乌梅丸方证探析

Analysis on Prescription and Syndrome of Wumei Pill

乌梅丸是厥阴病证治主方,其病机是肝阳虚挟有郁火,为上真热,下虚寒。乌梅丸的病位不局限在经文描述的心或心下位置,与厥阴病相关的脏腑、经络、气血病变都可以出现乌梅丸证,其临床表现具有多态性。乌梅丸方证主要有3个方面:其一是寸关弦尺脉弱,为上盛下虚的乌梅丸的脉象特征;其二是面色暗晦或暗红、舌质暗红,是厥阴相火内郁、病在血分的特征性表现;其三是舌苔中后部黄浊、胁腹部按之实,为木不疏土,水浊不化的重要表现。乌梅丸方药里黄连、黄柏等苦寒药用量并非一成不变,须根据舌苔厚薄、脉力强弱判断寒热比重而灵活变化用量。

Wumei pill is the main prescription for jueyin syndrome.Its pathogenesis is liver-yang deficiency with stagnation of fire,which is the upper true heat and the lower deficiency of cold.The disease location of Wumei pill is not limited to the heart or under the heart,which is described in the text.The disease of zang-fu organs,meridians and blood-qi related to jueyin disease can appear the syndrome of Wumei pill,and its clinical manifestation has polymorphism.There are three main aspects in the prescription syndrome of Wumei pill:the weak pulse of the first inch,which is the feature of the pulse of Wumei pill with the deficiency of the upper and lower parts,and the dark or dark red complexion and the dark red nature of the tongue,the third is that the middle and back of the tongue fur is yellow and turbid,and the abdomen is pressed to the solid,which is the important expression of the wood not dredge the earth,and the water is turbid.The dosage of bitter and cold medicines such as Coptis chinensis and Phellodendron Amurense in Wumei pill is not invariable,and it must be flexibly treated according to the thickness of tongue coating and the strength of pulse to judge the specific gravity of cold and heat.