乌梅丸在临床中常加减应用,若是辨治蛔厥证,通常可用乌梅丸原方原量,用汤剂时可酌情减少方药物用量;若是上热下寒夹虚证或辨治肝热阳郁证,必须重视因病变证机主次而酌情调整药物用量,亦即确定药物用量务必与主治病变证机和病证表现切切相应。如热重者可加大黄连、黄柏用量,亦可酌情减少辛热药用量;若寒重者可加大辛热药用量,或减少苦寒药用量;若正气虚弱甚者可加大人参、当归用量;乌梅用量必须因病变证机轻重而增减,治病用方用药贵在思路清晰,恰到好处,随机应变。 治蛔厥证 蛔得酸则静,故此方用乌梅、苦酒之酸以制蛔;蛔得苦则下,故用黄连、黄柏之苦以下蛔;蛔得辛则伏,故用附子、干姜、桂枝、细辛、蜀椒之辛以伏蛔;蛔得甘则动,故用人参、当归之甘以诱蛔。在临床中,运用乌梅丸主治蛔厥证而没有用于治疗慢性胆囊炎多,其实临证只要慢性胆囊炎的表现符合蛔厥证者,以法用之则能取得良好治疗效果。 庞某,女,42岁。有数年慢性胆囊炎病史,曾作胆囊结石手术,术后仍脘腹胸胁胀痛,时轻时重,中西药治疗可症状改善不明显。刻诊:胃痛腹胀,心下痞满,气逆胸胁,而尔胸胁胀痛,手足厥冷,不欲冷食,口干不欲多饮,口苦,舌质暗淡,苔黄厚腻,脉沉弱。辨为寒热错杂夹虚证,治当清上温下,兼以补虚,给予乌梅丸变汤剂,乌梅15克,黄连12克,细辛3克,干姜6克,当归10克,黄柏12克,桂枝3克,红参6克,附子3克,花椒3克,枳实10克,白芍12克,山楂24克,醋20毫升。6剂,每日1剂,水煎服,分3服。二诊:胃脘痞满减轻,手足转温,又以前方6剂。三诊:苔厚腻基本消退,口苦减轻,又以前方6剂。四诊:诸证均较前明显好转,又以前方6剂。五诊:诸证悉除,又将前方变汤剂为散剂,巩固治疗2个月。随访1年,一切尚好。 用方体会:该病例手足厥冷辨为寒证,口苦、苔黄厚腻辨为湿热,因心下痞满,胃痛腹胀辨为浊气壅滞,又因脉沉弱辨为虚,以此辨为寒热夹虚证。方中乌梅收敛止泻;黄连、黄柏,清热燥湿;附子、干姜、桂枝、细辛、花椒,温阳散寒;人参,当归,补益气血;加枳实行气导滞,白芍补血缓急止痛,山楂消食化瘀。方药相互为用,以取其效。 治久利证 乌梅丸“又主久利”,方中乌梅、苦酒收敛止泻;黄连、黄柏清泄上热;附子、干姜、桂枝、细辛、蜀椒温暖下寒;人参、当归补益气血。上诉可知乌梅丸是主治上热下寒夹虚证或寒热错杂夹虚证的重要治病方。 杨某,女,61岁。有慢性溃疡性结肠炎近2年,每天大便至少3次,时呈水样,时呈脓样,数经治疗,腹泻仍在,近半年来又增腹中肠鸣且响声如雷。刻诊:腹泻因食凉或受凉加重,手足厥冷,下肢轻微水肿,经常口腔溃疡,疮面灼热疼痛,面色萎黄,形体消瘦,口渴饮水不多,舌质红,苔薄黄,脉沉弱。辨为上热下寒夹虚证,治当清上温下,兼以补虚,给予乌梅丸变汤剂,乌梅24克,黄连12克,细辛3克,干姜6克,当归12克,黄柏12克,桂枝3克,红参10克,附子6克,花椒3克,诃子10克,醋20毫升。6剂,每日1剂,水煎服,每日分3服。二诊:腹泻明显改善,口腔溃疡痊愈,又以前方6剂。三诊:唯独腹中雷鸣仍在,加姜半夏12克,粳米20克,又以前方6剂。四诊:腹中肠鸣次数减少,又以前方6剂。五诊:诸证解除,欲巩固治疗,复以前方6剂。随访半年,一切尚好。 用方体会:腹泻因食凉或受凉而加重辨为寒,口腔溃疡灼热疼痛辨为热,因面色萎黄,形体消瘦辨为虚,以此辨为上热下寒夹虚证。方中以乌梅收敛止泻;黄连、黄柏清泄上热,附子、干姜、桂枝、细辛、花椒,温暖下寒,人参、当归补益气血,加诃子增强收敛固涩,因腹中肠鸣又加半夏燥湿降逆,粳米益气,兼防辛散药伤气、苦寒药伤胃。方药相互为用,以取得预期治疗效果。 治肝热阳郁证 根据“厥阴之为病,消渴,气上撞心,心中疼热,饥而不欲食,食则吐蛔。”当属肝热阳郁证。此方中乌梅、苦酒酸甘化阴,滋补肝体,以治消渴;黄连、黄柏以苦寒清热,以治心中疼热;少用附子、干姜、桂枝、细辛、蜀椒之辛,辛热通达阳郁,以治饥而不欲食;气血不足,人参、当归之甘能补肝体,以治病体夹虚。本方中诸药相互为用,清热不遏阳,通阳不助热。肝体阴而用阳,阳主动,用滋阴药虽能滋肝,但妨肝阳主动,所以滋肝必用通阳,以使阴得阳而化生。
Wumei Pill often in the clinical application of addition and subtraction, if the hard evidence in Treating蛔usually Wumei Pill available to the original amount of the original, decoction can be used to reduce the drug dosage as appropriate; if the heat or the Lower Cambrian in Treating Liver Deficiency folder yang hot Melancholia, attention must be given due to local primary and secondary lesions and, where appropriate, evidence of drug dosage adjustment, that is, be sure to determine the drug dosage changes and charge card and be absolutely sure the performance of the corresponding diseases. Such as TG may increase Huanglian, Huangbai used, as appropriate, may also reduce the amount of medicinal hot Xin; if Han Xin weight can increase the amount of heat medicinal, or reduce the amount of cold medicine; if righteousness could be worse weak increase ginseng, Chinese angelica dosage; Mume dosage must be due to the severity of disease and changes in card machines, to use with your medical treatment in the clear, right, act according to circumstances.
蛔hard evidence rule
蛔acid is a static and therefore side with Black Plum, Bitters蛔the acid to the system;蛔too hard the next, so with Huanglian, suffered the following蛔Huangbai;蛔Sim is a V, so use Aconite, Ginger, Guizhi , Asarum,蜀椒to the symplectic蛔V;蛔Gambari will have to move, so use ginseng, Chinese angelica to the Gan蛔induced. Clinical use of Wu Mei Wan蛔charge card and not hard for the treatment of chronic cholecystitis and more, in fact, as long as the clinical manifestations consistent with chronic cholecystitis蛔hard evidence, the law can be used to obtain a good therapeutic effect.
庞某, F, 42-year-old. For several years history of chronic cholecystitis, cholelithiasis has been the subject of surgery, postoperative pain is still脘abdominal胸胁, the time when light weight, in the western medicine treatment can improve the symptoms was not obvious. Carved patient: stomach bloating,心下痞full, gas inverse胸胁, and Seoul胸胁pain, hand-foot-厥冷, do not want to cold, dry mouth do not want to drink more, pain, dim tongue, thick and greasy yellow coating , Shen weak pulse. Identified as cold and heat Deficiency mixed folder, when the Qing government, under the temperature, and to补虚given change Wumei Pill decoction, Mume 15 grams, 12 grams Huanglian, breviscapus 3 grams, 6 grams ginger, angelica 10 grams, Huangbai 12 grams, Guizhi 3 grams, 6 grams of red ginseng, monkshood 3 grams, 3 grams pepper, Zhishi 10 g, Radix Paeoniae Alba 12 grams, 24 grams of Hawthorn, 20 milliliters of vinegar. 6, one day,水煎服, sub-3. Second consultation: full胃脘reduce the swelling of the liver, hand, foot and turn the temperature, again in front of six. Three patient: basic regression thick and greasy coating, reduce pain, on the front 6. Four diagnostic methods: evidence from the former were significantly improved, again in front of six. Five consultation: evidence from悉除, the front will change for the powder decoction, to consolidate the treatment of 2 months. 1 year follow-up, everything is still good.
Used to understand: The cases identified for hand, foot and厥冷cold syndrome, pain, thick yellow greasy moss identified as heat, due to age心下痞, stomach distention浊气identified as壅滞, because of weak pulse Shen identified as true, folder identified as a deficiency for the cold and heat. Fangzhong Mume Zhixie convergence; Coptis, Phellodendron, Qingre dampness; Aconite, Ginger, Guizhi, Asarum, pepper, and cold-dispelling Onyang; ginseng, Chinese angelica, benefit qi and blood;导滞increase gas Hovenia implemented, Radix Paeoniae Alba Buxue priorities pain, blood Xiaoshi hawthorn. Prescriptions for the use of each other in order to select the effect.
Giuly governance certification
Wumei Pill "and the main long-Lee", Fangzhong Mume, Bitters Zhixie convergence; Coptis, Phellodendron清泄on the heat; Aconite, Ginger, Guizhi, Asarum, Lower Cambrian蜀椒warm; ginseng, Chinese angelica blood tonic. Wu Mei Wan appeal, we can see is under the charge on the hot or cold chills and fever mixed folder folder Deficiency Deficiency of
治蛔厥证
蛔得酸则静,故此方用乌梅、苦酒之酸以制蛔;蛔得苦则下,故用黄连、黄柏之苦以下蛔;蛔得辛则伏,故用附子、干姜、桂枝、细辛、蜀椒之辛以伏蛔;蛔得甘则动,故用人参、当归之甘以诱蛔。在临床中,运用乌梅丸主治蛔厥证而没有用于治疗慢性胆囊炎多,其实临证只要慢性胆囊炎的表现符合蛔厥证者,以法用之则能取得良好治疗效果。
庞某,女,42岁。有数年慢性胆囊炎病史,曾作胆囊结石手术,术后仍脘腹胸胁胀痛,时轻时重,中西药治疗可症状改善不明显。刻诊:胃痛腹胀,心下痞满,气逆胸胁,而尔胸胁胀痛,手足厥冷,不欲冷食,口干不欲多饮,口苦,舌质暗淡,苔黄厚腻,脉沉弱。辨为寒热错杂夹虚证,治当清上温下,兼以补虚,给予乌梅丸变汤剂,乌梅15克,黄连12克,细辛3克,干姜6克,当归10克,黄柏12克,桂枝3克,红参6克,附子3克,花椒3克,枳实10克,白芍12克,山楂24克,醋20毫升。6剂,每日1剂,水煎服,分3服。二诊:胃脘痞满减轻,手足转温,又以前方6剂。三诊:苔厚腻基本消退,口苦减轻,又以前方6剂。四诊:诸证均较前明显好转,又以前方6剂。五诊:诸证悉除,又将前方变汤剂为散剂,巩固治疗2个月。随访1年,一切尚好。
用方体会:该病例手足厥冷辨为寒证,口苦、苔黄厚腻辨为湿热,因心下痞满,胃痛腹胀辨为浊气壅滞,又因脉沉弱辨为虚,以此辨为寒热夹虚证。方中乌梅收敛止泻;黄连、黄柏,清热燥湿;附子、干姜、桂枝、细辛、花椒,温阳散寒;人参,当归,补益气血;加枳实行气导滞,白芍补血缓急止痛,山楂消食化瘀。方药相互为用,以取其效。
治久利证
乌梅丸“又主久利”,方中乌梅、苦酒收敛止泻;黄连、黄柏清泄上热;附子、干姜、桂枝、细辛、蜀椒温暖下寒;人参、当归补益气血。上诉可知乌梅丸是主治上热下寒夹虚证或寒热错杂夹虚证的重要治病方。
杨某,女,61岁。有慢性溃疡性结肠炎近2年,每天大便至少3次,时呈水样,时呈脓样,数经治疗,腹泻仍在,近半年来又增腹中肠鸣且响声如雷。刻诊:腹泻因食凉或受凉加重,手足厥冷,下肢轻微水肿,经常口腔溃疡,疮面灼热疼痛,面色萎黄,形体消瘦,口渴饮水不多,舌质红,苔薄黄,脉沉弱。辨为上热下寒夹虚证,治当清上温下,兼以补虚,给予乌梅丸变汤剂,乌梅24克,黄连12克,细辛3克,干姜6克,当归12克,黄柏12克,桂枝3克,红参10克,附子6克,花椒3克,诃子10克,醋20毫升。6剂,每日1剂,水煎服,每日分3服。二诊:腹泻明显改善,口腔溃疡痊愈,又以前方6剂。三诊:唯独腹中雷鸣仍在,加姜半夏12克,粳米20克,又以前方6剂。四诊:腹中肠鸣次数减少,又以前方6剂。五诊:诸证解除,欲巩固治疗,复以前方6剂。随访半年,一切尚好。
用方体会:腹泻因食凉或受凉而加重辨为寒,口腔溃疡灼热疼痛辨为热,因面色萎黄,形体消瘦辨为虚,以此辨为上热下寒夹虚证。方中以乌梅收敛止泻;黄连、黄柏清泄上热,附子、干姜、桂枝、细辛、花椒,温暖下寒,人参、当归补益气血,加诃子增强收敛固涩,因腹中肠鸣又加半夏燥湿降逆,粳米益气,兼防辛散药伤气、苦寒药伤胃。方药相互为用,以取得预期治疗效果。
治肝热阳郁证
根据“厥阴之为病,消渴,气上撞心,心中疼热,饥而不欲食,食则吐蛔。”当属肝热阳郁证。此方中乌梅、苦酒酸甘化阴,滋补肝体,以治消渴;黄连、黄柏以苦寒清热,以治心中疼热;少用附子、干姜、桂枝、细辛、蜀椒之辛,辛热通达阳郁,以治饥而不欲食;气血不足,人参、当归之甘能补肝体,以治病体夹虚。本方中诸药相互为用,清热不遏阳,通阳不助热。肝体阴而用阳,阳主动,用滋阴药虽能滋肝,但妨肝阳主动,所以滋肝必用通阳,以使阴得阳而化生。
Wumei Pill often in the clinical application of addition and subtraction, if the hard evidence in Treating蛔usually Wumei Pill available to the original amount of the original, decoction can be used to reduce the drug dosage as appropriate; if the heat or the Lower Cambrian in Treating Liver Deficiency folder yang hot Melancholia, attention must be given due to local primary and secondary lesions and, where appropriate, evidence of drug dosage adjustment, that is, be sure to determine the drug dosage changes and charge card and be absolutely sure the performance of the corresponding diseases. Such as TG may increase Huanglian, Huangbai used, as appropriate, may also reduce the amount of medicinal hot Xin; if Han Xin weight can increase the amount of heat medicinal, or reduce the amount of cold medicine; if righteousness could be worse weak increase ginseng, Chinese angelica dosage; Mume dosage must be due to the severity of disease and changes in card machines, to use with your medical treatment in the clear, right, act according to circumstances.
蛔hard evidence rule
蛔acid is a static and therefore side with Black Plum, Bitters蛔the acid to the system;蛔too hard the next, so with Huanglian, suffered the following蛔Huangbai;蛔Sim is a V, so use Aconite, Ginger, Guizhi , Asarum,蜀椒to the symplectic蛔V;蛔Gambari will have to move, so use ginseng, Chinese angelica to the Gan蛔induced. Clinical use of Wu Mei Wan蛔charge card and not hard for the treatment of chronic cholecystitis and more, in fact, as long as the clinical manifestations consistent with chronic cholecystitis蛔hard evidence, the law can be used to obtain a good therapeutic effect.
庞某, F, 42-year-old. For several years history of chronic cholecystitis, cholelithiasis has been the subject of surgery, postoperative pain is still脘abdominal胸胁, the time when light weight, in the western medicine treatment can improve the symptoms was not obvious. Carved patient: stomach bloating,心下痞full, gas inverse胸胁, and Seoul胸胁pain, hand-foot-厥冷, do not want to cold, dry mouth do not want to drink more, pain, dim tongue, thick and greasy yellow coating , Shen weak pulse. Identified as cold and heat Deficiency mixed folder, when the Qing government, under the temperature, and to补虚given change Wumei Pill decoction, Mume 15 grams, 12 grams Huanglian, breviscapus 3 grams, 6 grams ginger, angelica 10 grams, Huangbai 12 grams, Guizhi 3 grams, 6 grams of red ginseng, monkshood 3 grams, 3 grams pepper, Zhishi 10 g, Radix Paeoniae Alba 12 grams, 24 grams of Hawthorn, 20 milliliters of vinegar. 6, one day,水煎服, sub-3. Second consultation: full胃脘reduce the swelling of the liver, hand, foot and turn the temperature, again in front of six. Three patient: basic regression thick and greasy coating, reduce pain, on the front 6. Four diagnostic methods: evidence from the former were significantly improved, again in front of six. Five consultation: evidence from悉除, the front will change for the powder decoction, to consolidate the treatment of 2 months. 1 year follow-up, everything is still good.
Used to understand: The cases identified for hand, foot and厥冷cold syndrome, pain, thick yellow greasy moss identified as heat, due to age心下痞, stomach distention浊气identified as壅滞, because of weak pulse Shen identified as true, folder identified as a deficiency for the cold and heat. Fangzhong Mume Zhixie convergence; Coptis, Phellodendron, Qingre dampness; Aconite, Ginger, Guizhi, Asarum, pepper, and cold-dispelling Onyang; ginseng, Chinese angelica, benefit qi and blood;导滞increase gas Hovenia implemented, Radix Paeoniae Alba Buxue priorities pain, blood Xiaoshi hawthorn. Prescriptions for the use of each other in order to select the effect.
Giuly governance certification
Wumei Pill "and the main long-Lee", Fangzhong Mume, Bitters Zhixie convergence; Coptis, Phellodendron清泄on the heat; Aconite, Ginger, Guizhi, Asarum, Lower Cambrian蜀椒warm; ginseng, Chinese angelica blood tonic. Wu Mei Wan appeal, we can see is under the charge on the hot or cold chills and fever mixed folder folder Deficiency Deficiency of