小柴胡加葛根汤速效辨治甲流一例
患者是33岁的男性,体质壮实,劳累后出现外感症状,医院查呼吸道感染病毒提示甲流。医院予布洛芬、止咳水治疗后无改善,反有纳差、便稀之证,遂求中医药治疗。刻证:发热、汗出、咳嗽、有痰,黄稠痰,难咯出,流鼻涕清水鼻涕,鼻塞,不怕冷。头痛,眉棱骨痛,眼球痛。身体累重,口干,不口苦,咽痛,胸满,深呼吸疼痛,左腹部疼痛,大便成形,小便黄,舌红苔薄黄腻,脉浮弦数。
处方:柴胡24 黄芩15 法半夏15 党参15 生姜3片(自备)大枣10 甘草12 葛根40 生石膏30 连翘10 薏苡仁30 桔梗15 枳实15 白芍15 白芷10 2剂。
嘱患者回家立即煎煮1剂,每1.5小时喝一次,所有药汤分3次喝完,再煮药渣1次,晚饭后半小时顿服。
下午回访,患者服药2次(2/3剂)后,已感觉好很多,嘱其继续服用。
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Soz0uN9ruNwe4fItZ4PiLY62R42ur8FZz/tFjvL7u5WCKs+8c4+JrV7jII/q226uqbTYHvK/+/PZSsGuq+2203znMmdhvMN7Dim2xWLMZ3bouNT8k5SZJ2QSJ0XECP2KxXuGjn94m5YzzD0+e5vadOe49vE/kaoqZiAjQ6hdvDU1vB3lbZJ7sNicDWdOd//mvPcMv/ZtMlwPLXH2tvDwCffbN3gN8uXruXAP9zInW8qpr5ntfvtbsK98seI8e4/V34OJrV3j7Rvu4uQ13H1tZ1W2O2cudfffNjVfmGeP4i91u1H13tuNvDb5G+mZSZpxvxv8Vo2Z/T8cbG2KjiAhwXQcT+LhhiN+oca9Wo+5E3Kn7RMZgTZWXXjrK7Z99QsJNYiqVyrDMmhAR2RZ/WP13XT/3ayFRPWwORe/4l3Gz+eG3S4MPrNrS2um1zdeKHXkmzpGvtHqbO9cHB7a6ycejNHcDg1PvnN5gGtlaq0fQz164zuS5zeaCbxTKr/a0U9rj5ODyzfh5nnPTPZ/ztV/5ZazxaPg+Iwb2ew71sE7FwINGwCsvfYHfOn+eH/2fH3O7OMvN/3eNw59P48eMQlxEnj4bhThAfbGBjcAsB3m7l7x7Lb5bQ3zi+RRTX+ytEpTtM2Ym+bXEv+9rP/GTZ34ZPzIYQvbZgL+XOcoPb3xEw3gYJ8G53zjHe1f+Jx+VfkyqfIdkIyT52aP8k3/xbTWni4h0iiU8/GrQnCDezu0hLHW8pP553wnPO8f7CnCAEENkPGKhIXRc/vrDG3ixGIv3Fyk//Dn/5eJ/4oOffsyzzx7mro3jUOPw3Z+TaNQU4iIinZy4w0R8Eo8Y1qyk90a94pO/+KSerD81WyGgvtOP8dRJmFTf54wSskgcx9SpmTgjIxN86bPP8lff/z4jsRQ/+L/XGHVTmFiMxXqCiWePcNs33PW12IuIyDo1FrEmAmto/xouVgG+Q+wArTZR6OHj4CYcItdjv+vwW//0l5n07/P7v/sfOPn3/wEvHj4IfplnkjDeuE/08BP+5E//mypxEZFuKvYhY2Yf2FatMwQ53n7EaBjb/59iYSxFylaIeS4HYgn+7nOTEBj++T/+Vcqf3uTlZydIRONU4pa/ubHIfTwO7fd4cG9OlbiISHcRZfsQa6Lmhii7OBdXL7oKDasqfJgcTMzz9WfrTBifoxMJDqY8EkGZb5/8EkF1gbv3q7y/0OCDjxc4NAKnp+p8++SzTCRDhbiIyMYiKvYBlhBnF/9r2Q7v9p98NaUPla+nExydGmFsJMXEgWc4tO8AN29+yqHJQ3zjF38B/+E84UiSQ4c+x/jh5/mbnyzwR99f4ONFVyEuIrI5y5J9QC1a2tVN6u0g960PDD51TZ68//W38/zpD+5x/W6Vv37/feIJn8znjxAnYj8hmRePsFit8/LLr3Dq5GliqUnmyx6hk1SfuIhIL3xqRJElZXbXftXLC7W1XjDqdvfv6iWr3bCHicdj1Op1YrEUV358k19MH8NYWDIuP5tfxCbG+R9Xv8e49Xkm9Jl3FqkGcVXiIiK9CqkTsvkiK0+UaYe3xVpLPVra6SeSATiuQ6O6iOcYGpHD+zfv8PPbc4RhxEfz8/zgxx/SCB0W6j6BdYi5EIU+URQpxEXk6RM3IwOfW7e7JyitbYa3gwEifGo7/UhPvZTTywYsqyVIYQMXz4uB67Nvv8EkHEI/pGYtxvFoVGvEEwkWwoC5yCGMErh4CnERefpMmRcGPjci3BVBbgCnNYfdtgbgyU4zHHG+2PdZS+FDohjgeDihx5gzSj1wWIoMk889j7UBfmMJxzWUraGaGMWPYrg4CnERefq87H2drWzi6FPb8cVULM2VYTGwZB/u6LNI0xH3Jfb1sPXoWq984RVSqSQmCrD1BkePpnn+S6dppL/MojPCkc8cIZZMYIxD0osTd2OETkBkQm2AIiJPH4vlSuO/Ugq/jx14JLchZcZwiW3rs/Vw2yYLELFkHxJpNPqOi5HkVxM59juHn+h9FeIi8pSy3Ax/zGxwldv2Ixq2OsA1DEkzikd8259u4zs2RYRqQt9hBsO4OcgL7gle8k4zYvY9+WdQiIuIbM1s8D3eD/7isd5jpQA3fME9ySuxbzzW+8lwUIiLiGyDO9FNfhD8GeXo3rZf27Zmg3/G+QK/FP/2tl9fhpdCXERkG1lrMWZ7lnazHQu2b9c1ZW/Rim0iIttoq2FrjFme/63glkfRFDMRkV2kXX0rwKUXCnEREZEhpRAXEREZUgpxERGRIaUQFxERGVIKcRERkSGlEBcRERlSCnEREZEhpRAXEREZUgpxERGRIaUQFxERGVIKcRERkSGlEBcRERlSCnEREZEhpRAXEREZUgpxERGRIeX9+h8YXjli+O2z0cAXicVieJ43tPvfhmGI7/tE0eB/ByIiIk+a12gE/Ojj2EAnG2NIJpNDG95truviui5BENBoNHb6cURERHriBFFI3Q8GOjkejw99gHfyPA/XdXf6MURERHrihGGEH4R9n2iM2ZOB53neTj+CiIhITxyDA7b/MN6LAQ579+cSEZG9xzNujOYgddvXiXupGV1ERGQYeZaoFd8KZRERkWHiRBb6rcJFRERk53nJRIowCgDNkRYRERkmTsyLCCN/p59DRERE+uSNj3nEkw6gRU5ERESGiZdMGsY0rUpERGToOJ4DCU8D20RERIaNY4zFHyDDd3qeeGE6TXq6sKPPICIispOcVMoSG6ASd5zBdzEt5rOk0+nVv9cFcpF8dpruMV3gzwuQ/VZ24GcQEREZds74mGH/eH9VteM4g4d4YZpsHnKFEqVS63chR6YwTTqbp7j6YKbXfQbFfJ4CWZThIiLyNDOv/2HDerGQ/D/rbZ74lrcfLRYpZjJk1n6cz5LNF8nOlJhZDuci+WyWfHqG0vKHrc/WJvtamRyFQm7dfXqxtLQ0wFkiIiJPlnOtGPKDH/ce4IlEYmv94V0CHCCTzZIBSsXOdM6Qyzer9HZrezGfI1/MMlPqqORX/S6QywDp7vcRERHZK5y7lYC7lUdPMWtX4FvpC99Uqbiu2RyATI58LkPhzwtAgXy+SCaXo1mXF8ln02Q7y/JigUJR/eUiIrL3eUuRwVIBkpseuOUK/BGaIQ3pzPr6OZMrUAIoTFPI5CjkNq6xC/k8RbLklOEiIrLHeXXrYuw40H3p1S33gfegmM82m8szuc3DNztDadX3JYpFKKZLQIb2qPWVSl1ERGTvcgyGyNm4Tzwejz/eCny63RyeZWajgWiF6dVN5m3FYrNCX26Kb/aVb1api4iI7BWO8VzcTZZd3ey7LSnmyabTyxV4oTSzQfVcJJ8vUCwU1k81KxQoZrJkafaDi4iIPE0c13WJbTJYLQzD7b9rx5zwTK7QnCe+0bHFAoVia5T66i8oFIpkss0m+Hxeq7eJiMjTxfE8i+ttfECj0cDabVxbvZgn2yy/yRUe1fRdJJ/LQy7PusMKefLFLLlcpjk9rZB/9NxxERGRPcSJuWwa4tZaarXatgV5c/Q4ZGcK64N5/cHLQb3mC6anCysD2DI5ctlm4CvHRUTkaeF4niHmbT5wrR3kW1ekWOLRo9Bbx+bzhS4jzVtrqmdnVlXx2ZkZssU8OZXjIiLylPBct7cdyay1VKtVEonEFhZ8aU4JgzzZdH6DY7LMlGZIt1dmK3RW4QWm06254jNr3wKao9uz2dZAN41QFxGRPc6LewC9NZVba6nX61uYN96cAtaL5qC3jiq8MN3c6SzbuY76GpkchQJks1nSxU2OExER2QPMif8YWixc+de9N5c7jkMyufkKb9upuTkK5Ao99KMDyxX7ZoG/CW2AIiIiw8B87fcCa4C/OFfv68THuo76DlOIi4jIMPD2xargJfo+MYqiPRviIiIiw8D7yssJKov9L+iyrXPHRUREpG/e3K2HBEFqp59DRERE+uT98INr4AB8baefRURERPrged4CzgbbkIqIiMju5SUTDWz0+LYaFRERkcfDS8ZjhNHG+4mLiIjI7uRNHBpFA81FRESGjzf+3Chho7+FXkRERGTneWNuiJdy+z5R88RFRER2lvfVg1OP3Iq0mzDsf4GYYbBXfy4REdl7TDUMrIksYaPR98mJRALX7b+K383q9bqCXEREhoIT1eoDBThAY8DzdqswDBXgIiIyNLytnGytpVqt4nkenucNuMf4zgvDkCAIFOAiIjJUthTi0Axy3/fxfa36JiIi8iRpL1EREZEhpRAXEREZUgpxERGRIaUQFxERGVIKcRERkSGlEBcRERlSCnEREZEhpRAXEREZUgpxERGRIaUQFxERGVIKcRERkSGlEBcRERlSCnEREZEhpRAXEREZUgpxERGRIaUQFxERGVIKcRERkSGlEBcRERlSCnEREZEh5f36HxheOWL47bPRwBeJxWJ4nocxZhsfbW8JwxDf94miwf+eRUREOnmNRsCPPo4NdLIxhmQyqfDugeu6uK5LEAQ0Go2dfhwREdkDnCAKqfvBQCfH43EFeJ88z8N13Z1+DBER2QOcMIzwg7DvE40xCqMBeZ63048gIiJ7gGNwwPYfxgrwwenvTkREtoNn3BjNQeq2rxPVjC4iIrKzPEvUim+FsoiIyDBxIgv9VuEiIiKy87xkIkUYBYDmL4uIiAwTJ+ZFhJG/088hIiIiffLGxzziSQfQAiQiIiLDxEsmDWOa8iQiIjJ0HM+BhKeBbSIiIsPGMcbiD5DhW5onXpgmnZ6mMPgVNlTMZ0mn02TzxcdwdRERkd3DS6Us4QAD0x1n8F1Mi8USZLKkOz/LZ3sI3iwzpRmyG3xbmE4zXYDsTImZjQ5afQbTW3iZyOQKFHKZAc8WERHZGm98zPQ9TdxxnC2FeKlYhHSOzvjL5AqUct2PXw747Lc2CPAi+WyW9jtAYTq96gVhtc4XgSwzpVJfz975spHOKMBFRGTneD/9OMSL9b4BijGGRCKx5RtnMhvHbKeVAJ+h1K28LubJZvOQK1AqbBSqKyGfndm4kn/Ek3S8KGzeIiAiIvIkmF/4TtVCxF+/2cPBrQAftAqfTqe7N11nchQKqytzWGke3yjAe2o+b4V8cYN79KR9DTZ+ln4tLS1t+RoiIvJ0c+5WAu5WHj3FzBhDMpncUjP6TKlEqZAjQ4ZcoUSpVNq4T7mYJ79hgBfJZ9NMl3IUSq0AL0yTbgdtxzHpbJ70TPu+/StMp1vXbT3zNgS4iIjIdvCWIoOlAiQ3PTCRSGzPzmWlIsVMlnxnoqYzGwRshlyuW2g2A7WzC72YzjGTzpJN51eO2rSJ/dGK+WyzJWArVbyIiMhj4tWti7HjQPelV9sV+HZtPVosliD9reVALBW3ZypYhgK5Vlv99o4az5DLK8BFRGT38QyGyNl4jlk8Ht/GvcOLFApFMtn08p+LJchmi2TT03SL82I2Tb7zg1VVcecUseZI85W6vf1dhlyhgGaCiYjIXuMZz6XZI959hLq7rUuyligWM2TbbenFAoVihmw+x0xuzfyyYp5stkC2WwAXpkk327nJFUrMbPg9tPvGV70IaHS5iIjsAZ7rujh244niYRhuX5AXgUyRfC5PtpCDQmF9/3gvsjN0n97dmgaWnqFUmln/dSvcM7mcAlxERIae53kWs8liL41GY/v6xDNZZgql5tzv1gC0TC6/Lf3NzfnkNEeQd7vgcoBrlTUREdkbnJgLrrfxAdZaarUadpNqvV+ZXGF5XvdWVz1rr5WeI0+pVCBbWL98azGfVYCLiMie43ieIeZtXmW3g3zbFKabi7Rks8152NMDrF5ezJNNp8kWc6vnm2fS0J4a1uoPb1foCnAREdlLPNftbUcyay3VanVLK7Y1FZhuVcUzuQztUeTThV43LWnJ5Ch0WWw9k50hn8uSba+fnp2hVBikB7w5kh6yaIl0ERHZjby4B73ugGKtpV6vb6GPvDXtKztDabkq7n8Tkk3v0F6qte8FWlZvotI2+FrrIiIij5eXSti+djHrDPJ+FaYtoigAAAF/SURBVKanKeUKHQG+2trtSDO53uZ3Lwd365zSujlnvVi/CpyIiMhuZr72e4E1wF+cq/d14lbXUd+a1VVz7/uH7x7aAEVERLbK2xergtf/1qJRFO1giKtqFhER8b7ycoLKYu/7ibdt55QzERER6Z83d+shQZDa6ecQERGRPnk//OAaOABf2+lnERERkT54nreAs8E2pCIiIrJ7eclEAxtt11ajIiIi8qR4yXiMMNp4P3ERERHZnbyJQ6NooLmIiMjw8cafGyVs9LfQi4iIiOw8b8wN8VJu3ydqnriIiMjO8r56cOqRW5F2E4b9LxAjTfq7ExGR7WCqYWBNZAkbjb5PTiQSuG7/VfzTrl6vK8hFRGTLnKhWHyjAARoDnvc0C8NQAS4iItvC28rJ1lqq1Sqe5+F53oB7jD8dwjAkCAIFuIiIbJsthTg0g9z3fXxfq76JiIg8STu1l6iIiIhskUJcRERkSCnERUREhpRCXEREZEgpxEVERIaUQlxERGRI/X+SMV53X4GCCgAAAABJRU5ErkJggg==
后面第三天于学校见到患者,除偶有咳嗽外,已无其他不适,嘱其服用小柴胡颗粒自行调养。
按语:患者当时已为少阳阳明之证,故用小柴胡加石膏,因其痰脓,故加排脓散,眉棱骨痛,加白芷。 应该是三阳合病更合适 柴葛解肌汤证,口干可以加生石膏。 老师言之有理,受教了 就是这个方,我加减后用来治疗新冠,甲流引起的发热效果很好
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