本源剂量结合腹诊谈茯苓桂枝甘草大枣汤

Study on Poria and Cinnamon Twig and Licorice and Fructus Jujubae Decoction Based on Original Dose in Combination with Abdominal Diagnosis

按照经方本源剂量,茯苓桂枝甘草大枣汤的药物剂量应为茯苓125 g,桂枝60 g,炙甘草30 g,大枣15枚,多数医家用其治疗奔豚病,但其并非奔豚病专方,凡有脐动悸(脐上、脐下皆可)、心悸欲得按、欲作奔豚、舌淡边有齿痕者皆可应用。本方既可温心阳、利小便、降肾气以泄奔豚,还可温脾利湿治泄泻,又可补中温肺降气以治咳。若患者胸满烦惊、周身困乏、夜梦多、脐动悸,又舌胖大,边有齿痕,合用柴胡加龙骨牡蛎汤和解少阳、镇静安神;若其人后背发冷如掌大,可合苓桂术甘汤加强温阳健脾之功;若患者伴有下肢挛急疼痛、畏寒、四肢不温,可合芍药甘草附子汤以缓急止痛。

According to the original dose of the classic formula,the drug dose of Poria and Cinnamon Twig and Licorice and Fructus Ju-jubae Decoction should include 125 g of Fuling(Poria),60 g of Guizhi(Ramulus Cinnamomi),30 g of Zhigancao(Radix Glycyrrhizae Praeparata),and 15 pieces of Dazao(Fructus Jujubae).Most doctors use it to treat"running piglet".However,this is not a specific formula for running piglet.Anyone who meets the criteria for palpitations under the navel(either above or below the navel)in combina-tion with symptoms and signs such as desire to press,running like small pigs,and teeth marks on the pale edge of the tongue can apply it.This formula can not only warm heart yang,induce diuresis,and reduce kidney qi to evacuate running piglet,but also warm spleen,drain dampness to treat diarrhea,and can replenish the middle energizer,warm lung,and lower qi to treat cough.If the patient has chest fullness,vexation,panic,fatigue,more night dreaminess,umbilical palpitations,and fat tongue with tooth marks,Bupleurum Decoction plus Os Draconis and Oyster Shell Decoction can be used to reconcile lesser yang,calm and tranquilize the mind.If the person feels cold in the back as big as palm,Poria,Cinnamon Twig,Atractylodes Macrocephala and Licorice Decoction can be combined to strengthen the function of warming yang and invigorating the spleen.If the patient is accompanied by lower limb spasm and acute pain,aversion to cold,cold limbs,Peony and Licorice and Aconite Decoction can be combined to relieve spasm pain.Clinically,it has been used to treat refractory diarrhea,lung cancer cough,chondroma hiccup with lower limb pain after radiotherapy and chemotherapy after breast cancer surgery with good efficacies.