世針針灸交流中心

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1.從零基礎參加系統學習中醫針灸

線上線下學習，系統，全面，實用

中藥不傳(chuan)之秘在(zai)劑量(liang)——干貨(huo)多宜收藏（2）

一、方劑中主(zhu)藥劑量改變(bian)致(zhi)使(shi)功用改變(bian)

《傷(shang)寒論(lun)》中(zhong)(zhong)(zhong)(zhong)小(xiao)(xiao)承(cheng)氣(qi)湯(tang)(tang)(tang)、厚(hou)樸(pu)三(san)物(wu)湯(tang)(tang)(tang)、厚(hou)樸(pu)大(da)(da)(da)黃(huang)(huang)湯(tang)(tang)(tang)都由(you)大(da)(da)(da)黃(huang)(huang)、厚(hou)樸(pu)、枳(zhi)(zhi)(zhi)實三(san)味藥(yao)(yao)(yao)(yao)組(zu)(zu)成。小(xiao)(xiao)承(cheng)氣(qi)湯(tang)(tang)(tang)中(zhong)(zhong)(zhong)(zhong)大(da)(da)(da)黃(huang)(huang)用(yong)量倍于厚(hou)樸(pu)，其(qi)功能(neng)瀉熱通便(bian)、消痞除滿；厚(hou)樸(pu)三(san)物(wu)湯(tang)(tang)(tang)中(zhong)(zhong)(zhong)(zhong)厚(hou)樸(pu)倍于大(da)(da)(da)黃(huang)(huang)，治(zhi)(zhi)(zhi)腹(fu)滿痛而大(da)(da)(da)便(bian)秘結。厚(hou)樸(pu)大(da)(da)(da)黃(huang)(huang)湯(tang)(tang)(tang),則(ze)治(zhi)(zhi)(zhi)支飲胸(xiong)滿，兼有腑實便(bian)秘者(zhe)。其(qi)藥(yao)(yao)(yao)(yao)量在三(san)方中(zhong)(zhong)(zhong)(zhong)各不(bu)相同(tong)(tong)(tong)，功效(xiao)側重點亦不(bu)同(tong)(tong)(tong)。《金匱要略》枳(zhi)(zhi)(zhi)術(shu)(shu)湯(tang)(tang)(tang)方、《內(nei)外(wai)傷(shang)辨(bian)》枳(zhi)(zhi)(zhi)術(shu)(shu)丸,兩方同(tong)(tong)(tong)為(wei)(wei)枳(zhi)(zhi)(zhi)實、白術(shu)(shu)二(er)藥(yao)(yao)(yao)(yao)組(zu)(zu)成，但枳(zhi)(zhi)(zhi)實湯(tang)(tang)(tang)中(zhong)(zhong)(zhong)(zhong)的枳(zhi)(zhi)(zhi)實用(yong)量（70克），倍于白術(shu)(shu)(30g)，故(gu)以(yi)(yi)消積導滯為(wei)(wei)主(zhu)；枳(zhi)(zhi)(zhi)實丸中(zhong)(zhong)(zhong)(zhong)的白術(shu)(shu)用(yong)量(60g)倍于枳(zhi)(zhi)(zhi)實(30g)，故(gu)以(yi)(yi)健脾和中(zhong)(zhong)(zhong)(zhong)為(wei)(wei)主(zhu)。補陽還五湯(tang)(tang)(tang)中(zhong)(zhong)(zhong)(zhong)用(yong)不(bu)同(tong)(tong)(tong)劑量的黃(huang)(huang)芪(qi)治(zhi)(zhi)(zhi)療(liao)腦梗塞恢復期對比(bi)觀察，黃(huang)(huang)芪(qi)劑量為(wei)(wei)其(qi)余各藥(yao)(yao)(yao)(yao)量總(zong)和的5倍以(yi)(yi)上，用(yong)黃(huang)(huang)芪(qi)每劑為(wei)(wei)120g者(zhe)治(zhi)(zhi)(zhi)療(liao)后的血小(xiao)(xiao)板聚(ju)集率(lv)改(gai)善最(zui)明顯，而60g者(zhe)次之(zhi)，30g者(zhe)最(zui)不(bu)明顯。藥(yao)(yao)(yao)(yao)理研(yan)究(jiu)證實，甘(gan)草(cao)(cao)與(yu)甘(gan)遂(sui)配伍應(ying)用(yong)，用(yong)量相等(deng)時無相反(fan)作(zuo)用(yong)，且能(neng)解(jie)除甘(gan)遂(sui)的毒(du)(du)性，若甘(gan)草(cao)(cao)用(yong)量大(da)(da)(da)于甘(gan)遂(sui)時，則(ze)有明顯的毒(du)(du)性反(fan)應(ying)，甘(gan)草(cao)(cao)用(yong)量越(yue)大(da)(da)(da)毒(du)(du)性也越(yue)大(da)(da)(da)。按中(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)理論(lun)，甘(gan)草(cao)(cao)反(fan)甘(gan)遂(sui)，藥(yao)(yao)(yao)(yao)理研(yan)究(jiu)又證實其(qi)解(jie)毒(du)(du)作(zuo)用(yong)，這進一(yi)步又說明藥(yao)(yao)(yao)(yao)物(wu)在配伍時，劑量的大(da)(da)(da)小(xiao)(xiao)、藥(yao)(yao)(yao)(yao)物(wu)之(zhi)間的比(bi)例(li)關系對療(liao)效(xiao)的影響(xiang)很大(da)(da)(da)，一(yi)旦比(bi)例(li)發生(sheng)改(gai)變，則(ze)導致藥(yao)(yao)(yao)(yao)理作(zuo)用(yong)改(gai)變。以(yi)(yi)上說明,臨證抓(zhua)住疾病的主(zhu)要矛盾，辨(bian)證正確、針對主(zhu)癥重用(yong)主(zhu)藥(yao)(yao)(yao)(yao)，組(zu)(zu)方合理，配伍嚴謹，藥(yao)(yao)(yao)(yao)量比(bi)例(li)合適(shi)，中(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)質量貨真(zhen)道(dao)地(di)，調劑和煎(jian)制認真(zhen)，療(liao)效(xiao)方可突出。

中藥不傳(chuan)之(zhi)秘在劑量(liang)——干貨多宜(yi)收(shou)藏（2）

二、方(fang)劑中(zhong)主藥(yao)劑量變化(hua)導致療效下降

徐靈胎曰(yue)：“一(yi)(yi)病(bing)必有主方(fang)，一(yi)(yi)方(fang)必有主藥”。在(zai)一(yi)(yi)些方(fang)劑(ji)中，方(fang)中主藥劑(ji)量(liang)(liang)變化(hua)會導致全方(fang)療(liao)效(xiao)(xiao)的(de)降(jiang)低。如四君子湯(tang)能增強巨噬(shi)細(xi)胞吞噬(shi)功(gong)能，如加大方(fang)中炙(zhi)甘草(cao)比例，這種作(zuo)用(yong)(yong)(yong)反見(jian)削弱,達到(dao)或超(chao)過全方(fang)總量(liang)(liang)的(de)1／3時(shi)，吞噬(shi)作(zuo)用(yong)(yong)(yong)明顯降(jiang)低。《攝生眾妙方(fang)》中主治痰熱(re)咳喘的(de)定喘湯(tang)用(yong)(yong)(yong)白(bai)果21枚,如將(jiang)白(bai)果減(jian)量(liang)(liang)到(dao)1／3或去(qu)掉白(bai)果,觀察對豚鼠組胺噴霧吸入致痙(jing)攣的(de)抑(yi)制效(xiao)(xiao)果,以(yi)用(yong)(yong)(yong)原(yuan)方(fang)白(bai)果劑(ji)量(liang)(liang)的(de)作(zuo)用(yong)(yong)(yong)最(zui)強,減(jian)量(liang)(liang)后其(qi)作(zuo)用(yong)(yong)(yong)降(jiang)低30％左右(you),不用(yong)(yong)(yong)白(bai)果者作(zuo)用(yong)(yong)(yong)消(xiao)失。六神丸(wan)的(de)抗炎作(zuo)用(yong)(yong)(yong)以(yi)原(yuan)方(fang)效(xiao)(xiao)果最(zui)好，如有一(yi)(yi)味藥量(liang)(liang)改變，可使作(zuo)用(yong)(yong)(yong)明顯減(jian)弱。人參白(bai)虎(hu)湯(tang)的(de)降(jiang)血糖(tang)作(zuo)用(yong)(yong)(yong)，知母與人參為(wei)(wei)1∶5時(shi)降(jiang)血糖(tang)作(zuo)用(yong)(yong)(yong)尚強，如二者比例為(wei)(wei)5∶9時(shi)，降(jiang)血糖(tang)作(zuo)用(yong)(yong)(yong)幾乎消(xiao)失。從上述復方(fang)配(pei)伍看，其(qi)機理是復雜的(de)，各成分之間配(pei)伍產生協同作(zuo)用(yong)(yong)(yong)，直接影響(xiang)臨床(chuang)療(liao)效(xiao)(xiao)。全方(fang)藥量(liang)(liang)巧妙的(de)結(jie)合產生獨特的(de)療(liao)效(xiao)(xiao)，恰到(dao)好處，缺一(yi)(yi)不可。

中(zhong)藥不傳之秘在劑量(liang)——干(gan)貨(huo)多宜收藏（2）

三(san)、劑量(liang)大小不同(tong)直(zhi)接影響療效(xiao)

中藥(yao)(yao)分(fen)量(liang)(liang)(liang)問題為(wei)(wei)(wei)歷(li)代醫家所重(zhong)視。對于一(yi)些(xie)急(ji)癥(zheng)、重(zhong)證(zheng)(zheng)、疑難(nan)證(zheng)(zheng)，在(zai)(zai)辨(bian)(bian)證(zheng)(zheng)正確(que)的(de)(de)(de)(de)情況下投以重(zhong)劑(ji)(ji)(ji)，往(wang)(wang)往(wang)(wang)能(neng)收到事(shi)半功倍的(de)(de)(de)(de)效(xiao)(xiao)果(guo)。如(ru)一(yi)男(nan)性患(huan)(huan)者，闌尾術后(hou)(hou)(hou)半年(nian)，覺腹部(bu)脹痛(tong)，變換(huan)體位(wei)或可緩解，得矢氣(qi)(qi)而(er)(er)后(hou)(hou)(hou)快。曾服(fu)(fu)用(yong)(yong)(yong)(yong)(yong)多種(zhong)理氣(qi)(qi)活血(xue)通便(bian)藥(yao)(yao)物(wu)(wu)(wu)。五(wu)靈脂(zhi)亦(yi)用(yong)(yong)(yong)(yong)(yong)過，但(dan)(dan)其(qi)量(liang)(liang)(liang)最(zui)多不過9g，效(xiao)(xiao)果(guo)不佳，病情逐漸加(jia)(jia)(jia)重(zhong)。經X線透視診為(wei)(wei)(wei)腸粘連、不全(quan)梗阻。據其(qi)有(you)(you)(you)(you)手(shou)(shou)術史、痛(tong)有(you)(you)(you)(you)定處、舌質紫(zi)暗(an)、脈弦緊(jin)有(you)(you)(you)(you)力，辨(bian)(bian)證(zheng)(zheng)為(wei)(wei)(wei)氣(qi)(qi)滯血(xue)瘀，腑氣(qi)(qi)不通。施方重(zhong)用(yong)(yong)(yong)(yong)(yong)五(wu)靈脂(zhi)60g，白芍30g，黃芩10g，甘(gan)草(cao)10g，水煎(jian)服(fu)(fu)。1劑(ji)(ji)(ji)痛(tong)減輕，3劑(ji)(ji)(ji)后(hou)(hou)(hou)癥(zheng)狀基(ji)本消(xiao)(xiao)失，時或隱隱作(zuo)(zuo)痛(tong)。遂連服(fu)(fu)上方15劑(ji)(ji)(ji)后(hou)(hou)(hou)用(yong)(yong)(yong)(yong)(yong)原方改(gai)為(wei)(wei)(wei)散劑(ji)(ji)(ji)，每(mei)(mei)服(fu)(fu)10g，每(mei)(mei)日(ri)3次(ci)，連用(yong)(yong)(yong)(yong)(yong)半年(nian)，未(wei)見(jian)復(fu)(fu)發(fa)(fa)。另一(yi)女患(huan)(huan)者，患(huan)(huan)痙攣性斜頸3年(nian)，曾在(zai)(zai)某醫院2次(ci)手(shou)(shou)術，術后(hou)(hou)(hou)半年(nian)，癥(zheng)狀復(fu)(fu)發(fa)(fa)加(jia)(jia)(jia)重(zhong)，服(fu)(fu)用(yong)(yong)(yong)(yong)(yong)歸(gui)芍六君子湯(tang)每(mei)(mei)劑(ji)(ji)(ji)加(jia)(jia)(jia)蟬蛻30g，1月后(hou)(hou)(hou)癥(zheng)狀消(xiao)(xiao)失，隨(sui)訪1年(nian)終(zhong)止發(fa)(fa)作(zuo)(zuo)。又一(yi)13歲男(nan)患(huan)(huan)者，患(huan)(huan)風濕性舞蹈病半年(nian)，在(zai)(zai)黃芪桂枝(zhi)五(wu)物(wu)(wu)(wu)湯(tang)中加(jia)(jia)(jia)蟬蛻20g，治(zhi)(zhi)(zhi)療(liao)2月后(hou)(hou)(hou)，癥(zheng)狀控(kong)制(zhi)。近年(nian)來(lai)，在(zai)(zai)治(zhi)(zhi)(zhi)療(liao)血(xue)管(guan)神經性頭痛(tong)時,在(zai)(zai)辨(bian)(bian)證(zheng)(zheng)用(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)的(de)(de)(de)(de)基(ji)礎上，又加(jia)(jia)(jia)用(yong)(yong)(yong)(yong)(yong)川芎50～70g，不但(dan)(dan)效(xiao)(xiao)果(guo)很好，且未(wei)出現不良(liang)反(fan)(fan)應(ying)。據藥(yao)(yao)理研究,川芎不但(dan)(dan)有(you)(you)(you)(you)中樞鎮靜作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)，而(er)(er)且能(neng)擴張血(xue)管(guan)，降低血(xue)壓，小(xiao)量(liang)(liang)(liang)能(neng)興(xing)奮心臟(zang)，大(da)量(liang)(liang)(liang)則使心臟(zang)抑制(zhi)。劉(liu)(liu)日(ri)才(cai)用(yong)(yong)(yong)(yong)(yong)大(da)劑(ji)(ji)(ji)量(liang)(liang)(liang)紅孩(hai)兒(200～500g)治(zhi)(zhi)(zhi)療(liao)出血(xue)證(zheng)(zheng)，每(mei)(mei)日(ri)1劑(ji)(ji)(ji)，分(fen)4次(ci)服(fu)(fu)用(yong)(yong)(yong)(yong)(yong)，經治(zhi)(zhi)(zhi)65例(li)全(quan)部(bu)有(you)(you)(you)(you)效(xiao)(xiao)。據藥(yao)(yao)理研究，紅孩(hai)兒具有(you)(you)(you)(you)止血(xue)、抗菌(jun)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)，能(neng)提高纖維蛋白原含(han)量(liang)(liang)(liang)，修復(fu)(fu)傷口(kou)。濃(nong)煎(jian)至(zhi)(zhi)膏(gao)狀，止血(xue)效(xiao)(xiao)果(guo)最(zui)佳。傅文錄(lu)用(yong)(yong)(yong)(yong)(yong)川芎嗪針治(zhi)(zhi)(zhi)療(liao)腦血(xue)栓病人，開始用(yong)(yong)(yong)(yong)(yong)常(chang)規靜脈滴注每(mei)(mei)次(ci)4～5支(zhi)(zhi)(80～100mg)效(xiao)(xiao)果(guo)不好，后(hou)(hou)(hou)來(lai)又增加(jia)(jia)(jia)至(zhi)(zhi)20支(zhi)(zhi)(200～400mg)，病人肢(zhi)體功能(neng)恢復(fu)(fu)正常(chang)。又治(zhi)(zhi)(zhi)療(liao)10余例(li)，也多有(you)(you)(you)(you)良(liang)效(xiao)(xiao)。周虎臨(lin)床應(ying)用(yong)(yong)(yong)(yong)(yong)川烏30～60g治(zhi)(zhi)(zhi)療(liao)陰寒(han)(han)內盛的(de)(de)(de)(de)胃脘痛(tong)，寒(han)(han)邪(xie)偏盛的(de)(de)(de)(de)痹(bi)證(zheng)(zheng)(坐骨神經痛(tong))觀(guan)(guan)察320例(li)效(xiao)(xiao)果(guo)較好，連續大(da)劑(ji)(ji)(ji)量(liang)(liang)(liang)應(ying)用(yong)(yong)(yong)(yong)(yong)60天，未(wei)發(fa)(fa)生一(yi)例(li)中毒。說明(ming)川烏劑(ji)(ji)(ji)量(liang)(liang)(liang)在(zai)(zai)30～60g之(zhi)間(jian)是(shi)安全(quan)的(de)(de)(de)(de)。劉(liu)(liu)尚(shang)延常(chang)用(yong)(yong)(yong)(yong)(yong)細(xi)辛5～15g配入復(fu)(fu)方中對許多牙痛(tong)患(huan)(huan)者應(ying)用(yong)(yong)(yong)(yong)(yong)觀(guan)(guan)察，均無不良(liang)反(fan)(fan)應(ying)而(er)(er)療(liao)效(xiao)(xiao)更佳。劉(liu)(liu)逢(feng)臣(chen)對多種(zhong)疼痛(tong)、咳逆上氣(qi)(qi)之(zhi)證(zheng)(zheng)在(zai)(zai)相(xiang)應(ying)的(de)(de)(de)(de)配伍中大(da)劑(ji)(ji)(ji)量(liang)(liang)(liang)應(ying)用(yong)(yong)(yong)(yong)(yong)細(xi)辛(10～15g)收到滿意效(xiao)(xiao)果(guo)。細(xi)辛的(de)(de)(de)(de)用(yong)(yong)(yong)(yong)(yong)量(liang)(liang)(liang)與劑(ji)(ji)(ji)型、用(yong)(yong)(yong)(yong)(yong)法有(you)(you)(you)(you)密(mi)切關系。據文獻介(jie)紹,細(xi)辛入湯(tang)劑(ji)(ji)(ji)的(de)(de)(de)(de)用(yong)(yong)(yong)(yong)(yong)量(liang)(liang)(liang)即(ji)使是(shi)散劑(ji)(ji)(ji)的(de)(de)(de)(de)4倍、12倍，也不致引起不良(liang)反(fan)(fan)應(ying)。湯(tang)劑(ji)(ji)(ji)中細(xi)辛用(yong)(yong)(yong)(yong)(yong)至(zhi)(zhi)15g，只要煎(jian)煮20分(fen)鐘，其(qi)毒性也不會超過散劑(ji)(ji)(ji)的(de)(de)(de)(de)3g。大(da)量(liang)(liang)(liang)的(de)(de)(de)(de)臨(lin)床和實(shi)驗(yan)資料(liao)證(zheng)(zheng)明(ming)，大(da)劑(ji)(ji)(ji)量(liang)(liang)(liang)用(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)能(neng)明(ming)顯(xian)提高療(liao)效(xiao)(xiao)，這與大(da)劑(ji)(ji)(ji)量(liang)(liang)(liang)用(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)能(neng)增加(jia)(jia)(jia)藥(yao)(yao)物(wu)(wu)(wu)的(de)(de)(de)(de)有(you)(you)(you)(you)效(xiao)(xiao)濃(nong)度(du)和作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)強度(du)、改(gai)變藥(yao)(yao)物(wu)(wu)(wu)的(de)(de)(de)(de)補瀉功能(neng)和影響作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)方向有(you)(you)(you)(you)關。

四(si)、季節不(bu)(bu)同方中劑量不(bu)(bu)變會影響療(liao)效

《內經》曰：“人以天地(di)之氣(qi)生(sheng)，四(si)時(shi)(shi)之法成”。春(chun)溫夏熱(re)、秋涼冬寒是四(si)時(shi)(shi)正常氣(qi)候(hou)變(bian)化的(de)規(gui)律，人體的(de)生(sheng)理病理亦在(zai)隨(sui)四(si)時(shi)(shi)的(de)氣(qi)候(hou)交替而(er)變(bian)化。中(zhong)(zhong)醫(yi)(yi)把人體的(de)生(sheng)理、病理與自然氣(qi)候(hou)結合起(qi)來研究疾病的(de)轉歸及預(yu)后，又(you)作為臨(lin)床藥(yao)物(wu)處方的(de)依據(ju)。中(zhong)(zhong)醫(yi)(yi)對同(tong)(tong)(tong)一陽證或陰證，在(zai)不(bu)同(tong)(tong)(tong)季節適(shi)當地(di)應(ying)(ying)用(yong)不(bu)同(tong)(tong)(tong)性能、分量的(de)藥(yao)物(wu),尤其(qi)是復方中(zhong)(zhong)藥(yao)物(wu)劑量也應(ying)(ying)隨(sui)季節不(bu)同(tong)(tong)(tong)而(er)增減。如《千金(jin)翼方》中(zhong)(zhong)的(de)三(san)(san)黃(huang)(huang)(huang)(huang)丸，主治男(nan)子五勞七傷、消渴、不(bu)生(sheng)肌(ji)肉、婦(fu)人帶下、手足寒熱(re)。此(ci)方應(ying)(ying)四(si)季氣(qi)候(hou)不(bu)同(tong)(tong)(tong)而(er)用(yong)量各(ge)異。春(chun)三(san)(san)月(yue)(yue):：黃(huang)(huang)(huang)(huang)芩(qin)120g，黃(huang)(huang)(huang)(huang)連120g，大(da)(da)黃(huang)(huang)(huang)(huang)90g；夏三(san)(san)月(yue)(yue)：黃(huang)(huang)(huang)(huang)芩(qin)180g，黃(huang)(huang)(huang)(huang)連210g，大(da)(da)黃(huang)(huang)(huang)(huang)30g；秋三(san)(san)月(yue)(yue)：黃(huang)(huang)(huang)(huang)芩(qin)180g，黃(huang)(huang)(huang)(huang)連90g，大(da)(da)黃(huang)(huang)(huang)(huang)60g；冬三(san)(san)月(yue)(yue)：黃(huang)(huang)(huang)(huang)芩(qin)90g，黃(huang)(huang)(huang)(huang)連60g，大(da)(da)黃(huang)(huang)(huang)(huang)150g，為小(xiao)蜜丸，服1月(yue)(yue)病愈。《徐大(da)(da)椿醫(yi)(yi)書(shu)全集》載(zai)四(si)時(shi)(shi)加減柴胡(hu)湯，由柴胡(hu)、白術(shu)各(ge)60g，大(da)(da)腹檳榔4枚并皮用(yong)，陳(chen)皮37.5g，生(sheng)姜37.5g，桔梗52.5g；冬三(san)(san)月(yue)(yue)柴胡(hu)稍(shao)(shao)多，春(chun)三(san)(san)月(yue)(yue)減白術(shu)、增枳實(shi)；夏三(san)(san)月(yue)(yue)又(you)增甘草，仍用(yong)枳實(shi)、白術(shu)；秋三(san)(san)月(yue)(yue)同(tong)(tong)(tong)冬三(san)(san)月(yue)(yue)，惟(wei)陳(chen)皮稍(shao)(shao)多，水(shui)煎(jian)，分溫三(san)(san)服，半小(xiao)時(shi)(shi)進一服。用(yong)治五臟(zang)寒熱(re)。上述三(san)(san)黃(huang)(huang)(huang)(huang)丸和四(si)時(shi)(shi)加減柴胡(hu)湯藥(yao)量隨(sui)時(shi)(shi)應(ying)(ying)變(bian)，取(qu)其(qi)突出療效。

中(zhong)藥不(bu)傳之秘在劑(ji)量——干貨(huo)多宜(yi)收藏（2）

五、劑量大小不同可導致作用相反

同一味藥(yao)用(yong)于(yu)同一病理狀態的(de)病人，隨著藥(yao)量(liang)(liang)(liang)的(de)增(zeng)減會出現不同的(de)藥(yao)效反應。黃連(lian)、龍膽草用(yong)1～2g能(neng)健(jian)胃，增(zeng)進(jin)食欲，3～6g可(ke)燥濕瀉火解毒(du)，大(da)(da)量(liang)(liang)(liang)則會刺激胃壁引(yin)起惡心(xin)、嘔吐(tu)；防己小(xiao)量(liang)(liang)(liang)能(neng)使尿量(liang)(liang)(liang)增(zeng)加(jia)，而大(da)(da)量(liang)(liang)(liang)則作(zuo)用(yong)相(xiang)反；紅花少用(yong)能(neng)活(huo)血(xue)(xue)，多用(yong)則破血(xue)(xue)。艾(ai)葉3～5g可(ke)開胃，8g左右溫經止血(xue)(xue)、止痛，大(da)(da)量(liang)(liang)(liang)則引(yin)起胃腸道炎癥。蒼耳子少量(liang)(liang)(liang)則輕而上至顛頂，重(zhong)用(yong)則通(tong)下走足膝。白術中(zhong)(zhong)劑(ji)(ji)量(liang)(liang)(liang)健(jian)脾止瀉，大(da)(da)劑(ji)(ji)量(liang)(liang)(liang)則可(ke)通(tong)瀉。中(zhong)(zhong)國中(zhong)(zhong)醫研(yan)究(jiu)院中(zhong)(zhong)藥(yao)研(yan)究(jiu)所曾對(dui)五(wu)苓散(san)的(de)利(li)尿作(zuo)用(yong)進(jin)行研(yan)究(jiu)，按仲景方劑(ji)(ji)量(liang)(liang)(liang)則利(li)尿效果(guo)最佳；若各(ge)藥(yao)等量(liang)(liang)(liang)，利(li)尿效果(guo)則明顯減弱(ruo)；若顛倒藥(yao)量(liang)(liang)(liang)，則利(li)尿作(zuo)用(yong)更差。因此，臨(lin)證遣藥(yao)組方，用(yong)藥(yao)定其(qi)(qi)適量(liang)(liang)(liang)，是保證治療效果(guo)的(de)關鍵，給藥(yao)劑(ji)(ji)量(liang)(liang)(liang)不同，其(qi)(qi)效果(guo)也不相(xiang)同。

中藥不傳之秘在劑量——干貨多宜收藏(zang)（2）

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