马智慧+耿贇+方邦江

摘 要 升降散定名于清代医家杨栗山所著《伤寒瘟疫条辨》，原为治瘟疫15方之首方。其方由僵蚕、蝉衣、姜黄、大黄这4味药组成，方中僵蚕、蝉蜕为气分药，升阳中之清阳，姜黄、大黄为血分药，降阴中之浊阴，一升一降，调和气血，宣泄三焦气机，共奏解郁宣透，降火泄热之功，配伍精当。经过多年的发展已不仅限于治疗疫病，在内外科疾病中也广泛应用。笔者查阅近5年的文献，对升降散的应用作一概述。

关键词 升降散 临床应用 文献综述

中图分类号：R289.1 文献标识码：A 文章编号：1006-1533（2016）05-0041-04

Overview of clinical application of Shengjiang powder in five years

MA Zhihui， GENG Yun， FANG Bangjiang*（Department of Emergency， Longhua Hospital of Shanghai University of Traditional Chinese Medicine， Shanghai 200032， China）

ABSTRACT Shengjiang powder was named in the book Shanghan Wenyi Tiaobian written by physician YANG Lishan in Qing dynasty， which was originally created as the primary formula for treating the epidemic febrile diseases. The formula of Shengjiang powder consists of bombyx batryticatus， periostracum cicada， turmeric and rheum officinale baill. Bombyx batryticatus and periostracum cicada are used as ascending drugs and turmeric and rheum officinale baill are used for descending the turbid. Both ascending and descending are precisely matched to regulate Qi and Blood. After years of development， it has been not only limited to the treatment of epidemic febrile diseases but also widely applied in internal medicine and surgical diseases. The application of Shengjiang powder is overviewed based on nearly five years of literature.

KEY WORDS Shengjiang powder， clinical application； literature review

升降散是老一辈医家十分推崇的名方，其雏形见于明代龚廷贤《万病回春·瘟疫门》，载为内府仙方。明代张鹤腾《伤暑全书》将其收录为治暑良方，后得清代医家杨栗山的发挥，载于《伤寒瘟疫条辨》，将其作为治疗瘟疫15方之首。此后，升降散广泛应用于临床。该方原由僵蚕、蝉蜕、姜黄、大黄、黄酒、蜂蜜这6味药组成，具有升清降浊，解郁宣透，降火泄热之功，后世多以前4味入药。无论外感或者内伤，若辨证精准，用之则效如桴鼓。现将近5年升降散的临床应用做简要论述。

1 临床应用

1.1 呼吸系统疾病

陈怡等[1]运用升降散加减（蝉蜕10～20 g，僵蚕 10～20 g，姜黄10～15 g，大黄3～10 g，荆芥10～15 g，薄荷10～15 g，桔梗10～15 g，焦栀子3～10 g，连翘10～15 g，玄参10～20 g，麦冬10～15 g，甘草3～6 g，车前子30 g）合刺络放血法治疗儿童急性扁桃体炎41例，对照组口服头孢呋辛酯治疗41例，治疗5 d，治疗组总有效率90.24%，对照组总有效率78.05%，治疗组优于对照组，差异有统计学意义（P<0.05）。郑丽等[2]运用升降散随症加减（僵蚕15 g，蝉蜕……