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名方新用之黄芪桂枝五物汤-
名方新用之黄芪桂枝五物汤

名方新用之黄芪桂枝五物汤

黄芪桂枝五物汤

黄芪桂枝五物汤首见于张仲景《金匮要略》。由黄芪9g、白芍9g、桂枝9g、生姜18g、大枣4枚组成。有温经益气、活血、通痹之功效。主治肌肉麻木不仁之血痹证。临床以四肢麻木不仁、微恶风寒、舌淡、脉微涩而紧为应用要点。

黄芪

白芍

桂枝

【临床新用】

1. 治疗血痹证

有报道应用治疗血痹身痛30余例,疗效显著。用黄芪桂枝五物汤加味:黄茂30g、桂枝9g、白芍30g、独活15g、当归15g、鸡血藤30g、姜枣为引。水煎服,每日l刘,分2一3次服。5天为一疗程。

气血不足者加白术,肾虚加杜仲、续断,寒湿盛加仙灵脾,风寒重加防风,淤血重加桃仁、红花,上肢重加羌活,下肢重加木瓜、五加皮。

2.治疗末梢神经炎

临床报道,黄芪桂枝五物汤治疗末梢神经炎有效率为62%。短者3剂见效,长者6剂见效。

3.治疗中风后遗症

黄芪桂枝五物汤治疗中风后遗症,收效良好。

病案举例:患者,男,60岁,农民。左肢瘫痪,大便不畅,舌质红,脉细无力,证属气虚血淤阻络之中风证。方用黄芪桂枝五物汤加减: 黄芪60g、桂枝12g、白芍15g、伸筋草30g、薏苡仁30g、生姜10g、大枣5枚,水煎服,每日1剂。服药1剂后上下肢活动有好转,继服30剂后上下肢活动明显好转,又继服1剂后恢复正常。

4.糖尿病

证属气虚寒凝者,用黄芪桂枝五物汤有良效。一般服20一30剂有明显效果。笔者治疗20例,收效良好。结果:症状消失9例,好转8例,有效3例。

另外,对原发性低血压亦有良好的治疗效果;对胃脘痛、硬皮病、冻伤、面肌痉挛.、急性脑梗死、增生性骨关节病(肿痛消失,活动复常)等病证的治疗,效果亦佳。

【现代研究】

本方煎剂可增强机体的免疫功能。方中黄芪有保肝、利尿、改善血流动.力学、促进造血功能、抗衰老.、解毒、抗菌、抗病毒、抗肿瘤等作用,黄芪皂苷有扩张血管、强心、抗心肌缺血等作用,白芍与甘草长于解痉止痛,桂枝能缓解胃肠痉挛性疼痛。桂枝.、白芍均有抗菌作用等。

总之,全方对免疫功能有调节作用,并有扶正补养之功,解痉止痛之效。

【注意事项】

本方药性偏温,血痹属热者,不宜使用。

【按语】

方药五味,配伍精当。黄芪得桂枝不留邪,桂枝得黄芪益气而振奋卫阳,芍药配桂枝调营卫而和表里,大枣养血益气助黄芪、白芍之功,生姜调和营卫。五药合用,益气温经,和血通痹。临床应用广泛,凡见肌肤麻木不仁者,不论是风湿痹证、产后痹证、哺乳期血痹等,均可用本方加减应用。

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