国医大师李士懋治寒凝型胸痹常用中药药对探析

Analysis on the commonly used couplet medicines of TCM master LI Shi-mao in treating coagulated cold coronary heart disease

国医大师李士懋教授认为寒凝型胸痹的病机为本虚标实,本虚而生内寒,寒阻运化而致气血失和,进一步萌生痰湿或瘀血。针对寒凝型胸痹,李老提出"寒凝散之"的治疗原则,通过"外散""内温"二法使"寒凝"得以温化外散,使人体气机的升降出入恢复正常。文章总结了李老治疗寒凝型胸痹的常用中药药对:如温化散行之辛温药对:桂枝与麻黄、附子与细辛;清久寒郁遏体内而化之热,少佐辛寒药对:豆豉与栀子、石膏与知母;补益扶阳散寒之辛甘药对:人参与干姜、桂枝与甘草;调畅气机,化瘀祛寒之辛苦药对:生姜与枳实、干姜与黄连;走窜力强,驱寒止痛之辛香药对:沉香与丁香、乳香与没药等。

TCM master LI Shi-mao believes that the pathogenesis of chest discomfort is weakness inside and excess outside.The deficiency of healthy qi generates the cold inside,and the cold obstructes the circulation of qi and blood which produces dampness and blood stagnation.Professor LI proposed the principle of dispersing the cold stagnation in treating chest discomfort.The‘cold stagnation’mainly relies on the‘external dispersion’and‘internal dissipation’two methods to enable the‘cold stagnation’to be warmed and dissipated,so that the circulation of the human qi activity can be returned to normal.In this paper the common groups of herbs that professor LI usually used are summed up and analyzed.For example,the medicine of pungent and warm is to warm and disperse:Guizhi and Mahuang,Fuzi and Xixin;the medicine of pungent and cold is to suppress the body heat:Douchi and Zhizi,Shigao and Zhimu;the medicine of pungent and sweet is good for supporting yang;Reshe and Ganjiang,Guizhi and Gancao;the medicine of pungent and bitter is used to regulate qi activity:Shengjiang and Zhishi,Ganjiang and Huanglian;the medicine of pungent and fragrant is strong in driving cold out and stopping pain:Chenxiang and Dingxiang,Ruxiang and Moyao,etc..