桂枝汤加减方应用

Application of Modified Cinnamon Twig Decoction

桂枝汤是调理外感内伤、气血营卫的首选方,张仲景在桂枝汤基础上加桂枝、附子等温性药,或芍药、党参等生津药,使方有偏阳偏阴之分,加葛根或厚朴、杏仁,使方有偏于升降之性;加黄芪或当归,使方有偏于气血之分。外证中,偏于阳的加减方有桂枝甘草汤、桂枝甘草龙骨牡蛎汤、桂枝去芍药加蜀漆龙骨牡蛎救逆汤、桂枝加桂汤、桂枝加附子汤、桂枝去芍药汤、桂枝附子汤。偏于阴的加减方有芍药甘草汤、桂枝新加汤、桂枝去桂加白术茯苓汤、桂枝加芍药汤。偏于升的加减方有桂枝加葛根汤,偏于降的加减方有瓜蒌桂枝汤、桂枝加厚朴杏子汤。内证中,偏于守中调内脏的加减方有四逆汤、小建中汤、黄芪建中汤。偏于通行经络的方为黄芪桂枝五物汤。桂枝汤中加滋养阴血之药,补虚而无凝滞之忧,如桂枝汤加黄芪、桂枝芍药知母汤、桂枝去芍药加麻黄附子细辛汤。治疗经脉不利的当归四逆汤、当归四逆加吴茱萸生姜汤、温经汤,用药亦有在里在外之侧重。守仲景加减之道,则表里内外之病皆易治也。

Cinnamon Twig Decoction is the first choice for regulating external contraction and internal injuries,qi and blood,nutrient and defense qi.On the basis of Cinnamon Twig Decoction,Guizhi(Ramulus Cinnamomi),Fuzi(Radix Aconiti Lateralis Preparata)and other warming drugs,or Shaoyao(Rhizoma Dioscoreae),Dangshen(Radix Codonopsis)and other fluid-generating drugs can be added to make formulas either partial to yang or partial to yin;Gegen(Radix Puerariae Lobatae)or Houpo(Cortex Magnoliae Officinalis)and Xingzi(Semen Armeniacae Amarum)can be added to make formulas either partial to ascending or partial to descending;Huangqi(Radix Astragali)or Danggui(Radix Angelicae Sinensis)can be added to make formulas either partial to qi or partial to blood.In terms of external syndrome,the modified formulas partial to yang include Cinnamon Twig and Licorice Decoction,Cinnamon Twig and Licorice and Dragon Bone and Oyster Shell Decoction,Cinnamon Twig Decoction Minus Peony Plus Folium Dichroae and Dragon Bone and Oyster Shell Decoction for Saving from Collapse,Cinnamon Twig Decoction with Extra Cinnamon,Cinnamon Twig Decoction Plus Radix Aconiti Lateralis Preparata,Cinnamon Twig Decoction Minus Peony,Cinnamon Twig and Aconite Decoction.The modified formulas partial to yin include Peony and Licorice Decoction,Newly Modified Cinnamon Twig Decoction,Cinnamon Twig Decoction Minus Cinnamon Plus White Atractylodes and Poria Decoction,Cinnamon Twig Decoction Plus Peony.The modified formulas partial to ascending include Cinnamon Twig Decoction Plus Pueraria,while the ones partial to descending include Trichosanthes and Cinnamon Twig Decoction,Cinnamon Twig Decoction Plus Officinal Magnolia Bark and Semen Armeniacae Amarum Decoction.In terms of internal syndrome,the modified formulas partial to keeping the middle and regulating the internal organs include Frigid Extremities Decoction,Minor Center-Fortifying Decoction,Astragalus Center-Fortifying Decoction.The ones partial to dredging meridians is Astragalus and Cinnamon Twig Five Substances Decoction.Cinnamon Twig Decoction supplemented with drugs that nourish yin and blood can nourish deficiency without stagnation,such as Cinnamon Twig Decoction Plus Radix Scutellariae,Cinnamon Twig and Peony and Rhizoma Anemarrhenae Decoction,Cinnamon Twig Decoction Minus Peony combined with Ephedra and Aconite and Asarum Decoction.The ones that can treat blocked meridians include Chinese Angelica Frigid Extremities Decoction,Chinese Angelica Frigid Extremities Decoction combined with Evodia and Fresh GingerDecoction,Channel-Warming Decoction with medication focusing on the interior or exterior.If we can stick to the way of adding and subtracting Zhang Zhong-jing,the diseases inside and outside the body can be easily cured.