| 胡竞文,周纯子,张翔,等.施维群临证处方配伍经验探析——以旋覆代赭汤为例[J].浙江中医药大学学报,2024,48(12):1534-1537. |
| 施维群临证处方配伍经验探析——以旋覆代赭汤为例 |
| Analysis of SHI Weiqun’s Experience in Prescription Compounding in Clinical Practice-Taking Xuanfu Daizhe Decoction as An Example |
| DOI：10.16466/j.issn1005-5509.2024.12.009 |
| 中文关键词: 旋覆代赭汤 胃气上逆 吞咽功能障碍 贲门失弛缓症 中药配伍 医案 名医经验 施维群 |
| 英文关键词: Xuanfu Daizhe Decoction adverse rising of stomach Qi dysphagia achalasia of cardia compatibility of Chinese medicine medical records experience of famous doctors SHI Weiqun |
| 基金项目:2022年全国名老中医药专家传承工作室建设项目(国中医药人教函﹝2022﹞75号) |
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| 中文摘要: |
| [目的] 学习并总结施维群教授面对噎膈病症时，以旋覆代赭汤为主方的用药配伍思路及经验。[方法] 通过门诊跟诊学习、收集整理病案及查阅相关文献，探讨旋覆代赭汤的组成、功效、方义和现代药理学研究，总结施维群教授对旋覆代赭汤的临证使用经验以及组方配伍心得，并举施维群教授诊治的中风后吞咽障碍和贲门失弛缓症2则病案加以验证。[结果] 旋覆代赭汤是《伤寒论》中治疗胃虚痰阻气逆的代表方，常用于治疗消化系统疾病。现代医学研究扩大了旋覆代赭汤的应用范围，证实了旋覆代赭汤在其他系统疾病的治疗中也能取得良好疗效。施维群教授认为，在临证使用旋覆代赭汤时，当抓住病机，各种原因所致的胃气上逆均可使用；组方配伍时当兼以理气，同时调和脾胃，并审证求因巧用合方，最后还需回顾全方，通过整体观念平衡方药寒热。所附医案，上述四大要点贯穿始终，均取得良好疗效。[结论] 施维群教授对旋覆代赭汤的运用具有独到理解，组方配伍时紧扣“降逆勿忘理气、芍甘调和脾胃、审证当需求因、寒热务需平衡”四大要点。其经验独具一格，临床疗效显著，值得同道借鉴参考。 |
| 英文摘要: |
| [Objective] To summarize and study Professor SHI Weiqun’s thoughts and experience in the use of Xuanfu Daizhe Decoction as the main decoction for dysphagia. [Methods] Through outpatient study， case collection and review of related literature， the composition，efficacy，component analysis and modern pharmacology of Xuanfu Daizhe Decoction were investigated to summarize Prof. SHI Weiqun’s experience in the use of as well as in the formulation of the said decoction， and to verify the results by citing two cases of poststroke dysphagia and pancreatic ataxia that were diagnosed and treated by Prof. SHI Weiqun. [Results] Xuanfu Daizhe Decoction is a representative prescription for treating stomach vacuity and phlegm blocking Qi and reverse in Treatise on Febrile Diseases. It is frequently utilized for treating digestive disorders. Modern medical research has broadened the application scope of Xuanfu Daizhe Decoction and demonstrated that it can also achieve favorable therapeutic effects in the treatment of other systemic diseases. Prof. SHI Weiqun maintains that in the clinical application of Xuanfu Daizhe Decoction， the pathogenesis should be grasped， it can be employed for gastric Qi inversion caused by various causes. The combination of the formula should be integrated with the regulation of Qi， concurrently reconcile the spleen and stomach， and verify the skillful application of the prescription. Eventually， it is necessary to review the entire formula through the overall concept of balancing the cold and heat of the prescription. The attached medical records encompassed the above four points throughout and attained good therapeutic effects. [Conclusion] Prof. SHI Weiqun has a unique understanding of the application of Xuanfu Daizhe decoction， and closely follows the four key points of “don’t forget to regulate Qi， regulate the spleen and stomach， verify the demand cause， and balance cold and heat”. His experience is unique， the clinical effect is remarkable， worthy of reference. |
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