《金匮要略》“中风篇”防己地黄汤、风引汤方证及其在中风、神志疾病中的运用

Fangji Dihuang Decoction formula syndrome and Fengyin Decoction formula syndrome:application in stroke and mental disorders

防己地黄汤、风引汤均出自《金匮要略·中风历节病脉证并治第五》,主治中风。然而,这2首方剂极为生僻,在临床罕见运用,且难以常理可喻。研究发现:方证条文的背后存在明确的现代病理生理学发病机制,可以用现代科学的语言进行解读、诠释。防己地黄汤可以滋阴补肾,息风通络,可用于治疗脑梗死、老年痴呆、阿尔兹海默病等脑血管疾病导致的狂躁不安,开启后世养阴息风法治疗中风先河;方中大剂量生地黄可以补液扩容,改善灌注,其药证可增订为"主治烦躁、发狂,旁治血证、水病、便秘、羸瘦也"。风引汤可以清热息风,重镇安神,可用于治疗脑梗死、并发肢体瘫痪、癫痫发作,且中医辨证属于火热亢盛者,具有较好的镇静作用,可能相当于"东方的奥氮平",开启后世平肝潜阳法治疗中风先河。上述中风诸方可以合方而用,在中风、神志疾病中具有极高的运用价值。

Fangji Dihuang Decoction and Fengyin Decoction, which were firstly recorded in Synopsis of the Golden Chamber, could be used to treat stroke. However, both of these two decoctions are used infrequently. There is a clear pathogenesis of modern pathophysiology behind Fangji Dihuang Decoction syndrome and Fengyin Decoction syndrome, which can be interpreted by modern language of science. Fangji Dihuang Decoction can nourish Yin, tonify kidney, extinguish the wind, and dredge collaterals. It could be used to treat mania caused by cerebral infarction, senile dementia, Alzheimer′s disease and other cerebrovascular diseases, and opened up the precedent of nourishing Yin and expelling wind to treat stroke in later generations. Fengyin Decoction can clear heat, extinguish the wind, and calm the mind. It can be used to treat cerebral infarction, limb paralysis and epileptic seizures with heat syndrome. It may be equivalent to 'oriental olanzapine', and opened up the precedent of smoothing liver and suppressing Yang to treat stroke in later generations. They can be used in the combination, with a high application value in treating stroke and mental diseases.