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首播

重播

  附子是名中药,临床应用有几千年的历史,早在西汉时期的《淮南子》中就有“天雄,乌喙,药之大毒也,良医以活人”的记载。明代张介宾推誉附子为药中之“四维”,指出附子、大黄为药之良将,人参、熟地黄为药之良相。更有古代医家云:保命之法,艾灸第一,丹药第二,附子第三,推崇附子为续命起死之要药。现扶阳派也常以大剂附子为主药,近代名医李可老先生创“破格救心汤”,重用附子对重症患者有起死回生之效。

  附子温阳益火,除寒湿,凡内伤外感证属虚寒者均可投之。金代医学家张洁古云:“益火之源以消阴翳,则便溺有节,乌附是也。”黑附子性走而不守,善治肾中寒,为治寒湿之圣药。《药性赋》云附子作用有三,去脏腑沉寒,补阳气不足,温暖脾胃,非附子不能补下焦阳虚,附子通行十二经络,无所不到,补命门真火,去沉寒痼冷,无不奏效。《本草备要》称附子味甘气热,生用发散,熟用峻补元阳,阳微欲绝者,起死回生,非此不为功。

  附子可通上达下,可升可降,可表可里,有斩关夺将之气。能引补气药,行十二经,追散失之元阳;引补血药入血分,以养不足之真阴;引发散药以逐在表之风寒;引温热药达下焦,去在里之寒湿。

  附子临床应用广泛,李时珍称其可治小儿慢惊、风湿麻痹、暴泻脱阳、久泻久痢、久病呕秽、肿满脚气、痈疽不敛、久漏冷疮。历代医家应用附子多有经验,如人参配附子治虚脱休克,干姜配附子回阳以治心力衰竭,黄芪配附子加强固表之功治气虚自汗,白术配附子温中以治脾虚泄泻,地黄加附子加强补血之功治血虚低热,当归配附子加强温经作用以调月经,桂枝加附子通阳以治风湿体痛,石膏配附子有清热强心作用,附子加磁石重镇治阳气衰弱之失眠,附子加知母治心阳不振而有口渴等。

  附子应用于临床,辨证配伍得当方可事半功倍,古人云:附子无干姜不热,得甘草则性缓,得肉桂则补命门,得生姜则发散。附子临床应用常入煎剂,久煮久煎可使其成分生物碱、乌头碱受到破坏,以去其毒性。

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