruction,sore mouth and tongue,tears in the wind,wind-cold,nasal congestion and toothache.The pathogenesis of the above diseases is mainly blood stasis,or cold coagulation,or yang qi deficiency,or cold dampness blockage,all of which are due to invasion of cold based on the deficiency of qi and blood,We should treat the primary and secondary of a disease at the same time,and fully consider the factors of constitution and disease.