乌梅丸原系《伤寒杂病论》方,由乌梅、细辛、附子、桂枝、人参、黄柏、黄连、干姜、当归、椒目组成,具有温脏、补虚、安蛔之功效,原多用治蛔厥。笔者以该方加减用治内科杂症,疗效颇好,兹举例如下。
1、泄泻
董某,男,62岁,1993年5月初诊。患者因腹泻2年余,屡治不效。诊见:面色晦黯,大便溏薄,夹有不消化食物,每天5～6次,伴有腹胀隐痛,时热时冷感,食少乏力,舌淡红、苔薄白腻,脉弦细。证乃久病缠绵,脾气虚弱,运化失权,兼寒热夹杂,治以温中补虚,收涩止泻,拟乌梅丸加减。处方:乌梅15g,干姜、黄柏各10g,炮附子、黄连、细辛、桂枝各3g,党参、神曲各30g。每天1剂,水煎服。7剂后大便次数明显减少,成形。30剂后大便基本复常。
按:本例泄泻,时间近2年余,西医未有明确诊断。肝硬化、肠肿瘤多见便溏,腹胀隐痛,夹有不消化食物,且病程较长,反复不愈,与本例近似。久泄不止,致脾土虚衰,中阳不温,运化失职。方中乌梅、干姜温中收涩;少佐附子、细辛、桂枝辛温之品,增强温脏之力;黄柏、黄连苦寒坚下,又能缓和方中诸药之温燥;党参、神曲补气健脾,和胃止泻。诸药对症,故能获效。
2、咳嗽
曹某,女,61岁,1991年初诊。患者系结肠癌术后肺转移化疗后,咳嗽痰少,色白质粘,咯出不爽,口干,时伴有胸闷不舒,气短便溏,食少腹胀,面色少华,舌淡红、苔少,脉濡。证属病久体弱,脾土亏虚,土不生金,宣肃失常。治以温中补虚,敛肺止咳。拟乌梅丸加减。处方:乌梅15g,干姜、黄柏、黄芩、椒目、紫苏叶、天竺黄各10g,炮附子、细辛、桂枝各3g,党参、黄芪各30g。水煎服,每天1剂。服药2周咳嗽减轻,去紫苏叶、天竺黄,再进2周,咳嗽平。
按:肺部转移性肿瘤形成慢性咳嗽,多见干咳,痰少难咯,久咳易累及脾脏,形成寒热错杂症。虽病位在肺,治宜兼顾肺、脾。方中乌梅味酸,敛肺止咳;黄柏、黄芩燥湿化痰;天竺黄、紫苏叶止咳平喘;附子、干姜、椒目、细辛、桂枝取“病痰饮者,当以温药和之”之意,且桂枝能温通上下,和血宽中;党参、黄芪补肺脾之气,扶助正气以祛邪。
3、胃脘痛
金某,男,68岁,1997年初诊。患者为胰腺癌术后,胃脘隐痛,食欲减退,食后饱胀,偶泛涎水,面色萎黄,形瘦,大便溏薄,舌淡、苔白,脉弦细。
Wu Mei Wan was formerly the "typhoid MISCELLANEOUS disease" side by Wu Mei, Asarum, Aconite, Guizhi, ginseng, Phellodendron, the Chinese, Ginger, Angelica, Law head, with a temperature dirty, Bu Xu, Hui-an's effectiveness , The original multi-use rule Hui Jue. I side with the addition and subtraction with diseases of internal medicine administration, quite a good effect, it follows, for example.
1, Diarrhea
Dongmou, M, 62 years old, first visit in May 1993. Patients with diarrhea as a result of more than 2 years, repeated rule is not effective. See diagnosis: dark complexion dim, soft stool thin, there are folders indigestion food, 5 to 6 times a day, accompanied by abdominal pain, when the heat when the cold flu, food less fatigue, tongue Danhong, moss Baini thin, veins Thin string. Certification is lingering ill for a long time, temper weakness, loss of transportation, cold and heat and inclusion, governance of Wen Buxu to close antidiarrheal Shibuya, Wu Mei Wan to be modified. Prescription: Wu Mei 15g, Ginger, the Phellodendron 10g, Aconite guns, the Chinese, Asarum, the Guizhi 3g, lanceolata, the Divine Comedy 30g. A day, Shuijian Fu. 7 after the apparent reduction in the number of stool, forming. 30 stool after the resumption of regular basic.
: Diarrhea in this case, the last time more than 2 years, Western medicine has not given a clear diagnosis. Liver, intestinal tumors will be more common pond, the stomach pain, indigestion folder there is food, and a longer course of disease, repeatedly Buyu, in this case and similar. For a long time just to vent, caused by virtual Pitu decline in non-Wen Yang, Yun of dereliction of duty. Wu Mei Fang, Wen Ginger received in Shibuya; Shaozuo Aconite, Asarum, Wen Xin Guizhi of goods, and enhance warm dirty power; Phellodendri, the Chinese cold Kennedy, the drug can ease Fang Zhu Wen's dry; dangshen, God Qu Qi spleen, stomach and diarrhea. All drug prescriptions, it can be effective.
2, cough
Jo, the woman, 61-year-old, newly diagnosed in 1991. Department of colon cancer in patients with lung metastases after chemotherapy, less phlegm coughing, color sticky white matter, Lo Chu in a bad mood, dry mouth, chest tightness, when not accompanied by Shu, then shortness of breath Greed, eat less bloating, Shaohua face, tongue Dan Hong , Less moss, moisten vein. Certification is a disease frail for a long time, Pitu deficiency, the soil is not golden, Xuan Su disorders. Wen to rule in Buxu, Convergence and lung cough. Wu Mei Wan to addition and subtraction. Prescription: Wu Mei 15g, Ginger, Phellodendron, baicalin, Law head, perilla leaf, the Wong Chuk 10g, Aconite gun, Asarum, the Guizhi 3g, lanceolata, the Astragalus 30g. Shuijian Fu, a day. 2 weeks to reduce cough medication to perilla leaves, Huang India, and then into the 2 weeks, coughing level.
: Metastatic lung tumor formation chronic cough, mostly dry cough, sputum 1, 10 less difficult, easy Chronic involving the spleen, cold and heat to form the wrong diseases. Although the disease in the lung, Zhiyi both lungs, spleen. Wu Mei Fang Wei Suan, Convergence and lung cough; Phellodendron, baicalin dampness phlegm; India yellow, purple perilla leaf cough antiasthmatic; Monkshood, Ginger, the head Law, Asarum, Guizhi check, "Tan Yin patients who When the temperature to drugs and the "means and can Guizhi warm-up and down, and blood in width; dangshen, Astragalus Feipi fill the air, in order to support healthy Quxie.
3, Epigastralgia
Kim, M, 68 years old, newly diagnosed in 1997. For patients with pancreatic cancer patients, Wei Wan secret anguish, loss of appetite, fullness after eating, even pan-Xianshui, looking chlorosis, Xingshou stool Greed thin, short tongue, moss white, thin veins string.
1、泄泻
董某,男,62岁,1993年5月初诊。患者因腹泻2年余,屡治不效。诊见:面色晦黯,大便溏薄,夹有不消化食物,每天5～6次,伴有腹胀隐痛,时热时冷感,食少乏力,舌淡红、苔薄白腻,脉弦细。证乃久病缠绵,脾气虚弱,运化失权,兼寒热夹杂,治以温中补虚,收涩止泻,拟乌梅丸加减。处方:乌梅15g,干姜、黄柏各10g,炮附子、黄连、细辛、桂枝各3g,党参、神曲各30g。每天1剂,水煎服。7剂后大便次数明显减少,成形。30剂后大便基本复常。
按:本例泄泻,时间近2年余,西医未有明确诊断。肝硬化、肠肿瘤多见便溏,腹胀隐痛,夹有不消化食物,且病程较长,反复不愈,与本例近似。久泄不止,致脾土虚衰,中阳不温,运化失职。方中乌梅、干姜温中收涩;少佐附子、细辛、桂枝辛温之品,增强温脏之力;黄柏、黄连苦寒坚下,又能缓和方中诸药之温燥;党参、神曲补气健脾,和胃止泻。诸药对症,故能获效。
2、咳嗽
曹某,女,61岁,1991年初诊。患者系结肠癌术后肺转移化疗后,咳嗽痰少,色白质粘,咯出不爽,口干,时伴有胸闷不舒,气短便溏,食少腹胀,面色少华,舌淡红、苔少,脉濡。证属病久体弱,脾土亏虚,土不生金,宣肃失常。治以温中补虚,敛肺止咳。拟乌梅丸加减。处方:乌梅15g,干姜、黄柏、黄芩、椒目、紫苏叶、天竺黄各10g,炮附子、细辛、桂枝各3g,党参、黄芪各30g。水煎服,每天1剂。服药2周咳嗽减轻,去紫苏叶、天竺黄,再进2周,咳嗽平。
按:肺部转移性肿瘤形成慢性咳嗽,多见干咳,痰少难咯,久咳易累及脾脏,形成寒热错杂症。虽病位在肺,治宜兼顾肺、脾。方中乌梅味酸,敛肺止咳;黄柏、黄芩燥湿化痰;天竺黄、紫苏叶止咳平喘;附子、干姜、椒目、细辛、桂枝取“病痰饮者,当以温药和之”之意,且桂枝能温通上下,和血宽中;党参、黄芪补肺脾之气,扶助正气以祛邪。
3、胃脘痛
金某,男,68岁,1997年初诊。患者为胰腺癌术后,胃脘隐痛,食欲减退,食后饱胀,偶泛涎水,面色萎黄,形瘦,大便溏薄,舌淡、苔白,脉弦细。
Wu Mei Wan was formerly the "typhoid MISCELLANEOUS disease" side by Wu Mei, Asarum, Aconite, Guizhi, ginseng, Phellodendron, the Chinese, Ginger, Angelica, Law head, with a temperature dirty, Bu Xu, Hui-an's effectiveness , The original multi-use rule Hui Jue. I side with the addition and subtraction with diseases of internal medicine administration, quite a good effect, it follows, for example.
1, Diarrhea
Dongmou, M, 62 years old, first visit in May 1993. Patients with diarrhea as a result of more than 2 years, repeated rule is not effective. See diagnosis: dark complexion dim, soft stool thin, there are folders indigestion food, 5 to 6 times a day, accompanied by abdominal pain, when the heat when the cold flu, food less fatigue, tongue Danhong, moss Baini thin, veins Thin string. Certification is lingering ill for a long time, temper weakness, loss of transportation, cold and heat and inclusion, governance of Wen Buxu to close antidiarrheal Shibuya, Wu Mei Wan to be modified. Prescription: Wu Mei 15g, Ginger, the Phellodendron 10g, Aconite guns, the Chinese, Asarum, the Guizhi 3g, lanceolata, the Divine Comedy 30g. A day, Shuijian Fu. 7 after the apparent reduction in the number of stool, forming. 30 stool after the resumption of regular basic.
: Diarrhea in this case, the last time more than 2 years, Western medicine has not given a clear diagnosis. Liver, intestinal tumors will be more common pond, the stomach pain, indigestion folder there is food, and a longer course of disease, repeatedly Buyu, in this case and similar. For a long time just to vent, caused by virtual Pitu decline in non-Wen Yang, Yun of dereliction of duty. Wu Mei Fang, Wen Ginger received in Shibuya; Shaozuo Aconite, Asarum, Wen Xin Guizhi of goods, and enhance warm dirty power; Phellodendri, the Chinese cold Kennedy, the drug can ease Fang Zhu Wen's dry; dangshen, God Qu Qi spleen, stomach and diarrhea. All drug prescriptions, it can be effective.
2, cough
Jo, the woman, 61-year-old, newly diagnosed in 1991. Department of colon cancer in patients with lung metastases after chemotherapy, less phlegm coughing, color sticky white matter, Lo Chu in a bad mood, dry mouth, chest tightness, when not accompanied by Shu, then shortness of breath Greed, eat less bloating, Shaohua face, tongue Dan Hong , Less moss, moisten vein. Certification is a disease frail for a long time, Pitu deficiency, the soil is not golden, Xuan Su disorders. Wen to rule in Buxu, Convergence and lung cough. Wu Mei Wan to addition and subtraction. Prescription: Wu Mei 15g, Ginger, Phellodendron, baicalin, Law head, perilla leaf, the Wong Chuk 10g, Aconite gun, Asarum, the Guizhi 3g, lanceolata, the Astragalus 30g. Shuijian Fu, a day. 2 weeks to reduce cough medication to perilla leaves, Huang India, and then into the 2 weeks, coughing level.
: Metastatic lung tumor formation chronic cough, mostly dry cough, sputum 1, 10 less difficult, easy Chronic involving the spleen, cold and heat to form the wrong diseases. Although the disease in the lung, Zhiyi both lungs, spleen. Wu Mei Fang Wei Suan, Convergence and lung cough; Phellodendron, baicalin dampness phlegm; India yellow, purple perilla leaf cough antiasthmatic; Monkshood, Ginger, the head Law, Asarum, Guizhi check, "Tan Yin patients who When the temperature to drugs and the "means and can Guizhi warm-up and down, and blood in width; dangshen, Astragalus Feipi fill the air, in order to support healthy Quxie.
3, Epigastralgia
Kim, M, 68 years old, newly diagnosed in 1997. For patients with pancreatic cancer patients, Wei Wan secret anguish, loss of appetite, fullness after eating, even pan-Xianshui, looking chlorosis, Xingshou stool Greed thin, short tongue, moss white, thin veins string.