半夏泻心汤证治要点及其临床应用探析

An Analysis of Diagnosis and Treatment of Pinellia Decoction for Purging Stomach-fire and Its Clinical Applications

半夏泻心汤出处,其一见《伤寒论》第149条,其二见《金匮要略·呕吐哕下利病脉证治》。此方是辛开苦降、升降有序、寒温并用、攻补兼施、调和脾胃的代表方剂,其治法属于八法中的和法。临证中不乏大师称其为:“掌握了半夏泻心汤,就可治好一半脾胃病。”可见此方在临床中应用之广泛。但要用好此方,必须精确辨别它的适应证,以及病因、病机、病位、病性,对其类方亦应该理解,才能适应临床之用,做到辨证准确,达到有是证、用是方、为是药。

Pinellia Decoction for Purging Stomach-fire comes from two books:one is the Article 149 of Treatise on Febrile Diseases,and the other is Synopsis of the Golden Chamber.This prescription is a representative one characterized by combining Xinkai and Kujiang,ascending and descending,cooling and warming,reinforcement and elimination to regulate the function of spleen and stomach.Its treatment belongs to the Mediation Method of the eight method.According to masters,if you can expertly apply the Pinellia Decoction for Purging Stomach-fire you can cure half of the spleen and stomach diseases from which its wide application can be seen.But to take advantage of this prescription and ensure clinical effect,we must accurately identify indications,as well as etiology,pathogenesis,disease location,and disease nature.Meanwhile,we have to achieve further understanding of similar decoction.With accurate differentiation of syndrome,proper formula can be applied.