范少华　伍大华　刘芳　李红梅　蒋军林　姚婷

〔摘要〕 麻木为临床常见病症，发病因素多样，病变涉及多个学科。国医大师刘祖贻认为麻木病在肌肤，气血亏虚为发病之本，邪滞血脉为发病之标，气血不通、经脉失养为基本病机，气血失调贯穿疾病发展始末，治疗上重视调理气血，临床上主张病证结合，擅用经方黄芪桂枝五物汤为基础方加减治疗麻木：中风后肢体麻木，常用黄芪桂枝五物汤合涤痰汤;糖尿病性周围神经麻木，常用黄芪桂枝五物汤合益气养阴通脉汤;颈椎病上肢麻木，常用黄芪桂枝五物汤合葛桂舒筋饮;腰椎间盘突出症下肢麻木，常用黄芪桂枝五物汤合独活寄生汤;癌症放化疗后手足麻木，常用黄芪桂枝五物汤合参楼扶正解毒方;功能性麻木，常用黄芪桂枝五物汤合柴胡疏肝散。

〔关键词〕 麻木;气血理论;病证结合;黄芪桂枝五物汤;刘祖贻

〔中图分类号〕R255.6       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.01.001

〔Abstract〕 Numbness is a common clinical disease with various pathogenesis factors and lesions involving multiple disciplines. National TCM Master LIU Zuyi believes that numbness is on the skin， and deficiency of Qi and blood is the root cause of the disease. Pathogen stagnation in blood and vessels is the symptom of the disease. Qi and blood dysfunction and the failure of meridians nourishment are the basic pathogenesis. Qi and blood disorder runs through the development of the disease. The treatment focuses on regulating Qi and blood， and clinically advocates combination of disease and syndrome. He is good at treating numbness with classical formula， modified Huangqi Guizhi Wuwu Decoction. The treatment of numbness after stroke commonly used Huangqi Guizhi Wuwu Decoction combined with Ditan Decoction; The treatment of diabetic peripheral nerve numbness commonly used Huangqi Guizhi Wuwu Decoction and Yiqi Yangyin Tongmai Decoction. The treatment of cervical spine disease upper limb numbness commonly used Huangqi Guizhi Wuwu Decoction combined with Gegui Shujin Decoction. The treatment of lumbar disc herniation lower limb numbness commonly used Huangqi Guizhi Wuwu Decoction combined with Duhuo Jisheng Decoction. The treatment of numbness of hands and feet after chemoradiotherapy of cancer commonly used Huangqi Guizhi Wuwu Decoction and Shenlou Fuzheng Jiedu Formula.

〔Keywords〕 numbness; Qi and blood theory; combination of disease and syndrome; Huangqi Guizhi Wuwu Decoction; LIU Zuyi

麻木是以局部或全身肌膚、肢体发麻，甚或全然不知痛痒为特征的一类临床常见病症。西医认为麻木可能是由血流受限或神经损伤而引起的各种疾病、紊乱或异常的一种症状[1]，其发病因素多样，病变涉及多个学科。目前西医尚无有效的治疗方法，多采用营养神经和对因对症治疗。国医大师刘祖贻经验丰富，精通杂科，对麻木的治疗有其独特之处，认为麻木病在肌肤，根在脏腑，气血亏虚为发病之本，邪滞血脉为发病之标，气虚不运、血虚不荣、邪滞血脉导致气血不通、皮肉经脉失养为其基本病机。……