吴晓玲 郑鑫蓥 刘鑫

摘要：劉鑫教授研读《伤寒论》，临床运用柴胡桂枝汤颇具心得，认为临床凡属太阳少阳并病，营卫不和，少阳枢机不利，均可用柴胡桂枝汤治疗，体现了中医“异病同治”的原则。临床诊疗时，不拘泥于某方治某病，着眼于“证”的异同，体现辨证论治的内涵。

关键词：柴胡桂枝汤;《伤寒论》;太阳少阳并病;异病同治

中图分类号：R222.2    文献标识码：A    文章编号：2095-5707（2021）03-0060-03

DOI： 10.3969/j.issn.2095-5707.2021.03.014        开放科学（资源服务）标识码（OSID）：

Medical Examples of Liu Xins Application of Chaihu Guizhi Decoction

WU Xiao-ling1， ZHENG Xin-ying1， Instructor： LIU Xin2*

（1. Hunan University of Chinese Medicine， Changsha 410208， China; 2. The First Affiliated Hospital of University of South China， Hengyang 421001， China）

Abstract： Professor Liu Xin studies Shang Han Lun， and has some experience in clinical application of Chaihu Guizhi Decoction. He thinks that Chaihu Guizhi Decoction can be used in the treatment of Taiyang disease involving Shaoyang meridian， disharmony between Nutritive qi and Defensive qi， and obstruction of cardinal in Shaoyang， which embodies the principle of “same treatment for different diseases” in TCM. In clinical diagnosis and treatment， we should not only stick to a certain prescription to treat a disease， but focus on the similarities and differences of “syndrome types”， so as to truly understand the connotation of syndrome differentiation and treatment.

Key words： Chaihu Guizhi Decoction; Shang Han Lun; Taiyang disease involving Shaoyang meridian; same treatment for different diseases

柴胡桂枝汤出自《伤寒论？辨太阳病脉证并治》，“伤寒六七日，发热微恶寒，支节烦疼，微呕，心下支结，外证未去者，柴胡加桂枝汤主之”，“太阳病，或已发热，或未发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名为伤寒”，可看出发热微恶寒、肢体关节烦热疼痛、微呕均为太阳伤寒表证未除的表现;而心下支结同小柴胡汤证胁下硬满，为胃中满闷感，兼有恶心欲呕，是太阳病传变入少阳之征象。柴胡桂枝汤，实则柴胡桂枝各半汤，其条文中叠用2个“微”字，示此证为太阳少阳并病之轻者[1]。刘鑫教授为湖南省名中医，临床经验丰富，师从国医大师熊继柏教授，临床常用柴胡桂枝汤治疗咳嗽、咽痛、隐疹、产后发热、痹证等辨证为太阳少阳并病之症。认为临床见恶寒发热、肢体关节疼痛、呕逆、心下满闷等症属太阳少阳并病，营卫不和，少阳枢机不利，即可运用此方，但见一证便是，不必悉俱。柴胡桂枝汤原方剂量为：柴胡四两，半夏二合半，桂枝、人参、芍药、黄芩、生姜各一两半，炙甘草一两，大枣六枚。临证视病情加减。……