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2009年3月10日星期二
中医常用三种退热法Three kinds of Chinese medicine commonly used cooling method
讲到发烧，恐怕每个人都有切身的体会。对发热的诊治，中西医学有不同的方法。但两者相比，中医诊治发热更富有特色。
为了便于大家理解，在讲具体内容之前，我们先来观察一种生活现象，如果我把一个高热的病人比作一壶正在烧开的水，“退热”就是要使这壶水冷却下来，你想有几种方法?我想至少有3种：首先，要把炉火关掉，以减少产热，这叫“釜底抽薪”;其次，应把壶盖打开，或将开水搅拌，以增加散热，所谓“扬汤止沸”;再次，可往开水中兑入冷水，甚至冰块，所谓“热者寒之”。其实，这三种方法在中医的退热治疗中都十分常用。下面就来具体讲讲这三种退热方法的应用。
1.釜底抽薪法
相当于中医“通腑泄热法”，即用苦寒通便的药物来达到退热的目的。主要适用于高热而有便秘的病人。如病人出现高热汗出，大便不通，腹胀、腹痛拒按，甚至胡言乱语，舌苔黄糙起刺，脉滑有力时。此犹如锅下柴多火旺，抽去柴薪则火熄热退。故常用大黄、芒硝等药，或将其配入清热方剂中，以通利大便，泻下热结，使邪热从下而去，可达到去火退热之功;再者，通便去火，又能保护阴液，犹如防止火太旺而将水烧干，限制体温上升，这也有利于退热。
2.扬汤止沸法
相当于中医“疏散退热法”，即用药性辛散的药物来达到退热的目的。它主要包括两个内容，一是发汗退热法，适用于表证发热的病人，常见发热与恶寒怕冷同时并见，无汗或有汗不畅，这是由于体表受外邪困遏引起的发热，因受邪性质的不同和病人体质的差异，又可分为风寒表证和风热表证两大类。前者恶寒明显，一般无汗，且兼有头痛，肢体酸痛，鼻塞流清涕，口不渴，咽喉不痛，脉浮紧等;后者发热明显，一般有汗，且兼有头痛，口渴，咽喉肿痛，脉浮数等。发汗退热法宜根据寒热之异来选取不同的药物，如风寒表证常用辛温发汗药，如麻黄、桂枝、羌活等;风热表证常用辛凉发汗药，如柴胡、升麻、薄荷等。通过发汗散邪，使邪热外达，发热随之减轻，从而达到退热之效，符合中医经典著作《黄帝内经》所说的“体若燔炭，汗也而散”的治则，发汗法对无汗高热者尤其有效。二是升散退热法，适用于内有郁热的病人，因邪热内郁于里，常表现为发热，胸膈烦热，口干唇裂，面色红赤，口舌生疮，舌红苔黄，脉数等，可于清热方剂中酌加薄荷、升麻等以加强疏散清热之功，此符合《黄帝内经》所说的“火郁发之”的治则。但应注意的是，发汗退热法虽十分常用，且有很好的退热作用，但过汗能损伤津液，故对体虚病人应当慎用。
3.热者寒之法
也是中医最常用的退热法之一，即用药性寒凉(甘寒或苦寒)的药物来达到退热的目的。主要适用于发热而不恶寒的病人。如见高热不退，汗出较多，口渴喜喝冷饮，脉象洪大而数时，为热盛津伤证，此时不能用发汗退热法，宜用甘寒退热法，如石膏、生地、麦冬等;如见高热烦躁，口燥咽干，便秘尿热，舌红苔黄，脉数有力，为热毒炽盛证，当用苦寒清热法，如黄连、黄芩、黄柏、栀子等。由于本类药物性多寒凉，易伤脾胃，故应注意适可而止。
最后，值得指出的是，上述三法皆宜于实热证，不宜于虚热证;在临床上可以单独应用，如能根据具体情况结合应用则退热效果会更好。另外，病人高热大汗时，中医并不主张用冰袋等冷敷法，以免影响出汗，反不利于退热。
Mentioned fever, I am afraid that everyone has personal experience. Diagnosis and treatment of fever, Chinese and Western medicine have different approaches. However, both compared to the Chinese medicine diagnosis and treatment of fever is more unique. U.S. in order to facilitate understanding, speaking at the specific content, we first observed the phenomenon of a life, if I put a high fever are sick as a pot of boiling water, "fever" is to put the pot of water to cool down, There are several ways you think? I want to have at least three kinds: First of all, it is necessary to turn off the fire in order to reduce heat production, called "drastic"; Secondly, should be put壶盖open, or to water mixing, to increase the bulk hot, the so-called "Yang soup boil only"; again, allowed to gain access to water in兑入cold water, and even ice, the so-called "hot from cold." In fact, these three methods in Chinese medicine the treatment of fever are very common. Here's to talk about specific methods of the three cooling applications.
1. Drastic method Equivalent to traditional Chinese medicine "Tongfu泄热Law", which uses cold Tongbian antipyretic drugs to achieve the purpose. Mainly applicable to high fever and constipation patients. Patients such as high fever sweat, faeces barrier, abdominal distension, abdominal pain by refusing to even Gibberish, yellow tongue coating umbrosa from thorns, when a strong pulse Waterloo. This is like many Huowang firewood under the pot, removing firewood put out the fire hot back then. It is commonly used rhubarb, Glauber's salt, such as medicines, or with income Qingre prescription in order to Tom Lee stool, diarrhea under the hot junction, so that evil away from the hot, can reach the reactive去火antipyretic; Furthermore, Tongbian go fire, while protecting阴液as if the prevention of fire and water wang too dry, limiting the temperature rise, which is also conducive to cooling.
2. Jan soup boiling method only Equivalent to traditional Chinese medicine "evacuation fever law", that is, medication辛散of the drug to achieve the purpose of cooling. It mainly includes two elements, one sweating fever law, applies to evidence of febrile patients恶寒common cold and fever at the same time and see, no Khan or Khan has impeded, This is because the body surface by外邪the hardship caused to suppress fever, due to the different nature of evil and sick physical differences, can be divided into hot and wind chill table card table card two broad categories. The former恶寒Obviously, the general non-Khan, and a combination of headache, aching limbs, blocked flow-ching T,不渴the mouth, throat pain, tight floating pulse, etc.; latter fever Clearly, there is generally Khan, and a combination of headache, thirst, sore throat, floating pulse, etc.. Transpiration cooling method appropriate under the cold and heat differences to select different drugs, such as evidence of common cold Xin Wen diaphoretic, such as ephedra, Guizhi, Notopterygium etc.; evidence of commonly used hot wind辛凉diaphoretic, such as Chaihu, acteoside , mint and so on. Scattered through the sweating evil, so evil things hot up, then reduce the heat to achieve the cooling effect, in line with the classics of Chinese medicine, "Huang Di Nei Jing" as "body if Burnt charcoal, Khan is also the break up" the rule is, sudorific Anhidrotic heat on those who are particularly effective. Second, casual or cooling law, apply to have the hot Yu sick, because of evil with Yu in hot years, usually fever,胸膈烦热, dry mouth lip, pale red red, mouth sores, mamillata Carex Huang , pulse, etc., can be Qingre Prescription Medium酌加mint, Cimicifuga, such as to enhance the evacuation Qingre of power, this in line with the "Huang Di Nei Jing," described as "hair of the fire Yu" is the rule. It should be noted, is that sweating Although fever is very common, and have very good cooling effect, but before Khan can damage body fluid, it should be used with caution on sick体虚.
3. Hot from cold Law Chinese medicine is the most commonly used method of cooling one, that is, use of cold (or cold甘寒) drugs to achieve the purpose of cooling. Mainly applicable to heat without恶寒patients. See such as high fever not to reclaim, more sweat, thirst-hi cold drink, and several Hong pulse when hot Sheng Jin injury card, at this time should not use sweating fever law, antipyretic甘寒suitable method, such as gypsum , root, Ophiopogon japonicus, etc.; see heat such as irritability,口燥throat, constipation, hot urine, mamillata Carex yellow, pulse a few powerful drug for flaming hot card, when used cold Qingre law, such as Coptis, Scutellaria, Phellodendron, Gardenia, etc..
Because of the many types of drug-induced cold, easily hurt the spleen and stomach, it should be noted that in moderation. Finally, it should be noted that the above three methods in the real hot-Safe certification, not in the cards虚热; up alone in clinical applications, such as the specific circumstances in accordance with the joint application of the cooling effect will be even better. In addition, high fever sweat when sick, do not advocate use Chinese medicine, such as cold pack method, so as not to affect sweating, is not conducive to anti-fever.
为了便于大家理解，在讲具体内容之前，我们先来观察一种生活现象，如果我把一个高热的病人比作一壶正在烧开的水，“退热”就是要使这壶水冷却下来，你想有几种方法?我想至少有3种：首先，要把炉火关掉，以减少产热，这叫“釜底抽薪”;其次，应把壶盖打开，或将开水搅拌，以增加散热，所谓“扬汤止沸”;再次，可往开水中兑入冷水，甚至冰块，所谓“热者寒之”。其实，这三种方法在中医的退热治疗中都十分常用。下面就来具体讲讲这三种退热方法的应用。
1.釜底抽薪法
相当于中医“通腑泄热法”，即用苦寒通便的药物来达到退热的目的。主要适用于高热而有便秘的病人。如病人出现高热汗出，大便不通，腹胀、腹痛拒按，甚至胡言乱语，舌苔黄糙起刺，脉滑有力时。此犹如锅下柴多火旺，抽去柴薪则火熄热退。故常用大黄、芒硝等药，或将其配入清热方剂中，以通利大便，泻下热结，使邪热从下而去，可达到去火退热之功;再者，通便去火，又能保护阴液，犹如防止火太旺而将水烧干，限制体温上升，这也有利于退热。
2.扬汤止沸法
相当于中医“疏散退热法”，即用药性辛散的药物来达到退热的目的。它主要包括两个内容，一是发汗退热法，适用于表证发热的病人，常见发热与恶寒怕冷同时并见，无汗或有汗不畅，这是由于体表受外邪困遏引起的发热，因受邪性质的不同和病人体质的差异，又可分为风寒表证和风热表证两大类。前者恶寒明显，一般无汗，且兼有头痛，肢体酸痛，鼻塞流清涕，口不渴，咽喉不痛，脉浮紧等;后者发热明显，一般有汗，且兼有头痛，口渴，咽喉肿痛，脉浮数等。发汗退热法宜根据寒热之异来选取不同的药物，如风寒表证常用辛温发汗药，如麻黄、桂枝、羌活等;风热表证常用辛凉发汗药，如柴胡、升麻、薄荷等。通过发汗散邪，使邪热外达，发热随之减轻，从而达到退热之效，符合中医经典著作《黄帝内经》所说的“体若燔炭，汗也而散”的治则，发汗法对无汗高热者尤其有效。二是升散退热法，适用于内有郁热的病人，因邪热内郁于里，常表现为发热，胸膈烦热，口干唇裂，面色红赤，口舌生疮，舌红苔黄，脉数等，可于清热方剂中酌加薄荷、升麻等以加强疏散清热之功，此符合《黄帝内经》所说的“火郁发之”的治则。但应注意的是，发汗退热法虽十分常用，且有很好的退热作用，但过汗能损伤津液，故对体虚病人应当慎用。
3.热者寒之法
也是中医最常用的退热法之一，即用药性寒凉(甘寒或苦寒)的药物来达到退热的目的。主要适用于发热而不恶寒的病人。如见高热不退，汗出较多，口渴喜喝冷饮，脉象洪大而数时，为热盛津伤证，此时不能用发汗退热法，宜用甘寒退热法，如石膏、生地、麦冬等;如见高热烦躁，口燥咽干，便秘尿热，舌红苔黄，脉数有力，为热毒炽盛证，当用苦寒清热法，如黄连、黄芩、黄柏、栀子等。由于本类药物性多寒凉，易伤脾胃，故应注意适可而止。
最后，值得指出的是，上述三法皆宜于实热证，不宜于虚热证;在临床上可以单独应用，如能根据具体情况结合应用则退热效果会更好。另外，病人高热大汗时，中医并不主张用冰袋等冷敷法，以免影响出汗，反不利于退热。
Mentioned fever, I am afraid that everyone has personal experience. Diagnosis and treatment of fever, Chinese and Western medicine have different approaches. However, both compared to the Chinese medicine diagnosis and treatment of fever is more unique. U.S. in order to facilitate understanding, speaking at the specific content, we first observed the phenomenon of a life, if I put a high fever are sick as a pot of boiling water, "fever" is to put the pot of water to cool down, There are several ways you think? I want to have at least three kinds: First of all, it is necessary to turn off the fire in order to reduce heat production, called "drastic"; Secondly, should be put壶盖open, or to water mixing, to increase the bulk hot, the so-called "Yang soup boil only"; again, allowed to gain access to water in兑入cold water, and even ice, the so-called "hot from cold." In fact, these three methods in Chinese medicine the treatment of fever are very common. Here's to talk about specific methods of the three cooling applications.
1. Drastic method Equivalent to traditional Chinese medicine "Tongfu泄热Law", which uses cold Tongbian antipyretic drugs to achieve the purpose. Mainly applicable to high fever and constipation patients. Patients such as high fever sweat, faeces barrier, abdominal distension, abdominal pain by refusing to even Gibberish, yellow tongue coating umbrosa from thorns, when a strong pulse Waterloo. This is like many Huowang firewood under the pot, removing firewood put out the fire hot back then. It is commonly used rhubarb, Glauber's salt, such as medicines, or with income Qingre prescription in order to Tom Lee stool, diarrhea under the hot junction, so that evil away from the hot, can reach the reactive去火antipyretic; Furthermore, Tongbian go fire, while protecting阴液as if the prevention of fire and water wang too dry, limiting the temperature rise, which is also conducive to cooling.
2. Jan soup boiling method only Equivalent to traditional Chinese medicine "evacuation fever law", that is, medication辛散of the drug to achieve the purpose of cooling. It mainly includes two elements, one sweating fever law, applies to evidence of febrile patients恶寒common cold and fever at the same time and see, no Khan or Khan has impeded, This is because the body surface by外邪the hardship caused to suppress fever, due to the different nature of evil and sick physical differences, can be divided into hot and wind chill table card table card two broad categories. The former恶寒Obviously, the general non-Khan, and a combination of headache, aching limbs, blocked flow-ching T,不渴the mouth, throat pain, tight floating pulse, etc.; latter fever Clearly, there is generally Khan, and a combination of headache, thirst, sore throat, floating pulse, etc.. Transpiration cooling method appropriate under the cold and heat differences to select different drugs, such as evidence of common cold Xin Wen diaphoretic, such as ephedra, Guizhi, Notopterygium etc.; evidence of commonly used hot wind辛凉diaphoretic, such as Chaihu, acteoside , mint and so on. Scattered through the sweating evil, so evil things hot up, then reduce the heat to achieve the cooling effect, in line with the classics of Chinese medicine, "Huang Di Nei Jing" as "body if Burnt charcoal, Khan is also the break up" the rule is, sudorific Anhidrotic heat on those who are particularly effective. Second, casual or cooling law, apply to have the hot Yu sick, because of evil with Yu in hot years, usually fever,胸膈烦热, dry mouth lip, pale red red, mouth sores, mamillata Carex Huang , pulse, etc., can be Qingre Prescription Medium酌加mint, Cimicifuga, such as to enhance the evacuation Qingre of power, this in line with the "Huang Di Nei Jing," described as "hair of the fire Yu" is the rule. It should be noted, is that sweating Although fever is very common, and have very good cooling effect, but before Khan can damage body fluid, it should be used with caution on sick体虚.
3. Hot from cold Law Chinese medicine is the most commonly used method of cooling one, that is, use of cold (or cold甘寒) drugs to achieve the purpose of cooling. Mainly applicable to heat without恶寒patients. See such as high fever not to reclaim, more sweat, thirst-hi cold drink, and several Hong pulse when hot Sheng Jin injury card, at this time should not use sweating fever law, antipyretic甘寒suitable method, such as gypsum , root, Ophiopogon japonicus, etc.; see heat such as irritability,口燥throat, constipation, hot urine, mamillata Carex yellow, pulse a few powerful drug for flaming hot card, when used cold Qingre law, such as Coptis, Scutellaria, Phellodendron, Gardenia, etc..
Because of the many types of drug-induced cold, easily hurt the spleen and stomach, it should be noted that in moderation. Finally, it should be noted that the above three methods in the real hot-Safe certification, not in the cards虚热; up alone in clinical applications, such as the specific circumstances in accordance with the joint application of the cooling effect will be even better. In addition, high fever sweat when sick, do not advocate use Chinese medicine, such as cold pack method, so as not to affect sweating, is not conducive to anti-fever.
“好睡” 七道汤"Sleep" 7 soup
饮食是最安全的方法，妥善运用有安神、镇静功效的中药调理，即可自然又健康的吃出睡意。以下推介七道汤饮，不妨试试：
一、酸枣仁汤：
酸枣仁三钱捣碎，水煎，每晚睡前一小时服用。酸枣仁能抑制中枢神经系统，有较恒定的镇静作用。对于血虚所引起的心烦不眠或心悸不安有良效。
二、静心汤：
龙眼肉、川丹参各三钱，以两碗水煎成半碗，睡前30分钟服用。可达镇静的效果，尤其对心血虚衰的失眠者，功效较佳。
三、安神汤：
将生百合五钱蒸熟，加入一个蛋黄，以200c.c.水搅匀，加入少许冰糖，煮沸后再以50c.c.的水搅匀，于睡前一小时饮用。百合有清心、安神、镇静的作用，经常饮用，可收立竿见影之效。
四、三味安眠汤：
酸枣仁三钱，麦冬、远志各一钱，以水500c.c.煎成50c.c.，于睡前服用。以上三种药材均有宁心安神镇静的作用，混合有催眠的效果。
五、桂圆莲子汤：
取桂圆、莲子各二两煮成汤，具有养心、宁神、健脾、补肾的功效，最适合于中老年人、长期失眠者服用。
六、养心粥：
取党参35公克，去子红枣10枚、麦冬、茯神各10公克，以2000c.c.的水煎成500c.c.，去渣后，与洗净的米和水共煮，米熟后加入红糖服用。可达养气血安神的功效，对于心悸(心跳加快)、健忘、失眠、多梦者有明显改善作用。
七、百合绿豆乳：
取百合、绿豆各25公克，冰糖少量，煮熟烂后，服用时加些牛奶，对于夏天睡不着的人，有清心除烦镇静之效，牛奶含色氨酸能于脑部转成血清素促进睡眠。
Food is the most safe way to have the proper utilization of sedative, sedation conditioning efficacy of Chinese medicine can be a natural and healthy吃出drowsiness. Introduce the following seven drink soup, try:
1, Suanzaoren Decoction: Three broken Suanzaoren money, decoction, taken one hour before going to bed every night. Suanzaoren can inhibit the central nervous system, there is a more constant sedation. For blood deficiency caused by the upset does not have disturbed sleep or palpitations good effect.
Second, pause soup: Longan meat,川丹Participation of all three money to两碗into半碗decoction, take 30 minutes before going to bed. Up to the effects of sedation, especially for the painstaking efforts of the virtual failure of insomnia, the efficacy of better.
Three, soothe the nerves soup: Lily raw money five steamed, add an egg yolk to 200c.c. water mix, add some rock sugar, boiling water and then mix in 50c.c., at bedtime for an hour drinking. Lily has heart, soothe the nerves, the role of sedation, often drinking, we can get instant results.
Four, shamisen Anmyeon soup: Three Suanzaoren money, Ophiopogon japonicus, Polygala all 1 money, with water 500c.c.煎成50c.c., taken just before going to bed. These three herbs have sedative sedative Ningxin the role of hypnosis has mixed results.
Friday, longans philoxeroides soup: Check longans, philoxeroides the 22 boiled soup, with Yangxin, Nanjing God, spleen, kidney efficacy, the most suitable for the elderly, those taking long-term insomnia.
VI aizoon porridge: Check dangshen 35 grams dates go sub-10, Ophiopogon japonicus,茯神the 10 grams to 2000c.c. The decoction into 500c.c., go after Java, and wash the rice and water共煮, add brown sugar and cooked rice after the taking. Up to raise the effectiveness of blood and soothe the nerves, the heart palpitations (rapid heartbeat), forgetfulness, insomnia, dream of many who have marked improvement in the role.
Seven, Lily mung bean milk: Check Lily, mung bean, 25 grams each, a small amount of crystal sugar, cooked rotten after taking the time add more milk, the people can not sleep for the summer, there is除烦heart sedative effect of milk containing tryptophan in the brain can be transformed into serotonin to promote sleep.
一、酸枣仁汤：
酸枣仁三钱捣碎，水煎，每晚睡前一小时服用。酸枣仁能抑制中枢神经系统，有较恒定的镇静作用。对于血虚所引起的心烦不眠或心悸不安有良效。
二、静心汤：
龙眼肉、川丹参各三钱，以两碗水煎成半碗，睡前30分钟服用。可达镇静的效果，尤其对心血虚衰的失眠者，功效较佳。
三、安神汤：
将生百合五钱蒸熟，加入一个蛋黄，以200c.c.水搅匀，加入少许冰糖，煮沸后再以50c.c.的水搅匀，于睡前一小时饮用。百合有清心、安神、镇静的作用，经常饮用，可收立竿见影之效。
四、三味安眠汤：
酸枣仁三钱，麦冬、远志各一钱，以水500c.c.煎成50c.c.，于睡前服用。以上三种药材均有宁心安神镇静的作用，混合有催眠的效果。
五、桂圆莲子汤：
取桂圆、莲子各二两煮成汤，具有养心、宁神、健脾、补肾的功效，最适合于中老年人、长期失眠者服用。
六、养心粥：
取党参35公克，去子红枣10枚、麦冬、茯神各10公克，以2000c.c.的水煎成500c.c.，去渣后，与洗净的米和水共煮，米熟后加入红糖服用。可达养气血安神的功效，对于心悸(心跳加快)、健忘、失眠、多梦者有明显改善作用。
七、百合绿豆乳：
取百合、绿豆各25公克，冰糖少量，煮熟烂后，服用时加些牛奶，对于夏天睡不着的人，有清心除烦镇静之效，牛奶含色氨酸能于脑部转成血清素促进睡眠。
Food is the most safe way to have the proper utilization of sedative, sedation conditioning efficacy of Chinese medicine can be a natural and healthy吃出drowsiness. Introduce the following seven drink soup, try:
1, Suanzaoren Decoction: Three broken Suanzaoren money, decoction, taken one hour before going to bed every night. Suanzaoren can inhibit the central nervous system, there is a more constant sedation. For blood deficiency caused by the upset does not have disturbed sleep or palpitations good effect.
Second, pause soup: Longan meat,川丹Participation of all three money to两碗into半碗decoction, take 30 minutes before going to bed. Up to the effects of sedation, especially for the painstaking efforts of the virtual failure of insomnia, the efficacy of better.
Three, soothe the nerves soup: Lily raw money five steamed, add an egg yolk to 200c.c. water mix, add some rock sugar, boiling water and then mix in 50c.c., at bedtime for an hour drinking. Lily has heart, soothe the nerves, the role of sedation, often drinking, we can get instant results.
Four, shamisen Anmyeon soup: Three Suanzaoren money, Ophiopogon japonicus, Polygala all 1 money, with water 500c.c.煎成50c.c., taken just before going to bed. These three herbs have sedative sedative Ningxin the role of hypnosis has mixed results.
Friday, longans philoxeroides soup: Check longans, philoxeroides the 22 boiled soup, with Yangxin, Nanjing God, spleen, kidney efficacy, the most suitable for the elderly, those taking long-term insomnia.
VI aizoon porridge: Check dangshen 35 grams dates go sub-10, Ophiopogon japonicus,茯神the 10 grams to 2000c.c. The decoction into 500c.c., go after Java, and wash the rice and water共煮, add brown sugar and cooked rice after the taking. Up to raise the effectiveness of blood and soothe the nerves, the heart palpitations (rapid heartbeat), forgetfulness, insomnia, dream of many who have marked improvement in the role.
Seven, Lily mung bean milk: Check Lily, mung bean, 25 grams each, a small amount of crystal sugar, cooked rotten after taking the time add more milk, the people can not sleep for the summer, there is除烦heart sedative effect of milk containing tryptophan in the brain can be transformed into serotonin to promote sleep.
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