本文主要研究内容
作者熊兴江（2019）在《木防己汤方证特征及其治疗重症心衰研究》一文中研究指出：木防己汤出自《金匮要略》,主治"膈间支饮"。然而,该方结构奇特,寒温并用,补泻同施,不可以常理解读、诠释。研究发现,木防己汤属少阴阳明合病,且方中配伍生石膏这一千古疑难问题具有深刻的病理生理学基础,符合临床实际,并非"不可理喻"。木防己汤方证特征包括:(1)在现代医学的疾病方面,木防己汤可用于急慢性心力衰竭、右心功能不全、全心衰、舒张功能不全心衰等各种类型的心力衰竭;肺部感染加重心衰、慢性阻塞性肺病急性发作、肺源性心脏病急性加重等肺部疾病;全心衰导致的双侧大量胸腔积液,且运用常规利尿剂疗效不佳者;痹证的治疗,包括痛风急性发作、风湿热、风湿性关节炎、类风湿性关节炎;风湿热及风湿性心脏病在以前发病率很高,推测该方在古代很可能用于风湿性心脏病伴心力衰竭的治疗。(2)在症状方面,木防己汤还可用于:喘憋,胸闷,胸满,喘息不能平卧,呼吸困难,甚则端坐位;心下、胃脘部位的胀满不适;脸色发黑、发暗、发紫,二尖瓣面容;头面、四肢水肿;口干,口渴,欲冷饮方舒,贪凉,不愿厚衣、厚被,畏热喜凉,烦躁;神疲乏力,气短懒言,纳差,便秘,大便干结难解,甚至数日一行,下肢水肿伴有小便不利,小便量少,色黄,且对利尿剂反应较差,甚至出现利尿剂抵抗,对常规的利尿方案不敏感;心率快,很难用西药控制;真武汤治疗无效;舌质暗红,舌干少津,舌苔黄,苍老苔,脉数,或沉紧。在管理危重症患者过程中,还认识到:阳虚水饮是心衰之"常态",是临床最常见的证型,也是最简单的证型;阳虚水饮化热则是心衰之"变态",是临床中的特殊类型,但这是一种客观存在,且运用常规温阳化饮法基本无效,如真武汤;阳虚水饮化热证的背后,存在深刻而复杂的病理生理学作用机制,且化热多提示预后不良,是运用生石膏的指征;少阴热化证的病理生理学机制与此相同;对于木防己汤方中配伍生石膏的疑难问题,历代医家众说纷纭,但大多以经解经、随文敷衍、不求甚解、无解强解,甚至"以其昏昏使人昭昭",需要重新审视、解读;木防己汤方证加减法中的"虚"与"实"不是言病机,而是指体征,"虚"是指阳虚水饮化热合并阳明经证的治疗,而"实"是指阳虚水饮化热合并阳明腑证的治疗,该条文符合现今临床实际,其背后存在深刻的病理生理学作用机制。
Abstract
mu fang ji shang chu zi 《jin kui yao lve 》,zhu zhi "ge jian zhi yin "。ran er ,gai fang jie gou ji te ,han wen bing yong ,bu xie tong shi ,bu ke yi chang li jie dou 、quan shi 。yan jiu fa xian ,mu fang ji shang shu shao yin yang ming ge bing ,ju fang zhong pei wu sheng dan gao zhe yi qian gu yi nan wen ti ju you shen ke de bing li sheng li xue ji chu ,fu ge lin chuang shi ji ,bing fei "bu ke li yu "。mu fang ji shang fang zheng te zheng bao gua :(1)zai xian dai yi xue de ji bing fang mian ,mu fang ji shang ke yong yu ji man xing xin li cui jie 、you xin gong neng bu quan 、quan xin cui 、shu zhang gong neng bu quan xin cui deng ge chong lei xing de xin li cui jie ;fei bu gan ran jia chong xin cui 、man xing zu sai xing fei bing ji xing fa zuo 、fei yuan xing xin zang bing ji xing jia chong deng fei bu ji bing ;quan xin cui dao zhi de shuang ce da liang xiong qiang ji ye ,ju yun yong chang gui li niao ji liao xiao bu jia zhe ;bi zheng de zhi liao ,bao gua tong feng ji xing fa zuo 、feng shi re 、feng shi xing guan jie yan 、lei feng shi xing guan jie yan ;feng shi re ji feng shi xing xin zang bing zai yi qian fa bing lv hen gao ,tui ce gai fang zai gu dai hen ke neng yong yu feng shi xing xin zang bing ban xin li cui jie de zhi liao 。(2)zai zheng zhuang fang mian ,mu fang ji shang hai ke yong yu :chuan bie ,xiong men ,xiong man ,chuan xi bu neng ping wo ,hu xi kun nan ,shen ze duan zuo wei ;xin xia 、wei wan bu wei de zhang man bu kuo ;lian se fa hei 、fa an 、fa zi ,er jian ban mian rong ;tou mian 、si zhi shui zhong ;kou gan ,kou ke ,yu leng yin fang shu ,tan liang ,bu yuan hou yi 、hou bei ,wei re xi liang ,fan zao ;shen pi fa li ,qi duan lan yan ,na cha ,bian bi ,da bian gan jie nan jie ,shen zhi shu ri yi hang ,xia zhi shui zhong ban you xiao bian bu li ,xiao bian liang shao ,se huang ,ju dui li niao ji fan ying jiao cha ,shen zhi chu xian li niao ji di kang ,dui chang gui de li niao fang an bu min gan ;xin lv kuai ,hen nan yong xi yao kong zhi ;zhen wu shang zhi liao mo xiao ;she zhi an gong ,she gan shao jin ,she tai huang ,cang lao tai ,mai shu ,huo chen jin 。zai guan li wei chong zheng huan zhe guo cheng zhong ,hai ren shi dao :yang xu shui yin shi xin cui zhi "chang tai ",shi lin chuang zui chang jian de zheng xing ,ye shi zui jian chan de zheng xing ;yang xu shui yin hua re ze shi xin cui zhi "bian tai ",shi lin chuang zhong de te shu lei xing ,dan zhe shi yi chong ke guan cun zai ,ju yun yong chang gui wen yang hua yin fa ji ben mo xiao ,ru zhen wu shang ;yang xu shui yin hua re zheng de bei hou ,cun zai shen ke er fu za de bing li sheng li xue zuo yong ji zhi ,ju hua re duo di shi yu hou bu liang ,shi yun yong sheng dan gao de zhi zheng ;shao yin re hua zheng de bing li sheng li xue ji zhi yu ci xiang tong ;dui yu mu fang ji shang fang zhong pei wu sheng dan gao de yi nan wen ti ,li dai yi jia zhong shui fen yun ,dan da duo yi jing jie jing 、sui wen fu yan 、bu qiu shen jie 、mo jie jiang jie ,shen zhi "yi ji hun hun shi ren zhao zhao ",xu yao chong xin shen shi 、jie dou ;mu fang ji shang fang zheng jia jian fa zhong de "xu "yu "shi "bu shi yan bing ji ,er shi zhi ti zheng ,"xu "shi zhi yang xu shui yin hua re ge bing yang ming jing zheng de zhi liao ,er "shi "shi zhi yang xu shui yin hua re ge bing yang ming fu zheng de zhi liao ,gai tiao wen fu ge xian jin lin chuang shi ji ,ji bei hou cun zai shen ke de bing li sheng li xue zuo yong ji zhi 。
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论文详细介绍
论文作者分别是来自中国中药杂志的熊兴江，发表于刊物中国中药杂志2019年02期论文，是一篇关于木防己汤论文,金匮要略论文,心力衰竭论文,胸腔积液论文,急危重症论文,中国中药杂志2019年02期论文的文章。本文可供学术参考使用，各位学者可以免费参考阅读下载，文章观点不代表本站观点，资料来自中国中药杂志2019年02期论文网站，若本站收录的文献无意侵犯了您的著作版权，请联系我们删除。
标签：木防己汤论文; 金匮要略论文; 心力衰竭论文; 胸腔积液论文; 急危重症论文; 中国中药杂志2019年02期论文;