https://wiki.chsoc.com/index.php?action=history&feed=atom&title=%E5%8C%BB%E6%A1%88%3A1974-08-%E5%A4%AA%E9%98%B3%E9%A3%8E%E6%B9%BF%EF%BC%88%E8%8C%83%E4%B8%AD%E6%9E%97%E5%8C%BB%E6%A1%88%EF%BC%89 2026-04-16T03:03:57Z 本wiki上该页面的版本历史 MediaWiki 1.43.5 https://wiki.chsoc.com/index.php?title=%E5%8C%BB%E6%A1%88:1974-08-%E5%A4%AA%E9%98%B3%E9%A3%8E%E6%B9%BF%EF%BC%88%E8%8C%83%E4%B8%AD%E6%9E%97%E5%8C%BB%E6%A1%88%EF%BC%89&diff=936&oldid=prev 2026-02-08T06:17:20Z

<p>上传中医医案</p> <table style="background-color: #fff; color: #202122;" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="zh-Hans-CN"> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">←上一版本</td> <td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">2026年2月8日 (日) 14:17的版本</td> </tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l33">第33行：</td> <td colspan="2" class="diff-lineno">第33行：</td></tr> <tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* 《三家医案》《经方治痹》《经方100首》</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* 《三家医案》《经方治痹》《经方100首》</div></td></tr> <tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Category:中医医案]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Category:中医医案]]</div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:外感病证]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:经方]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:伤寒论]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:现代医家]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:风湿痹痛]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:太阳证]]</ins></div></td></tr> <tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[Category:桂枝附子汤]]</ins></div></td></tr> </table>

OpenClaw https://wiki.chsoc.com/index.php?title=%E5%8C%BB%E6%A1%88:1974-08-%E5%A4%AA%E9%98%B3%E9%A3%8E%E6%B9%BF%EF%BC%88%E8%8C%83%E4%B8%AD%E6%9E%97%E5%8C%BB%E6%A1%88%EF%BC%89&diff=935&oldid=prev 2026-02-08T06:10:47Z

<p>上传中医医案</p> <p><b>新页面</b></p><div>{{医案信息<br /> |患者 = 杨某某，女性，60岁，农民。既往有风湿痛史<br /> |主诉 = 腰痛如割，不能转侧<br /> |症状 = 腰痛如割，不能转侧&lt;br/&gt;身觉阵阵畏寒发热&lt;br/&gt;手脚麻木&lt;br/&gt;面色青暗，唇乌&lt;br/&gt;舌质微红，苔白滑腻&lt;br/&gt;触双手背微凉&lt;br/&gt;脉浮虚<br /> |处方 = 桂枝附子汤主之；桂枝15克，制附片60克（久煎，一个半小时），生姜30克，炙甘草10克，红枣30克。四剂<br /> |疗效 = 上方连服四剂后，诸证悉减。再服四剂，基本痊愈。从此行走、劳动如常。1979年6月追访，患者谈及五年前病愈以后，未再复发。<br /> |医家 = 范中林<br /> |整理时间 = 2026-02-08<br /> }}<br /> == 临床表现 ==<br /> 患者1974年8月初，身觉不适，畏寒，头昏，身痛。某日正弯腰时，忽感腰部剧烈疼痛，不能伸直，头上直冒冷汗，遂倒床不起。腰痛如割，不能转侧，身觉阵阵畏寒发热，手脚麻木。面色青暗，唇乌，舌质微红，苔白滑腻，触双手背微凉，脉浮虚。<br /> == 病机分析 ==<br /> 病机：太阳证风湿相搏，卫阳兼血分虚寒，既往风湿遇外感诱发剧痛。患者素有风湿痛史，此次因外感诱发，风寒湿邪痹阻太阳经脉，气血运行不畅，故腰痛剧烈；卫阳已虚，故畏寒发热；阳气不能温煦四末，故手脚麻木、双手背凉。证属太阳表虚，风湿相搏。<br /> == 圆运动病机分析 ==<br /> 病机：太阳经气不利，风湿痹阻，卫阳虚损。<br /> <br /> 辨证要点：<br /> # 太阳经证：腰痛不能转侧，为太阳经脉循行部位病变<br /> # 风湿相搏：身痛、畏寒发热，为风寒湿邪外袭<br /> # 卫阳虚损：面色青暗、唇乌、双手背凉，为阳气不能温煦<br /> # 脉证相符：脉浮虚，正邪相争于表而正气已虚<br /> <br /> 治法方义：桂枝附子汤温经散寒，祛风除湿。桂枝通阳解表，附子温经逐寒，生姜助桂枝发散风寒，草枣和中益气。全方使风邪从表而解，寒湿从内而温，表里同治。<br /> == 治则治法 ==<br /> 温经散寒，祛风除湿。以温经散寒为主，祛风除湿为辅。<br /> == 处方用药 ==<br /> 处方以桂枝附子汤原方，药量斟酌变化。桂枝15克发散在表之风寒，通阳化气；制附片60克（久煎）温经逐寒止痛，助肾阳而立卫阳之基；生姜30克助桂枝发散风寒，使风邪从皮毛而出；炙甘草10克、红枣30克益中州、和营卫。全方配伍，三气（风、寒、湿）除而搏自解。<br /> == 疗效观察 ==<br /> 服药四剂后，诸证悉减，显示方药对证。再服四剂，基本痊愈，行走、劳动如常。五年后追访未复发，说明远期疗效巩固。本案体现了经方&amp;quot;方证对应&amp;quot;的精准疗效。<br /> == 按语 ==<br /> 《伤寒论》指出：&amp;quot;伤寒八九日，风湿相搏，身体疼烦，不能自转侧，不呕不渴，脉浮虚而涩者，桂枝附子汤主之。&amp;quot;本例诸证与上条基本吻合，故按原方投之。范老在经方应用上，注重药量斟酌，本例加重桂枝发散风寒，加重附子温经逐寒，体现了&amp;quot;有是证用是药&amp;quot;的辨证精髓。本案提示：对于风湿痹痛，当辨六经，太阳证风湿相搏者，桂枝附子汤有良效。<br /> == 参考文献 ==<br /> * 《三家医案》《经方治痹》《经方100首》<br /> [[Category:中医医案]]</div>

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