清肺平喘現良方

文/龐素銀

“冬不藏精，春必溫病”。春季多風，人體一旦精氣虧虛，就容易因風邪侵襲而出現以咳喘為顯著特征的肺病。

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.

良方現世 Prescription for therapy

東漢末年，一場持續近十年的特大瘟疫致人死傷無數，“家家有位尸之痛，室室有號泣之哀”。這場瘟疫傳染性強，發病急驟，死亡率高。因患者多見怕冷、寒戰等癥狀，而得名“傷寒”。

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".

據醫圣張仲景的《傷寒雜病論》記載，傷寒病發后，病患一旦出現發熱、汗出、咳喘等癥狀，說明風寒邪氣已經化熱傷肺，宜以麻黃、石膏為主要成分的麻杏石甘湯對癥施治。

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

麻杏石甘湯只有四味藥，卻充分體現了“君臣佐使”的方劑配伍原則。其中，麻黃辛溫，宜宣肺平喘，為君藥；石膏辛涼，可清肺熱，為臣藥；杏仁苦平，輔佐麻黃宣降肺氣，有止咳之效；甘草甘溫，和中益氣，調和諸藥，與杏仁共為佐使藥。

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".

煎藥時，取君藥麻黃9 g左右，加水煎煮20 min～30 min，去除沫狀物后，按1∶1∶1∶4的標準，加入杏仁、炙甘草、石膏，再煎煮20 min即可。服用后可有效清熱宣肺、平喘止咳，在抗擊疫情中發揮出重要作用。

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.

傳承改良 Inheritance and improvement

古代中醫認為，杏仁有微毒，宜去皮尖后入藥。可現代醫學試驗發現，杏仁的毒性源自皮尖中的苦杏仁甙。苦杏仁甙可分解出氫氰酸，如果劑量輕微，非但不會對人體構成直接危害，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，麻杏石甘湯取消了杏仁去皮尖的工藝要求，只要求杏仁劑量控制在15 g以內。2020年，國家中醫藥管理局推薦使用治療新型冠狀病毒肺炎的“清肺排毒湯”，也是在麻杏石甘湯的基礎上改良而成。

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.

結 語 Conclusion

張仲景的《傷寒雜病論》確立了對傷寒病“六經分類”的施治原則，根據病因、癥狀和發展階段的不同，辨證下藥，麻杏石甘湯的標準密碼就在于“清熱平喘”，辛涼疏泄能清肺，定喘除煩效力張 。

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.