制附子与半夏炮制品配伍使用的临床探讨

A clinical study on the combined application of processed Fuzi and processed Banxia

乌头与半夏是中药配伍禁忌“十八反”的内容之一,理论上若将两种药物同用会发生剧烈的不良反应。制附子是乌头子根的加工品,成分与乌头大致相同,因乌头反半夏,因而许多医书记载附子不宜配半夏,并在中国沿袭已久。云南是高寒地区,附子在云南的使用频率很高。在云南昆明市中医医院使用制附子治病极为常见,临床诊疗时使用制附子与半夏炮制品配伍运用,疗效良好,多次获得患者好评。文章就附子与半夏配伍这一命题,将文献进行梳理归纳,结合昆明市中医医院实际应用情况进行探讨,以期为临床用药提供参考。临床上二者配伍应用古来有之,火神派医师常用制附子与半夏炮制品相配伍。提倡扶阳派学说的火神派医师在临床诊疗实践中可以证明制附子与半夏炮制品能配伍使用,但现代多数医家认为附子是川乌的附生根,二者成分大致相同,故大多认为半夏反附子。近年来,大家对二者是否相反的问题意见不一,而历代先贤都曾有过将制附子与半夏炮制品同用的例子,近现代临床也经常看到二者的配伍使用,且临床上辨证运用于治疗寒湿之证,文章旨在给临床医师提供一点参考。

Wutou(Radix Aconiti)and Banxia(Rhizoma Pinelliae)are one of the contents of eighteen taboos in the compatibility of TCM medicine.If the two drugs are used together,severe adverse reactions will occur.Processed Fuzi(Radix Aconiti Lateralis Preparata)is a processed product of Wutoa root,and its composition is roughly the same as that of Wutou.Because Wutou is anti-Banxia ternate,many medical books record that aconite is not suitable for pinellia,and it has been followed for a long time in China.Yunnan is an cold alpine region,and processed Fuzi is used frequently in Yunnan.It is very common to use processed Fuzi to treat diseases in Kunming Hospital of Traditional Chinese Medicine in Yunnan Province.The combination of processed Fuzi and processed Banxia shows a good effect in clinical diagnosis and treatment,and has been praised by patients for many times.In this paper,the literature on the proposition of the compatibility of Fuzi and Banxia is sorted and summarized,and relevant discussions is carried out according to the actual application in the hospital,with a view to providing a reference for clinical medication.Clinically,the combination of the two has existed since ancient times.Huoshen School(火神派)physicians often used processed Fuzi together with processed Banxia.Huoshen School physicians who advocate the theory of Fuyang School(扶阳派)can prove in clinical diagnosis and treatment practice that processed Fuzi and processed Banxia can be used compatibly.Most modern doctors believe that Fuzi is the epiphytic root of Chuanwu(Radix Aconiti),and the composition of the two is roughly the same,so most of them believe that Banxia is anti-Fuzi.In recent years,people have different opinions on whether the two are opposite,and ancient sages had used processed aconite with processed Banxia.The compatibility of the two is also often seen in modern clinical practice,which is used to treat cold and dampness syndromes based on syndrome differentiation,hoping to provide a reference for clinicians.