国医大师梅国强运用柴胡陷胸汤辨治肺炎临证思路撮要

Summary of TCM master Mei Guoqiang’s clinical thinking of treating pneumonia with Chaihu Xianxiong Decoction

柴胡陷胸汤由小柴胡汤与小陷胸汤合方化裁而成,既能和解表里之半,又可分消上下之势。本文旨在介绍国医大师梅国强教授运用柴胡陷胸汤辨治肺炎的临证思路。梅国强教授以《伤寒论》中少阳病误下后仲景所列举的三种病机转归为基础,结合临床实践,合理扩展了少阳病误下后的疾病转归途径。梅国强教授认为痰热互结、病兼少阳是少阳病误下后病机转归途径中应有之意,并且此种转归是现代肺炎发病的重要病机。因此,梅国强教授临证辨治肺炎,其治法融会和解少阳与清热化痰散结于一炉,遣方善用柴胡陷胸汤化裁,屡见奇效。本文以期从梅国强教授运用柴胡陷胸汤之范例,窥探其扩展经方运用之全貌。

Chaihu Xianxiong Decoction is made of Xiaochaihu decoction combined with Xiaoxianxiong decoction and changes in composition.It can not only eliminate superficial and internal symptoms,but also eliminate upward and downward trends.The purpose of this article is to introduce the clinical thinking of Professor Mei Guoqiang,a Chinese medical master,using Chaihu Xianxiong decoction to treat pneumonia.Professor Mei Guoqiang,based on the three pathogenesis transformations listed in Zhang Zhongjing’s Treatise on Febrile Diseases after misusing the downward method to treat Shaoyang disease,combined with clinical practice,reasonably expanded the disease transformation path after misusing the downward method to treat Shaoyang disease.Professor Mei Guoqiang believes that phlegm-heat interjunction,disease combined with Shaoyang disease is the inevitable pathogenesis of Shaoyang disease after the misuse of downward treatment,and that this transformation is an important pathogenesis of modern pneumonia.Therefore,Professor Mei Guoqiang’s clinical differentiation and treatment of pneumonia,which integrates the principles of resolving Shaoyang and clearing heat,resolving phlegm,and dispersing phlegm in one furnace,is adept at using Chaihu Chuxiong Tang to treat pneumonia,and has repeatedly achieved remarkable results.It is hoped that Professor Mei Guoqiang’s application of Chaihu Xianxiong Decoction can be used as an example to probe into his complete thought of expanding the way to use sutra prescriptions.