从麻黄“发汗”谈葛根汤治疗闭合性痤疮

Discussion of Discuss The Treatment of Closed Acne with Puerariae Decoction from The Point of “Inducing Sweat” of Mahuang

自汉代《伤寒论》中收载麻黄汤一方后,后世医家多认为麻黄是一味发汗解表、止咳平喘的要药。其实细想所谓"发汗"与"利水"等均是表达麻黄对水液代谢发挥了作用。本文试结合导师岳仁宋以脾虚为基础病机的痤疮辨治经验,从汗液的产生、对"发"的理解以及麻黄助肺脾肾调节全身水液代谢出发,阐述辛温宣散法应用于闭合性痤疮治疗的重要作用。提出闭合性痤疮病机根本在于正虚失运、气血运行不畅所致,治疗当以清热泻火为表、通行气血为本,治疗时可灵活应用麻黄。

After the collection of Mahuang Decoction from Treatise on Febrile Diseases,Later physicians believe that Mahuang is a drug with the function of inducing sweat and dispelling exogenous evils and relieving cough and asthma.In fact,'inducing sweat'and'promote the circulation of water'are all expressed that Mahuang plays a role in water metabolism.This article tries to combine with the experience of diagnosis and treatment of acne based on spleen deficiency,starting from the production of sweat,the understanding of'Fa',and the point of view of Mahuang can help lung,spleen and kidney to regulate the whole body water and liquid metabolism together,to expound the important role of Pungent-warm and Disperse method in the treatment of closed acne.It is suggested that the underlying pathogenesis of closed acne lies in the loss of positive vacuity and the loss of movement of Qi and blood.The treatment should be based on clearing heat and should focus on Qi and blood circulation,Mahuang can be used flexibly in treatment.