中国中药杂志

2020, v.45(12) 2735-2751

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《千金要方》小续命汤治疗面神经炎、四肢无力、颈椎病、急性脊髓炎、急性神经根炎、格林巴利综合征、多发性硬化、重症肌无力、运动神经元病、皮肌炎体会
Experience of treating facial neuritis, unexplained limb weakness, cervical spondylosis, acute myelitis, acute radiculitis, Guillain Barre syndrome, multiple sclerosis, myasthenia gravis, motor neuron disease, dermatomyositis with Xiaoxuming Decoction

熊兴江;
XIONG Xing-jiang;Guang′anmen Hospital, China Academy of Chinese Medical Sciences;

摘要(Abstract):

《千金要方》小续命汤为治疗中风、风痱病的经典名方。在古代,中风内涵极为广泛,包括面神经炎、急性脑梗死、急性脑出血、脑出血后遗症、不明原因的四肢无力、颈椎病、急性脊髓炎、急性神经根炎、格林巴利综合征、多发性硬化、重症肌无力、运动神经元病、皮肌炎、低钾麻痹、末梢神经炎等疾病。研究发现,①该方在面神经炎、急性脊髓炎、急性神经根炎、格林巴利综合征、不明原因的四肢无力、多发性硬化、运动神经元病、重症肌无力等神经系统疾病,皮肌炎等风湿免疫系统疾病的治疗中极为常见,不仅能改善症状,还能改善预后,提高患者远期生存率;②突然出现的肢体活动不利,面瘫,痛觉减退,而神志正常,排除火热证,则是辨证关键;③该方为治疗急性面神经炎的有效方,配合艾灸,常能1周治愈;④在治疗面神经炎伴高血压病,或伴急性脑血管疾病时,一般不升高血压,还具有一定的降压作用,体现了对血压的双向调节作用;⑤在治疗不明原因的四肢无力、急性脊髓炎、急性神经根炎、格林巴利综合征等时,能迅速改善症状;⑥该方为多发性硬化、运动神经元病的基础治疗方,长期服用能改善肢体无力症状,减少并发症发生,延缓病情进展,但远期预后多不佳;⑦在治疗重症肌无力时,能显著改善肌力,逐步停减激素,部分患者行胸腺瘤手术后,重症肌无力症状仍有反复者同样适用;⑧在皮肌炎、颈椎病等治疗中也具有一定作用;⑨生麻黄是小续命汤中君药,为起效关键,多从6 g起,逐步递增。另外,该方禁用于脸红,心率快,血压高,大便不通,舌质红,苔黄,脉弦数或弦劲有力,直冲寸口者。
Xiaoxuming Decoction is an ancient classic herbal formula for the treatment of stroke. In ancient times, the connotation of stroke was very extensive, including facial neuritis, acute cerebral infarction, acute cerebral hemorrhage, sequelae of cerebral hemorrhage, unexplained weakness of limbs, cervical spondylosis, acute myelitis, acute radiculitis, Guillain Barre syndrome, multiple sclerosis, myasthenia gravis, motor neuron disease, dermatomyositis, hypokalemic paralysis peripheral neuritis. It has been identified that: ①Xiaoxuming Decoction is very common in the treatment of cerebrovascular diseases, such as cerebral infarction, cerebral hemorrhage and other cerebrovascular diseases, facial neuritis, acute myelitis, acute radiculitis, Guillain Barre syndrome, unexplained limb weakness, multiple sclerosis, motor neuron disease, myasthenia gravis, and rheumatic and immune system diseases, such as dermatomyositis, and can not only alleviate symptoms, but also improve prognosis and the long-term survival rate. ②Sudden limb failure, facial paralysis, and hypoalgesia without heat syndrome are the key indications of Xiaoxuming Decoction. ③This is a special prescription for the treatment of acute facial neuritis, and can cure in one week in the combination with moxibustion. ④In the treatment of facial neuritis complicated with hypertension or acute cerebrovascular disease, Xiaoxuming Decoction generally has a certain antihypertensive effect, without any hypertensive effect, which reflected its two-way regulatory effect for blood pressure. ⑤In the treatment of unknown limb weakness, acute myelitis, acute radiculitis, Guillain Barre syndrome, Xiaoxuming Decoction can rapidly alleviate the symptoms. ⑥This is the basic formula for multiple sclerosis and motor neuron disease. Long term use of Xiaoxuming Decoction can alleviate the symptom of limb weakness, reduce the occurrence of complications and delay the progress of the disease, but with a poor long-term prognosis. ⑦In the treatment of myasthenia gravis, Xiaoxuming Decoction can significantly improve muscle strength, and gradually help stop hormone reduction. After thymoma surgery, Xiaoxuming Decoction is also applicable to some patients with recurrent myasthenia gravis. ⑧Xiaoxuming Decoction also plays a role in the treatment of dermatomyositis and cervical spondylopathy. ⑨Raw ephedra is the monarch drug of Xiaoxuming Decoction, which is the key to the effect. The dosage starts with 6 g is titrated in a small dose and increases gradually. In addition, this formula is forbidden for those with red face, fast heart rate, high blood pressure, blocked stool, red tongue, yellow fur, wiry and rapid pulse or powerful pulse, and spout pulse.

关键词(KeyWords): 小续命汤;面神经炎;高血压病;急性脊髓炎;急性神经根炎;格林巴利综合征;多发性硬化;重症肌无力;运动神经元病;皮肌炎
Xiaoxuming Decoction;facial paralysis;hypertension;acute myelitis;acute radiculitis;Guillain Barre syndrome;multiple sclerosis;myasthenia gravis;motor neuron disease;dermatomyositis

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81403375,81603479,81804084);; 中国科协青年人才托举工程项目(2017QNRC001);; 国家重点研发计划项目(2018YFC17044901);; 北京市自然科学基金项目(7194277);; 中国中医科学院育苗基金培育专项(ZZ11-073);中国中医科学院优秀青年科技人才项目(ZZ13-YQ-018)

作者(Author): 熊兴江;
XIONG Xing-jiang;Guang′anmen Hospital, China Academy of Chinese Medical Sciences;

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