升陷汤方证的临床应用

文章信息/Info

• Title:升陷汤方证的临床应用

• 卷期:2023年21卷24期

• 作者:宋秀平1， 司廷林2

• 1.山东中医药大学 第一临床医学院硕士研究生2020级，山东 济南 250014；2.山东中医药大学第二附属医院 肾病诊疗中心，山东 济南 250001

• Author(s):Song Xiuping1,Si Tinglin2

• 1. Grade 2020 Graduate，the First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Shandong Province, Jinan 250014, China; 250014, China; 2. Nephrotic Diagnosis and Treatment Center, the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong Province, Jinan 250001, China

• 关键词升陷汤 方证辨证 宗气下陷 医案

• Keywords:Shengxian decoction; prescription-syndrome; Zongqi subsidence ;medical case

• 摘要:方证辨证的特点是“有是证，用是方”，只要我们辨证明确，各种疾病均可运用升陷汤加减治疗，从而达到异病同治的目的。升陷汤广泛用于治疗宗气下陷所导致的各种疾病，原书中描述的病证较为繁杂不易掌握，导师在方证辨证的指导思想下，灵活运用升陷汤治疗各种疾病，并取得良好的疗效，现总结出升陷汤方证的临床应用特点，易于把握运用，下面将导师运用升陷汤治疗糖尿病肾病、胸痹、崩漏、哮病的医案进行报道，以期为临床应用升陷汤提供参考。                                                                                                                                                                                

• Abstract: The characteristic of prescription-syndrome is that "there is prescription with syndrome". As long as our syndrome differentiation is clear, all kinds of diseases can be treated with Shengxian Decoction, so as to achieve the purpose of treating different diseases with the same treatment. Shengxian Decoction is widely used to treat various diseases caused by the Zongqi subsidence. The diseases described in the original book are complicated and difficult to master. Under the guiding ideology of prescription-syndrome, the tutor flexibly used Shengxian Decoction to treat various diseases and achieved good curative effect. The clinical application characteristics of Shengxian Decoction are summarized, and it is easy to grasp and use. Here, the medical cases of treating diabetic nephropathy, thoracic obstruction, metrorrhagia and asthma with Shengxian Decoction are reported, so as to provide reference for clinical application of Shengxian Decoction.

  升陷汤出自《医学衷中参西录》，由生黄，知母，柴胡、桔梗，升麻组成。张锡纯在书中写到：“主治胸中大气下陷，气短不足以息。或努力呼吸，有似乎喘……诚难悉数。其脉象沉迟微弱，关前尤甚”[1]。张锡纯指出升陷汤中黄芪既补气又升气，且其质轻，中含氧气，与胸中大气有同气相求之妙用，因黄芪归脾、肺经，味甘，性微温，故配伍味苦性寒之知母，温苦升降并用，气机调畅，宗气得以充养；方中柴胡能引大气之陷者自左上升；升麻能引大气之陷者自右上升；桔梗能载诸药之力上达胸中 [1]。