国医大师张磊运用黄芩和黄连清热特点解析

Analysis of clearing heat characteristics of TCM master ZHANG Lei using Scutellariae Radix and Coptidis Rhizoma

文章通过系统整理国医大师张磊教授的带教讲解和临床病案,从病机、病证和用药配伍等方面深入阐释黄芩、黄连的清热特点和临证应用经验。黄芩善清少阳痞热,加升麻、葛根可增效;配伍木瓜、荔枝核增加黄芩清厥阴肝经郁热的功效;黄芩还能清解血分之热,联合活血化瘀、化痰、化湿、化浊等药,治疗疑难病症。黄连可清手少阴心经之火、胃肠之热、燥大肠之湿,可单用、或与黄芩同用。临床中,针对虚实夹杂、寒热错杂证,还需依据病机演变特点,精准选用包含黄芩、黄连的方剂。

By systematically sorting out the teaching explanations and clinical cases of TCM master ZHANG Lei, the heat-clearing characteristics and clinical application experiences of Scutellariae Radix and Coptidis Rhizoma are deeply interpreted from the aspects of disease syndrome, pathogenesis and prescription compatibility. Scutellariae Radix is expert in clearing dyspeptic fever of Shaoyang. Rhizoma Cimicifugae and Pueraria Lobate can enhance curative effect of Scutellariae Radix when use them together. As well as Chaenomeles Sinensis Koehne and Litchi Seed can assist Scutellariae Radix clear stagnated heat in liver meridian. Scutellariae Radix is also good at clearing heat caused by stagnation of qi by integrating with blood-activating and stasis-resolving medicine, phlegm-dissolving medicine, dampness-resolving medicine and turbidity-resolving medicine to treat difficult and complicated diseases. Coptidis Rhizoma can be used alone or together with Scutellariae Radix to clear fire of heart meridian of hand-shaoyin, heat of stomach intestine, and dry large intestine dampness. For the syndrome of asthenia and sthenia entrainment or cold and heat complex in clinical practice, it’s necessary to accurately select prescriptions containing Scutellariae Radix and Coptidis Rhizoma according to the characteristics of pathogenesis evolution.