五苓散临证思考

Clinical Thoughts on Wuling Powder

为拓展五苓散临床应用范围,通过分析五苓散治疗干燥综合征、急性脑梗死并发神经源性膀胱、肾结石伴肾盂积水、良性发作性位置性眩晕,以及参与组方清肺排毒汤治疗新型冠状病毒肺炎,总结五苓散临床应用。凡属气化不利、津停不布导致的水液输布、代谢障碍,表现为水停体内某一局部或为水蓄膀胱等,即使没有发热、脉浮等表证,均可使用五苓散化气布津、分消水气、通里达表。五苓散证病机概括为:水津不布,气化不利。五苓散当为三焦气化不利、调节人体津液代谢的方剂。

In order to enlarge the clinical application of Wuling powder,clinical application of Wuling powder is summed up through analysis of Wuling powder treating Sjogren syndrome, acute cerebral infarction complicated with neurogenic bladder, nephrolithiasis complicated with hydronephrosis, and benign positional vertigo, as well as analysis of Wuling powder in the prescription of Qingfei Paidu Tang in the treatment of Corona Virus Disease 2019. Induced by inhibited qi transformation and impairment of fluid distribution, disturbances of transportation and metabolism of watery humors are manifested by water retention in a part inside the body,or fluid accumulation in the bladder.In the case of the disturbances above,Wuling powder can be used to transform qi and distribute fluid,disperse fluid retention from the upper and the lower separately, and release the interior and the exterior, even though there is no fever, floating pulse, and other exterior syndromes. The pathologenesis of diseases mainly treated with Wuling powder is summarized as impairment of fluid distribution and inhibited qi transformation.Therefore,prescription of Wuling powder can be applied to regulating metabolism of fluid and humor in the body.