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药师释药——著名中成药六味地黄丸及其家族介绍

by Cindy Wu 26 Dec 2022 0 Comments

六味地黄丸

六味地黄丸,是著名中成药,也是非常常用的一类中成药。这一称谓来自钱乙(字仲阳,宋代东平人)所著的《小儿药证直诀》,六味地黄丸由熟地黄、山茱萸、山药、泽泻、丹皮、茯苓这六味中药组成。具有滋阴补肾之功效。用于肾阴亏损,头晕耳鸣,腰膝酸软,骨蒸潮热,盗汗遗精,消渴。

 

六味地黄丸的来源

 

药师释药——著名中成药六味地黄丸及其家族介绍

 

张仲景的《金匮要略》中有“肾气丸”(干地黄、薯蓣(山药)、山茱萸、茯苓、泽泻、丹皮、桂枝、附子(炮))。后来,宋代名医、儿科专家钱乙把肾气丸里面的附子和桂枝这种温补的药物去掉了,变成了现在的六味地黄丸,并用它来治疗小儿先天不足,发育迟缓等病症。

 

地黄丸的其他家族成员

六味地黄丸是千古名方,所谓地黄丸的其他家族成员,就是以六味地黄丸(地黄、山茱萸、山药、泽泻、丹皮、茯苓)的组成为基础,进行加减,而形成的系列“XX地黄丸”。

 

加两味药

1. 杞菊地黄丸

在六味地黄丸基础上加枸杞、菊花,主要是滋补肝肾、清肝明目、养阴,治疗肝肾阴虚导致的两目昏花、视物模糊或眼睛干涩,迎风流泪等。

2. 知柏地黄丸

本方为六味地黄丸加知母、黄柏而成。功效:滋阴降火。主治阴虚内热,适用于腰膝酸软,手足心热,盗汗,早泄,遗精,舌红少苔,脉细数人群。

 

药师释药——著名中成药六味地黄丸及其家族介绍

 

3. 麦味地黄丸(又名八仙长寿丸)

在六味地黄丸基础上加麦冬、五味子而成。功效:滋肾养肺。主治肺肾阴虚,适用于腰膝酸软,咳嗽气喘,乏力气短,口干,舌质淡红,苔白,脉沉人群。

 

加四味药

金匮肾气丸:市场上售卖的金匮肾气丸实际并非医圣张仲景肾气丸,而是宋代严用和《济生方》济生肾气丸,为六味地黄丸加桂枝、附子、牛膝、车前子而成。功效:温补肾阳,化气行水。适用于肾阳亏虚所致下肢水肿,腰膝酸软,小便不利,畏寒肢冷,舌质淡,苔白,脉沉人群。

 

加六味药

明目地黄丸:由“六味地黄丸”加“枸杞子、菊花、当归、白芍、蒺藜,煆石决明”组成。用于治疗老年视物昏花,早期白内障等病。

 

加减药味

左归丸:在六味地黄丸基础上减茯苓、泽泻、牡丹皮,加枸杞子、川牛膝、菟丝子、龟甲胶、鹿角胶,具有滋阴补肾,填精益髓之功,用于头目眩晕、腰酸腿软、遗精滑泄、自汗盗汗。

右归丸:在六味地黄丸基础上减茯苓、泽泻、牡丹皮,加枸杞子、杜仲、菟丝子、当归、鹿角胶组成,是补阳剂,具有温补肾阳,填精益髓之功,适用于肾阳不足、年老久病而出现的气衰神疲、畏寒肢冷、阳痿滑精、腰膝酸软,或饮食减少、大便不实,或小便自遗等。

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