桂枝湯的臨床驗案解析

桂枝湯，出自後漢張仲景《傷寒雜病論》，內固脾胃氣津，外以調和營衛，共奏調補陰陽氣血之功。《傷寒論》將之用於表虛外感、營虛衛弱；《金匱要略》將之用於妊娠產後調和營衛表裏，扶正祛邪。吾等依循傷寒論運用桂枝湯的大原則，掌握以正氣虧虛合併衛外不固為主要病機，再根據不同疾病的病理，靈活運用桂枝湯加減，可以治療多種疾病。包括：加健脾益腎藥物治療正虛感寒，久咳不癒；加養血祛風藥物治療脾虛血少，表衛不固的異位性濕疹；加寬胸理氣化痰活血藥物治療氣虛痰阻，胸陽不振的冠心病胸痺；加溫陽通脈，健脾利濕藥物治療中虛感寒的關節濕痺證；加溫經通絡、補腎助陽藥物治療腎虛感寒，證屬寒痺的坐骨神經痛。

關鍵字

桂枝湯；調和營衛；異位性濕疹；冠心病胸痺；關節痺痛

並列摘要

Guizhi decoction, derived from《The Typhoid Theory》written by Zhang Zhong-jing in the Han dynasty, can not only harmonize the nutrient and defense of the body surface, but also fortify the qi and fluid of the digestive system. According to《The Typhoid Theory》,Guizhi decoction is utilized on common cold for patient who is qideficiency on the body surface. What's more, in light of the experience written in《The Synopsis of Golden Chamber》,Guizhi decoction can also balance and strengthen the immune system during pregnancy and postpartum. Guizhi decoction suits for patient who is physically weak and qi-deficiency on the body surface. It can be used on a wide variety of disease effectively, including adding spleen-tonifying and kidney-invigorating drugs to treat post-infectious cough, adding blood-nourishing and dispelling wind drugs to treat atopic eczema, or combining drugs that improve qi and blood circulation with Guizhi decoction to relieve angina pectoris. Furthermor, through combining meridian-warming drugs with Guizhi decoction can also treat multiple arthritis or sciatica having cold hiding in the spleen or kidney system.