第四六八章 宁院长，我们爱你
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“准确的说是两个半方剂。龙腾小说ltxsba.com”宁远点头道：“在说方剂之前，我们先说说急性胰腺炎，中医认为，胰腺炎是胸结之证，所以用陷胸可以治疗，这可时候我们就要忽略病症在西医中的称谓和病因，排除干扰。”
“既然是陷胸之证，只要我们认准病因，就胆大的去用药，因此我的第一个方剂就是柴胡陷胸汤。柴胡陷胸汤是医圣张仲景的经典古方，由大柴胡汤和大陷胸汤组合而成。”
说到这里，宁远转身在身后的大黑板上写了三个中草药的名字：大黄、芒硝和甘遂。
写过之后，宁远转过身继续道：“大陷胸汤方子里的要只有三味，就是大黄，芒硝和甘遂，这三味药都是功能很强的谢老，之所以用这三味药，用的就是中医通里攻下的方法，胰腺炎胰腺坏死，淀粉酶进入肠道，而肠道在五脏六腑里就属于‘腑’，而‘腑’以通为用，以降为顺。”
“不少学中医的同学应该都知道，大黄在中药里面被称之为将军药，意思就是说大黄泄的作用就向战场上的将军一样，一往无前，《本草正义》里对大黄的解释是‘大黄迅速善走，无坚不破，荡涤积垢，有犁庭扫穴之功’，由此可见大奖药性的骏猛，一般用药，大黄都是慎之又慎，大多都只用到15克左右，然而医者用药，要随机应变，因时制宜，在患者病情的基础上，我把大黄用到了30克。”
“再一个，甘遂。学医的都知道。甘遂是有毒的。然而因为患者腹腔内有大量积液，甘遂有攻水逐饮之效，非用不可，不过药量上却要适当控制，一剂柴胡陷胸汤，外加针灸治疗，一夜，患者体内的淀粉酶就降了下来。”
“下面我们说说这次用到的第二个方剂。清胰承气汤。”说着话，宁远在黑板上写下清胰承气汤的名字继续道：“因为患者胰脏持续坏死，倒是肠胃毒素持续增加，第一个方剂虽然暂时缓解了病情，然而却并没有太大的效果，因此我又根据患者病情，用到了第二个方剂。”
“清胰承气汤是根据张仲景明芳大柴胡汤改动而来的，之所以用大柴胡汤，是因为大柴胡汤有着他的特性。”
“患者当时持续发热，胰腺发烟。腹部坚硬，因此我把之前的通里攻下。改成通里攻下，活血化瘀，再加上清热解毒。”
“众所周知，大柴胡汤分大小，大小柴胡汤的主要组成都有黄芩、半仙、生姜和大枣，唯一不同的是，小柴胡汤中有人参和甘草，而大柴胡汤中是大黄和枳实。大小柴胡汤的区别是，一个治疗表里之证，一个可以突破表里，进入表里和半表里之内甚至更深。”
“由于热寒往来，出现胸肋苦满，食欲不振，呕吐，头晕目需爱，这样的一些病症，西医中的称呼是常见的感冒之症，然而中医则认为是病邪入侵到了人体的半表半里只见，这个时候小柴胡汤就可以扶助正气，将病邪从半表半里只见祛除。”
“事实上小柴胡汤还有一个名字，叫太平方，和事佬，为什么叫太平方，和事佬，原因是因为小柴胡汤主要的功效就是‘和’，通俗的说就是调和，就好比劝架的，人体病症的一切不和，小柴胡汤几乎都可以治疗，什么阴阳不和，表里不和，情绪不和等等。”
“人常说十人九病，大病相应的来说还是比较少的，最常见的病症其实就是感冒发烧，若是能掌握小柴胡汤，在场的任何一位，都可以开个小诊所当医生，用得好，甚至还能称为名气不小的名医。”
“宁院长，您没开玩笑吧，就一个小柴胡汤，就能开诊所当医生？”台下有学生不信，高声问道。
“怎么，不信？”宁远笑呵呵的道：“既然不信，那么我慢慢说：“方歌有云：‘小柴胡汤和解功，半夏人参甘草从，少阳为病此方宗，那么小柴胡汤究竟能治疗多少病症呢？”
“首先阴阳不调，午热晚冷，一切阴阳不和的病症，都可以用小柴胡汤，同时小柴胡加减也有着很多变化，呕逆加生姜、陈皮；烦而不呕，去半夏、人参，加栝蒌；咳嗽去参、枣、生姜，加五味子、干姜；痰多加栝蒌、贝母；腹痛去黄芩，加芍药；心下悸，小便不利，去黄芩，加茯苓等等，单单这些变化，就能治疗数十种病症。”
“同时，小柴胡汤加陈皮、芍药，名柴胡双解散；加芒硝，名柴胡加芒硝汤；除黄芩、甘草，加桂枝、茯苓、龙骨、牡蛎、铅丹、大黄，名柴胡加龙骨牡蛎汤，治伤寒八、九日下之，胸满烦惊，小便不利，谵语，身重不可转侧；去半夏、人参、姜、枣，加桂枝、干姜，花粉、牡蛎，名柴胡桂枝干姜汤，治伤寒汗下后，胸满，微结，小便不利，渴而不呕，但头汗出，往来寒热，心烦者，也可以治疟发寒多热少，或但寒不热”
听着宁远说出关于小柴胡汤的变化，台下的学生一个个是嘴巴大张，有吃惊，有钦佩，有难以置信，很多人都无法理解，一个小小的小柴胡汤竟然可以有这么多变化，可以治疗这么多病症，要真是如此，单单学会一个小柴胡汤，别说开诊所了，绝对可以成为名气不小的名医。
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