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chai hu gui zhi tang 柴 胡桂枝湯 (in English and Chinese 中英文)

 translated by Joe Hing Kwok Chu 朱興國譯    按 此看中文  

Name of formula: chai hu gui zhi tang (Shang Han Lun)

Application: influenza, pleurisy, stomach ache, gastroxia (hyperacidity), stomach ulcer, duodenum ulcer, hepatitis, jaundice, pain between the ribs, chronic back pain and pain of sciatica.

Chai hu gui zhi tang is composed of xiao chai hu tang and gui zhi tang, half the amount of each. Its main usage is for chill and fever with pain in the limbs and body due to the combined syndromes of tai yang sickness and shao yang sickness.

Present usage includes ischemia in the brain to prevent brain infarction.

Composition:

chai hu 5 qian,  huang qin 3 qian,  dang shen 3 qian, ban xia 3 qian, zhi gan cao 2 qian,

sheng jiang 3 qian,  da zao 4 pieces slit open, gui zhi 4 qian, bai shao 4 qian.

Make into decoction.

New usage of chai hu gui zhi tang

1.   Ulcer of duodenum: where using H2 receptor blocker were ineffective, using chai hu gui zhi tang decoction of one dose per day, for 10 days as a therapy period, produced good result. It can inhibit the secretion of stomach pepsin thus reduces the damage of stomach lining. It can affect the secretion of gastrin and strengthen the protection of the mucus of duodenum. 

2.   Epilepsy: There was a study on treating 84 patients with epilepsy by using chai hu gui zhi tang decoction, once a day, with 10 days as a therapy period.  Result: 25 healed. 41 obviously effective. 13 got better. 5 ineffective. Total effectiveness: 94.05%.

3.  Recurring influenza: most of the time recurring cold or influenza infection is related to low immune system. There are studies that chai hu gui zhi tang can improve the immune system. In studies, it shows that chai hu gui zhi tang can cause the blood forming stem cells cause the lymphocytes into differentiation and activate the immune system of the young mice. There is a report that show chai hu gui zhi tang being used in acute inflammation of upper respiration tract of children. The result was among the 18 patients, 12 were obviously effective,  4 were effective, and 2 were ineffective.  The most obvious in improvement was fever, the next were eating appetite, cough, sneezing, and clear mucus.

4.   Viral infection with fever: This formula possesses good effect of antipyretic, antiviral, anti-infection. It is effective in treating fever caused by certain viral infection, and is effective in epilepsy caused by infection.  There was a study on using this formula to treat 112 cases of fever caused by infection by adding sheng shi gao, chuan xiong and cang zhu. Use one prescription a day or 2 prescriptions per day on more serious cases.  In general ineffectiveness showed after 5 days of treatment. Total effectiveness is 87.5%.

5.   Neurasthenia: neurasthenia is deemed being caused by the imbalance of excitement and depression of the cortex of the brain. The symptoms includes headache, dizziness, anxiety, tiredness, unable to concentrate, insomnia, forgetfulness, palpitation, short of breath, lack of appetite, flatulence, even skin allergy, impotence, spermatorrhea. Studies showed that this formula can balance the cortex of the brain in adjusting the extremes of excitement and depression. There is a study using this formula with adjustment in treating 60 patients with these symptoms, using one dose per day, 14 days as one therapy period, result were obtain within 1 to 2 periods. (Editor note: this term is not being used today in science).

6.   Lack of blood circulation in the brain: the recurring of transient ischemic attacks can cause temporary symptoms of the brain. About 25 to 40% developed into total brain infarction (brain tissues  become necrosis as a result of obstruction of local blood supply). Study showed that this formula can protect the neurons of the brain from damage during lack of blood circulation and can promote circulation, and can increase circulation to the brain.

Prevents the recurrence of peptic ulcers. [1]

[1] J Vet Med Sci. 2010 Jun;72(6):679-85. Epub 2010 Jan 20.

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柴胡桂枝湯 (傷寒論)

柴胡桂枝湯 是由小 柴胡湯桂 枝湯各半量而組成,主要用于太陽少陽合病引起的發熱惡 寒、肢體疼痛等症。

[主治] 寒疝腹中痛,痛連胸脅,寒 熱往來,小柴胡 湯證與桂 枝湯症並見者。應用於感冒,流感,肋膜炎,胃痛,胃酸過多症,胃潰瘍,十二指腸潰瘍,肝炎,黃疸,肋間神經痛 ,  神經過度緊張所引起之慢性胃痛,神經過敏而心悸亢進不眠,長期慢性背痛,坐 骨神經疼對服過發散劑後仍未全癒之感冒屢有良效。

少陽病,見寒熱往來 ,胸脅苦滿,默默不欲飲食。心煩喜噁, 口苦, 咽乾, 目眩, 舌苔薄白, 脈弦者。

[組成]

柴胡 5 錢,  黃芩 3 錢,   黨參 3 錢, 半夏 3 錢, 炙甘草 2 錢,

生薑 3 錢,  大棗 4 枚劈開﹐桂 枝 4 錢, 白芍 4 錢.

柴胡桂枝湯 是由 小柴胡湯 桂枝湯 各半 量而組成,主要用于太陽少陽合病引起的發熱惡寒、肢體疼痛等症。

註:柴胡桂枝湯可防消化 道潰瘍再發作。【1】

 

柴胡桂枝湯老方新用

資料來源:張景岳中醫藥研究中心  所屬地區:中國大陸


  

柴胡桂枝湯是《傷寒論》中治療太陽和 少陽並病的方劑,是由小柴胡湯合桂枝湯各半量而組成,主要用於太陽少陽合病引起的發熱惡寒、肢體疼痛等症。隨著其臨床運用和研究的深入,發現其有很多新的 用途。

  一、十二指腸潰瘍 柴胡桂枝湯對用H2受體拮抗劑治療無效的十二指腸潰瘍有良好效果,每日1劑,水煎服,10天 為1療程。研究表明柴胡桂枝湯可抑制胃蛋白酶的分泌,從而減低胃液對黏膜的損害作用,同時柴胡桂枝湯能影響促胃泌素的分泌,加強十二指腸黏膜的防禦作用。

  二、癲癇 研究認為癲癇放電現象是細胞內貯存的鈣在釋放過程中,鈣結合狀態的改變使與鈣相關的細胞內蛋白質、細 胞膜離子通道也發生變化,出現了神經元突髮型病理放電。柴胡桂枝湯可使一些相關性改變的每個步驟都受到抑制,從而達到抗癲癇作用。有人用本方治療84例癲 癇病人,每日1劑,10劑為1療程,結果治癒25例,顯效41例,好轉13例,無效5例,總有效率高達94.05%。

  三、反覆感冒 反覆感冒多與人的機體免疫功能低下有關,有研究發現柴胡桂枝湯能增強機體的免疫功能。實驗表明柴 胡桂枝湯可使造血幹細胞向淋巴細胞分化,並使正常幼鼠的免疫機能活化。據報道柴胡桂枝湯治療易感冒兒童急性上呼吸道炎症患者18例,結果顯效12例,有效 4例,無效2例,並且發現症狀改善最明顯的是發熱,其次是食欲、咳嗽、噴嚏、清涕。

  四、病毒感染性發熱 柴胡桂枝湯有良好的解熱、抗病毒、抗感染的作用。用於治療某些病毒感染引起的發熱有良好的 效果,並對感染引起的驚厥有效。據報導有人以本方加生石膏、川芎和蒼朮治療病毒感染性發熱112例,每日1劑,重者可1日2劑,一般服藥5劑有效,總有效 率為87.5%。

  五、神經衰弱 神經衰弱是大腦皮層興奮和抑制過程失去平衡所致,多見頭痛頭昏,焦慮煩燥,疲倦乏力,注意力不集 中,失眠健忘,心悸氣短,胃納減退,脘腹痞滿,甚至皮膚過敏、陽痿、遺精等。研究表明柴胡桂枝湯對人體內分泌系統有一定的調節作用,尤對腦皮質的興奮和抑 制有雙向調節作用,可調節和消除神經衰弱引起的一系列症狀。有人以柴胡桂枝湯加味治療神經衰弱60例,每日1劑,14天1療程,一般1~2療程即可獲效。


  六、腦缺血 反覆發作的腦局部血流一過性減少,於相應供應區出現短暫神經症狀,約25~40%在5年內發展為完 全型腦梗死。實驗表明柴胡桂枝湯對腦部神經元的缺血性損傷有保護作用,同時可促進血液循環,增加腦血流量,有良好的改善腦缺血的功能。

(牛忻群、牛國考/中國中醫藥報)

脊柱受傷

原載:《中國中醫藥報》總2319期

由柴胡桂技湯治支節煩疼體 會少陽主骨

劉永臣 內蒙古開魯縣中醫院


  
患者左,女,58歲。2003年5月8日初診。患骨質疏鬆症10年,一直腰酸背痛。5月7日不慎騎自行車摔倒,當即腰部偏左側劇痛,10多 分鐘後始勉強爬起。回家後自服高鈣片、乙烯雌酚、骨折挫傷散不效,反增腹痛,大便秘結,肢體浮腫。今日來診拍x線片示第五腰椎壓縮性骨折,腰椎廣泛密度減 低,腰椎彎向左側,第三、四腰椎骨刺形成骨橋。方以骨質增生丸改湯加味,3劑罔效。轉方用復元活血湯,仍無寸功。因思《內經》有少陽主骨之論(《素問熱 論》),且仲景傷寒論柴胡桂技湯有治支節煩疼之功,乃用下方:柴胡20g,黃芩15g,黨參30g,半夏15g,甘草10g,生姜15g,大棗12枚 ,桂枝15g,白芍20g,元胡20g,煅自然銅20g,鹿含草15g,杜仲炭30g,川斷30g,骨碎補20g。藥進1劑,腰腹痛均緩,肢腫盡消,大便 亦轉至正常。遂以上方為主連服18劑,連平素腰酸背痛亦告消失,隨訪至今未復發。
  體會:《靈樞經脈篇》有膽足少陽之脈,是主骨所生病者諸論;傷寒論146條更有傷寒六七日,發熱,微惡寒,支節煩疼,微嘔,心下支結,外 証未去者,柴胡桂枝湯主之之語,多年來,一直未引起足夠重視。據資料介紹,柴胡桂枝湯用於骨科疾病見於日本大塚稔(柴胡桂枝湯對骨科疾病的療效,國外醫 學中醫中藥分冊,1996,46(6):86),對骨質疏鬆症,目前西醫仍採用高鈣和雌激素,中醫多宗補益肝腎、強筋壯骨為主進行治療。本例用常法數易 不效,而用仲景法投劑則效,說明有其臨床基礎。
  關於支節,方有執認為是四肢百節;張錫駒則認為支者,經脈之支也;節者,骨節之交也。如此,支節不僅包括了現代所稱之關節,還包 含了調控關節之經脈,即與神經、血管、淋巴系統等有關。《素問五臟生成篇》又雲:諸筋者,皆屬於節。那麼,支、節、筋、骨構成的骨系統,實際上 包涵了四肢百節的全部活動功能,亦即少陽所主之骨和仲景所稱之支節。
  肝主筋、腎主骨,眾所周知。而少陽主骨實際上也是順理成章之事。肝藏血所以主筋,腎藏精所以主骨。而少陽為樞;少陽三焦為人體原氣之總司,主持諸氣; 少陽膽內附於肝,貯存肝之精汁,疏泄於胃腸而營行三焦,故少陽膽與三焦關乎人體氣血、津液、精之生化、疏泄者甚多,是以人體精微物質的生化疏泄,其正 常與否,取決於少陽之樞,而筋骨之榮枯亦然。這樣理解,我們不僅對內經凡十一臟取決於膽,少陽主骨等有了深刻認識,而且還將對小柴胡湯及其系列方能治 多種疾病加深理解,是為思求經旨,以演其所知云。D3
 

[1] J Vet Med Sci. 2010 Jun;72(6):679-85. Epub 2010 Jan 20.

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