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<div class="column"> <div class="article-tools"> <div class="article-tools-content" id="article-tools" style="display:none;"> <span class="article-tools-collect" data-tag="share_1"> <a class="btn btn-small btn-blue" title="收藏文章" onclick="sharethis('baidu', '', '《金匱要略》藥方的臨床應用')"><i class="icon16-star1"></i>收藏文章</a> </span> <a class="btn btn-small btn-blue" target="_self" href="http://www.gicrm.com/20121116/83070_2.shtml" style="color:red">下一頁<i class="icon16-page"></i></a> <span class="article-tools-share"> <a class="btn btn-small btn-blue" href="javascript:void(0);"><i class="icon16-share"></i>分享</a> <div style="display:none" id="share_pop" class="article-tools-share-pop"> <div class="dropdown"> <div class="dropdown-content"> <div class="bdsharebuttonbox" data-tag="share_1"> <a href="javascript:void(0);" class="bds_qzone" data-cmd="qzone" title="分享到QQ空間" style="margin-left:12px;" rel="nofollow">QQ空間</a> <a href="javascript:void(0);" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博" 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　<strong>　1 當歸芍藥散的應用</strong></p> <p> 　<strong>　方解：</strong>重用芍藥斂肝、和營、止痛，又佐以歸、芎以調肝和血，更配以茯苓、白術、澤瀉健脾滲濕。</p> <p> 　　<strong>案1.</strong>陰挺(子宮下垂)：梅某某，女，26歲，1989年10月5日初診。自訴已分娩2個月，分娩后即覺子宮脫出，站立時在陰道口外約1.5cm，自以為滿月后會自動上收，誰知滿月后仍然脫出，伴小腹隱痛不舒，喜按，口稍渴，面紅，飲食正常，大便軟，小便短，色黃，脈細弦。曾用補中益氣湯加味5劑，藥后自覺不適，口干口苦，子宮下垂仍然，乃來我處診治。因思此乃肝脾不和，濕熱內停，以致帶脈不約，遂用當歸芍藥散加味：當歸10g，白芍15g，白術10g，澤瀉10g，云苓10g，川芎5g，枳殼10g。囑服5劑，每日1劑。</p> <p> 　　1989年10月11日復診，藥后腹痛減輕，子宮下垂略有好轉，繼服5劑，以后患者又來診2次，用藥后全身癥狀逐漸減輕，子宮下垂好轉。前后共服藥20劑，諸癥全消。</p> <p> 　<strong>　按：</strong>陰挺與帶脈不約有關，而唐容川認為，帶脈屬脾，故陰挺多以脾論治而用補中益氣湯。又因肝脾二臟在生理上關系密切，在病理上也互有影響，如肝病可以傳脾，脾病也可以傳肝，所以陰挺雖與脾關系密切，但脾的病變也可由肝傳來，故治脾不效，應想到治肝，或肝脾同治。本例之所以用當歸芍藥散加味，是因本證具有小腹隱痛、小便偏短、大便軟、面色偏紅、精神尚可、脈弦細等肝脾不和、濕滯內停之象，故投以當歸芍藥散加味，其病很快治愈。</p> <p> 　<strong>　案2.</strong>胎漏、胎動不安(先兆流產)：藍某，女，34歲，1972年2月5日初診?；颊咄＝?0余天，陰道出血1周，出血量少，色暗紅，淋漓不絕，無血塊，伴有腰脹、少腹脹痛，胃納尚佳，無嘔吐、泛酸，口不干、略苦，二便正常。近半月來情緒不佳。經用黃體酮等止血之劑，血量稍少，但仍有陰道出血，脈弦，舌質淡紅、苔薄白。妊娠試驗陽性。此為肝脾不和，濕熱內停，迫血妄行。以當歸芍藥散加味：當歸10g，白芍15g，白術10g，澤瀉10g，云苓10g，川芎5g，桑寄生15g，阿膠9g，苧麻根10g，杜仲10g。共服10劑，血止，隨診，足月順產一男嬰。</p> <p> 　　<strong>按：</strong>《<a href='http://www.gicrm.com/flist/942395-1.html' target='_blank'>金匱要略</a>》云：“婦人懷妊，腹中癘痛，當歸芍藥散主之。”患者妊娠2個月出現腹痛，以當歸芍藥散為主方，又見出血，故加阿膠補血止血，病屬胎動不安，故加苧麻根安胎，腰痛加社仲、桑寄生補腎安胎。本方用于胎動不安，目前臨床醫生懼而不用，多用壽胎丸。但據日本中田敬吾的研究，其對妊娠期服用本方的40例中有回音的27例孕婦及兒童進行了回訪調查，結果未發現因服本方劑對母子健康有不良影響者;此外，在產后母體恢復和小兒發育方面未見到任何有害作用的跡象?，F代醫學認為，在受精卵分裂旺盛的妊娠初期服藥，畸形發生率高。但從本方的使用來觀察，在胚胎尚未形成以前給藥，改善母體內環境，使受精卵形成胚胎的發育過程獲得良好影響，未見有致畸型，而且對兒童的健康起著積極的作用。本人每年均可遇類似病例，用當歸芍藥散加味，大多數均獲滿意療效，足見經方療效之可靠。</p> <p> 　　<strong>案3.</strong>水腫(慢性腎炎)：胡某某，女，45歲，1990年9月12日初診。自訴患腎炎多年，晨起顏面腫，午后腳腫，現全身水腫半年余，但水腫不甚，納食尚可，面色萎黃，精神一般，大便軟，小便短少、色黃、無灼熱、不渾濁，舌質淡紅、苔薄白，脈細弦。尿蛋白+ + +。前醫用發汗利尿等法治療近3個月，水腫及蛋白尿均無好轉，余思其面色萎黃，脈弦細，浮腫不甚，擬診為血虛水濕內停，用當歸芍藥散原方：當歸10g，白芍15g，川芎6g，澤瀉10g，白術10g，茯苓10g。服藥7劑，水腫略減，尿蛋白減為+ +，原方再服7劑，水腫又減，尿蛋白減為+，繼服7劑，水腫全消，尿蛋白陰性。為鞏固療效，用原方再服1個月，至今未復發。</p> <p> 　<strong>　按：</strong>本病辨證關鍵在于抓住脈細弦，面色萎黃，為血虧之象，大便軟、水腫，為脾虛有濕之證，故用當歸芍藥散原方，效如桴鼓。</p> <p> 　　除以上所舉的3例之外，當歸芍藥散還可用于治療慢性闌尾炎、盆腔炎、附件炎、卵巢腫瘤、陰道出血、功能性子宮出血、帶下、習慣性流產、不孕癥、宮外孕、胎位不正、妊娠水腫、妊娠中毒癥、子癇、更年期綜合征、黃褐斑、細菌性痢疾、慢性腹瀉、肝炎、癃閉(前列腺肥大)、尿路結石、下肢瘀血等臨床常見病。以八綱分類：從表里來說屬里證，從陰陽來講屬陰證(足厥陰肝、足太陰脾)，從虛實來看屬虛實夾雜。其辨證要點，病因為肝郁脾虛，濕熱內滯，病位在肝脾，癥狀可出現血虛(面色白、頭昏、月經量少色淡、舌質淡等)、脾虛有濕(大便軟而不爽、小便不利、口粘)等癥狀組，應用的重點在腹部疾病。</p>  </div> <div style="font-size:14px;text-align: right;">(<a target="_blank" title="養生" href="http://www.gicrm.com/"><strong>養生</strong></a>)</div>  <div class="video"></div>  <div id="recommend" style="margin:20px 0;clear: both;"> <script type="text/javascript">document_write_ad(2);</script> </div>  <div class="badoo_badoo" style="width:630px;*margin-top:10px;padding-right:0px"><ul> <li style="border:none;margin-right:3px;background:none;margin-top:5px;color:#999">共3頁</li><li style="margin-right:3px;"><a href="http://www.gicrm.com/20121116/83071.shtml" class="red">上一篇</a></li><li class="thisclass" style="border-left:none;"><a>1</a></li><li style="border-left:none;margin:0px;"><a 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