清肺平喘现良方

文/庞素银

“冬不藏精，春必温病”。春季多风，人体一旦精气亏虚，就容易因风邪侵袭而出现以咳喘为显著特征的肺病。

As a saying goes, "If you don't store essence in winter, you'll get sick in spring."Spring is windy. Once there is deficient in vital energy, the human body is vulnerable to lung disease characterized by cough and asthma because of the invasion of wind pathogen.

良方现世 Prescription for therapy

东汉末年，一场持续近十年的特大瘟疫致人死伤无数，“家家有位尸之痛，室室有号泣之哀”。这场瘟疫传染性强，发病急骤，死亡率高。因患者多见怕冷、寒战等症状，而得名“伤寒”。

At the end of the Eastern Han Dynasty, a plague that lasted nearly ten years caused countless deaths and injuries. "Every family suffered from the death, and there were mourning in every room". The plague features highly infectious, sudden onset and high mortality. There were cold-feeling; chills and other symptoms so the disease was named "typhoid".

据医圣张仲景的《伤寒杂病论》记载，伤寒病发后，病患一旦出现发热、汗出、咳喘等症状，说明风寒邪气已经化热伤肺，宜以麻黄、石膏为主要成分的麻杏石甘汤对症施治。

According to the "Treatise on Febrile and Miscellaneous Disease", works of medical sage in Eastern Han DynastyZhang Zhongjing, when outbreak of typhoid, once there is fever, sweating, cough and asthma symptoms, it indicated that wind cold pathogen has changed into heat and hurt the lung. Prescription for therapy is Maxing Shigan soup with the main components of ephedra and gypsum.

君臣佐使 Monarch, Minister, Assistant and Guide

麻杏石甘汤只有四味药，却充分体现了“君臣佐使”的方剂配伍原则。其中，麻黄辛温，宜宣肺平喘，为君药；石膏辛凉，可清肺热，为臣药；杏仁苦平，辅佐麻黄宣降肺气，有止咳之效；甘草甘温，和中益气，调和诸药，与杏仁共为佐使药。

Maxing Shigan soup consists of only four herbs, but it fully embodies the TCM compatibility principle of "Monarch, Minister, Assistant and Guide". Among them, ephedra is regarded as "Monarch" because it tastes pungent-warm with the effect of lung-ventilating and asthmarelieving. Gypsum is regarded as "Minister" because it tastes pungent-cool with effect of clearing heat in the lung. Apricot tastes bitterpeace and assists ephedra in facilitating and relieving Lung-Qi. Licorice tastes sweet-warm with effect ofQi-replenishing and harmony. The compound of apricot and licorice are regarded as "Assistant".

煎药时，取君药麻黄9 g左右，加水煎煮20 min～30 min，去除沫状物后，按1∶1∶1∶4的标准，加入杏仁、炙甘草、石膏，再煎煮20 min即可。服用后可有效清热宣肺、平喘止咳，在抗击疫情中发挥出重要作用。

When decoct the soup, take about 9 grams of Ephedra, decoct from 20 minutes to 30 minutes, remove the foam, mix apricot; licorice and gypsum according to the standard of 1:1:1:4 and then decoct for 20 minutes. Taking the soup has the effect of heat-clearing; lung-ventilating; asthma-relieving and cough-relieving. As a result, the soup is playing an important role in fighting against the plague.

传承改良 Inheritance and improvement

古代中医认为，杏仁有微毒，宜去皮尖后入药。可现代医学试验发现，杏仁的毒性源自皮尖中的苦杏仁甙。苦杏仁甙可分解出氢氰酸，如果剂量轻微，非但不会对人体构成直接危害，而且有助于止喘宣肺。

Ancient TCM believed that apricot was slightly toxic, and should be used after skin tip.On the other hand, modern medical test found that the toxicity of apricot originates from hydrocyanic acid. The hydrocyanic acid comes from the extract of amygdaline in the skin tip. If the dose is slight, it will not only be harmless to the human body directly but also help lung-ventilating and cough- relieving.

此后，麻杏石甘汤取消了杏仁去皮尖的工艺要求，只要求杏仁剂量控制在15 g以内。2020年，国家中医药管理局推荐使用治疗新型冠状病毒肺炎的“清肺排毒汤”，也是在麻杏石甘汤的基础上改良而成。

Since then, specification of Maxing Shigan soup has deleted the process of peeling tip, and only required the dosage of almond to be controlled within 15 grams. In 2020, the National Administration of Traditional Chinese Medicine recommended the use of modified Qing Fei Pai Du Tang（mQFPD）for COVID-19 treatment, which is also based on Maxing Shigan soup.

结 语 Conclusion

张仲景的《伤寒杂病论》确立了对伤寒病“六经分类”的施治原则，根据病因、症状和发展阶段的不同，辨证下药，麻杏石甘汤的标准密码就在于“清热平喘”，辛凉疏泄能清肺，定喘除烦效力张 。

Zhang Zhongjing's"Treatise on Febrile and Miscellaneous Diseases" established the principle of "six classics classification" for the treatment of typhoid diseases, dialectically applying drugs according to the different etiology, symptoms and stages. The standard password of Maxing Shigan soup is "Heatclearing and asthma-relieving ". With pungent in flavor and cool in property, the soup has the effect of lung-clearing and asthma-relieving and removes the suffering.