伤寒论经方之小青龙汤!

 

3c. 小青龙汤

3c. Xiao Qinglong Tang

 

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Millwoods Acupuncture Center
102, 2603 Hewes Way
Edmonton AB,   Canada

Phone: (780) 466-8683
www.acupuncture123.ca
 







 

 

3c. 小青龙汤

3c. Xiao Qinglong Tang

 

1. 组成

1. Ingredients:

小青龙汤方:  麻黄(去节)三两, 芍药三两, 五味子半升, 干姜二两, 炙甘草 三两, 半夏 半升, 桂枝三两, 细辛三两.

Xiao Qinglong FangMahuang 45 g, Shaoyao 45 g, Wuweizi 40 g, Ganjiang 30 g, Zhi Gancao 45 g, Banxia 45 g, Guizhi 45 g, Xixin 45 g.

 

2. 治疗作用

2. Function:

《伤寒论》第40条:伤寒表不解,心下有水气,干呕、发热而咳,或咳、或利、或噎、或小便不利、少腹满、或喘者,小青龙汤主之。

Shanghan Lun paragraph 40: If the patient has body surface syndrome (headache, neck pain, chilly), and there is water Qi in the upper stomach, the patient has nausea, fever and cough, or has cough, or diarrhea, or stroking feeling in throat, or difficulty in urination, of bloating feeling in lower stomach, or asthma, use Xiao Qinglong Tang as the main formula for the treatment.

《伤寒论》第41条:伤寒,心下有水气。咳而微喘,发热不渴,服汤已渴者,此寒去欲解也,小青龙汤主之。

Shanghan Lun  paragraph 41: In the Shanghan disease, the patient has water Qi in the upper stomach, feels cough and slight asthma, fever but no thirsty, use Xiao Qinglong Tang for the treatment. If the patient feels thirsty after drink of the herbal tea, it indicates that the Cold Xieqi in the body is to leave.

《金匮要略 痰饮咳嗽病》第35条:咳逆倚息不得卧,小青龙汤主之。

Jin Kui Yao Luo    Phlegm, water, and cough, paragraph 35: If the patient feels severe cough, and hard to lie down horizontally, use Xiao Qinglong Tang as the main formula for the treatment.  

《金匮要略痰饮咳嗽病》第23条:病溢饮者,当发其汗,大青龙汤主之,小青龙汤亦主之。

Jin Kui Yao Luo    Phlegm, water, and cough, paragraph 23: If the patient has spilling swelling (in TCM, swelling can be classified into different category, such as Wind swelling, spilling swelling, stone swelling, kidney swelling, etc. Here means the spilling swelling), sweating therapy should be used. Use Da Qinglong Tang. Xiao Qinglong Tang can also be used. 

《金匮要略妇人杂病》第7条:妇人吐涎沫,医反下之,心下即痞,当先治其吐涎沫,小青龙汤主之;涎沫止,乃治痞,泻心汤主之。

Jin Kui Yao Luo  Female diseases, paragraph 7: If a woman spit saliva and her doctor however use colon-cleansing therapy, she would develop hard-bloating feeling in the upper stomach. For the treatment, it should first solve the spiting. Use Xiao Qinglong Tang. After stop of the saliva-spitting, treat the bloating by use of Xie Xin Tang.  

3. 辩证要点: 外寒里饮.

3. Key point for the indication for Xiao Qinglong Tang: Outside is cold and inside is water-accumulation (water Qi in side)

(1). 心下有水气: 干呕, 咳而微喘, 吐白色泡沫痰;

(1). There is Water Qi inside: The patient feels nausea, cough and slight short of breath, spits white color bubble phlegm.

(2). 溢饮: 四肢肿胀.

(2). Spilling water in the arms and legs: swelling in the arms and legs.

 

4. 临床常用病种:

4. Xiao Qinglong Tang is commonly used in the following clinic conditions:

感冒, 流行性感冒, 支气管炎, 肺炎, 支气管哮喘, 支气管扩张, 肺气肿, 百日咳, 肋间神经痛, 急性或慢性肾炎伴水肿, 浮肿, 腹水, 关节炎积水, 胃中留饮症 (胃酸症), 唾液过多症, 结膜炎, 泪囊炎, 湿疹, 水疱, 化脓性上额窦炎, 肥厚型鼻炎, 过敏性鼻炎, 喷嚏频发症等.

Common cold; Influenza; Bronchitis; Pneumonia; Bronchi asthma;  Bronchiectasia; Emphysema; Whooping cough; Intercostal neuralgia; acute or chronic nephritis with swelling; swelling, ascites; Joint swelling; Water accumulation in stomach (acid reflex condition); overwhelming saliva; conjunctivitis; dacryocystitis; Eczema; Suppurative on frontal sinusitis; Hypertrophic rhinitis; Allergic rhinitis; Frequent sneeze, etc.

 

5. 小青龙汤用于咳喘症之鉴别诊断:

5. Distinguish diagnosis when the formula is used for the treatment of cough and asthma:

(1). 小青龙汤: 咳喘伴有心下痞满, 或胃酸, 或吐白色泡沫痰.

(1). Xiao Qinglong Tang: Cough and asthma. The patient has bloating feeling in the upper stomach, or acid reflex, or spit of white color bubble phlegm.

(2). 小青龙汤加石膏: 小青龙汤证伴口干, 心烦.

(2). Xiao Qinglong Tang Jia Shigao: It is used for Xiao Qinglong Tang condition with dry mouth and irritated.

(3). 苓甘姜味辛夏仁汤: 用于小青龙汤证后期, 亦有咳喘水肿, 但无表证, 但有贫血, 肢寒, 脉沉弱等虚寒证.

(3). Ling Gan Jiang Wei Xia Ren Tang: It is used in the later stage of Xiao Qinglong Tang. The patient has cough, asthma and/or swelling, no body surface syndrome, but has anemia, cold hands and feet, and deep-weak pulse.

(4). 麻杏石甘汤: 汗出而咳喘, 无心下水气症 (如心下痞, 下利, 噎食, 小便不利, 少腹满等).

(4). Ma Xing Shi Gan Tang: The patient has sweat, asthma, and cough, but no Water-qi accumulation in the upper stomach (such as bloating feeling, diarrhea, difficulty in urination, bloating in lower stomach, etc.)

(5). 大青龙汤: 类似小青龙汤加石膏, 但病情更严重, 烦躁, 脉浮紧.

(5). Da Qinglong Tang: The indications for the use of Da Qinglong Tang is similar to that for Xiao Qinglong Tang jia Shigao, but the condition is severe. The patient feels more irritated, anxiety, with floating-tight pulse.

(6). 麦门冬汤: 咳喘, 干咳, 咽干, 痰难出. 咳嗽为主, 频发性, 刺激性咳嗽.

(6). Maimendong Tang: Cough, short of breath, dry throat. The phlegm is hard to spit out. It is mostly cough, which is in onset, as stimulating cough.

(7). 茯苓杏仁甘草汤: 胸中痞满痞闷, 短气.

(7). Fuling Xingren Gancao Tang: The patient feels bloating in chest, has short of breath.

(8). 《外台秘要》之神秘汤:  慢性咳嗽, 发作时奔喘, 坐卧不得.

(8). Wai Tai Mi Yao, Shen Mi Tang: Chronic cough. The patient feels acute cough as urgent asthma and feels hard to sit or stand up.

 

6. 小青龙汤用于过敏性鼻炎鼻窦炎之鉴别诊断:

6. Distinguish diagnosis when Xiao Qinglong Tang is used for the treatment of allergic rhinitis

(1). 小青龙汤: 咳喘伴有心下痞满, 或胃酸, 或吐白色泡沫痰.

(1). Xiao Qinglong Tang: See above.

(2). 小青龙汤加石膏: 小青龙汤证伴口干, 心烦.

(2). Xiao Qinglong Tang Jia Shigao: See above.

(3). 大青龙汤: 类似小青龙汤加石膏, 但病情更严重, 烦躁, 脉浮紧.

(3). Da Qinglong Tang: See above.

(4). 桂枝附子汤: 主要用于喷嚏频频.

(4). Guizhi Fuzi Tang: Mostly used for frequent sneeze.

(5). 葛根汤: 主要用于鼻塞伴头痛者.

(5). Gegen Tang: Mostly used for stiff nose with headache.

 

7. 小青龙汤用于关节炎之方剂鉴别:

7.  Distinguish diagnosis when Xiao Qinglong Tang is used for the treatment of arthritis:

(1). 小青龙汤用于四肢及诸关节水肿性关节炎 (溢饮症). 证属外寒里饮 (见前).

(1). Xiao Qinglong Tang is also used for the treatment of arthritis, especially the arthritis with swelling on the arm or leg. The patient has outside cold syndrome but inside water-accumulation condition (see above).

(2). 小青龙汤加石膏: 外寒里热, 烦躁, 口干, 舌干.

(2). Xiao Qinglong Tang Jia Shigao: The patient has joint pain, but also outside-cold but inside-hot syndrome (see above).

(3). 大青龙汤: 外寒里热更剧.

(3). Da Qinglong Tang: The joint is pain and swelling. There are stronger signs of outside-cold and inside-hot condition in the body.

(4). 麻黄加术汤: 外寒里湿, 关节炎初期.

(4). Mahuang Jia Zhu Tang: It is the formula in which herb Baizhu is added into the Mahuang Tang. It is used in the join pain and swelling and the outside-cold and inside-wetness condition.

(5). 麻杏石甘汤: 外寒里热较轻.

(5). Ma Xing Shi Gan Tang: Joint pain and swelling. The patient has also sweat and asthma (short of breath).

(6). 薏苡仁汤: 外寒里湿, 湿为主, 症较麻黄加术汤为重. 凡是含有附子之剂无效者可选用.

(6). Yiyiren Tang: It is used in joint pain and swelling and with the outside-cold and inside-wetness body condition. The wetness is more than the cold. The symptoms are severe than the Mahuang Jia Zhu Tang. This formula can be considered to use whenever a Fuzi-containing formula does not work.  

(7). 防己黄芪汤: 体胖易倦, 恶风多汗, 小便多不利之悠闲之人. 下肢常发胀, 膝部常不适而痛, 傍晚足肿而鞋袜发紧. 

(7. Fangji Huangqi Tang: The patient is usually overweight, dislikes wind and has more sweat, and tends to have difficulty in urination. The patient is usually the one who is lazy or tired to have labor action or movement. The legs are usually in kind of swelling or puffy condition. The knee tends to be sour or weak. The feet tend to be puffy, so that the shoes feel tight.  

(8). 桂枝附子汤: 汗出,身痛,脉浮虚.

(8). Guizhi Fuzi Tang: Sweat, pain in the body, and pulse is floating and weak.

(9). 白术附子汤: 汗出, 身痛, 小便频, 大便偏秘.

(9). Baizhu Fuzi Tang: Sweat, pain in the body, frequent urination but constipation.

(10). 甘草附子汤:汗出, 身痛, 擎痛不得屈伸, 小便不利.

(10). Gancao Fuzi Tang: Sweat, pain in the body, severe pain and spasm pain in the joint so that the joint is hard to bend, and difficult in urination.

(11). 桂芍知母汤, 大防风汤: 关节炎晚期, 有较明显肌肉萎缩, 气血不足.

(11). Gui Shao Zhimu Tang and Da Fangfeng Tang are used in the later stage of arthritis. The body has clear signs of Qi deficiency and Blood deficiency.

注意:

Notice:

1. 以上方剂用于关节炎治疗时,关注的是全身症状而不是关节局部表现。如果病人有相应的方证,用经方治疗全身症状后关节症状会自然减轻。比如说病人有鼻窦炎,流清鼻涕,打喷嚏,口干,稍烦, 稍便秘,并有关节酸痛,用小青龙汤加石膏后全身症状包括关节症状全都会明显改善。不必用防己,伸筋草,独活,羌活,牛膝,桑枝等常用的治疗关节炎的中药,也不必将鼻窦炎和关节炎分别治疗。

1. When use the formulae above for the treatment of arthritis, pay attention to the whole body symptoms more, rather than local symptoms in the joints. If the patient has corresponding indication to a herbal formula, the use of that herbal formula usually works well for the whole body and for the local joint symptoms. For example, if a patient has sinus problem, running nose, sneeze, dry mouth, slight irritated, slight constipation, as well as sour or pain in the joints, the herbal formula Xiao Qinglong Tang plus Shigao could solve the pain in the joints, along with the improvement of the whole body symptoms. It is not needed to use commonly used herbs that are for the arthritis, such as Fangji, Shenjincao, Duhuo, Qianghuo, Niuxi, Sangzhi, etc. It is neither needed to treat the sinus problem or arthritis separately.  

2. 如果病人肌肉关节痛有明显的外伤史,如车祸,长跑,碰撞伤等,还是用陈少东大夫的方法好 (见《跌损内伤金鉴》)。

2. If there is clear trauma history for the joint and muscle, such as car accident, falling down, slipper, bruise, lifting heavy stuff, continuous single motion, it is recommended to use the herbal therapy system introduced by Dr. Shaodong Chen refer to book Die Sun Nei Shang Jin Jian.


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 Millwoods Acupuncture Center is located in Edmonton, Alberta, Canada and serves Edmonton and its surrounding area, including: St. Albert, Big Lake, Spruce Grove, Stony Plain, Devon, Beaumont, Sherwood Park, Calgary, Red Deer and Whitecourt, Barrhead, Westlock, Wetaskiwin, Camrose, Fort Saskatchewan, Grande Prairie. Our clients also come from Vancouver and Saskatoon.