基于妇人产后体质特点探讨竹叶汤方证

Discussion About Formula-Syndrome of Laphatherum Decoction Based on Women′s Postpartum Physical Characteristics

竹叶汤的主治病证为产后中风,产后中风有两个特点:(1)易病痉:产后亡血,复加外感伤津,易致筋失所养,发为痉病;(2)易阳虚:产后亡血复汗,阴液已伤,气随津脱,阳气亦伤。产后气血聚于阳明,注于乳房,化生乳汁,故产后阳明经气旺盛,一旦受邪,极易化热,且易郁结。故竹叶汤证病机为阳虚中风,且易致痉,阳明热盛,且易郁结。竹叶汤用人参、附子温补少阴阳气,在桂枝汤的基础上加桔梗利肺气,葛根升津防痉,防风解表防痉,竹叶辛寒,解阳明经热结,去白芍,防经气流通不利,加大了生姜用量,促经气流通,防止痹结。

The main treatment syndrome of Laphatherum Decoction is postpartum stroke.Postpartum stroke has two characteristics:(1)It is prone to spasm,postpartum blood loss,combined with externally contracted fluid injury,which is easy to cause tendon nutrient loss and spasm;(2)It is prone to yang deficiency,postpartum blood loss and sweating.Yin fluid has been injured,so qi loses with fluid,and yang qi is also injured.Postpartum qi and blood gather in yang brightness meridian,is injected into the breast and transformed into milk.Therefore,postpartum yang brightness meridian has strong meridian qi.Once it is attacked by pathogens,it is very easy to turn heat and easy to stagnate.Therefore,the pathogenesis of Laphatherum Decoction syndrome is yang-deficiency stroke,which is easy to cause spasm;when yang brightness meridian has excessive heat,it is prone to stagnation.In Laphatherum Decoction,Renshen(Radix Ginseng)and Fuzi(Radix Aconiti Lateralis Preparata)are used to warm and nourish yang qi of less yin meridian.On the basis of Cinnamon Twig Decoction,Jiegeng(Radix Platycodonis)is used to promote lung qi;Gegen(Radix Puerariae Lobatae)is used to generate fluid and prevent spasm;Fangfeng(Radix Saposhnikoviae)is used to release the exterior and prevent spasm;Zhuye(Folium Phyllostachydis Henonis)which is pungent and cold is used to remove heat stagnation of yang brightness meridian.Baishao(Radix Paeoniae Alba)is removed to prevent meridian qi from moving unsmoothly;The amount of Shengjiang(Rhizoma Zingiveris Recens)is increased to promote meridian qi circulation and prevent arthralgia and stagnation.