妊娠咳嗽,属风寒。盖肺脏内主气,外司皮毛,皮毛不密,寒邪乘之,则咳嗽。嗽久亦恐
坠胎,宁肺止嗽散加减用之。有久嗽不愈,多因脾土虚而不能生肺气,以致腠理不密,外邪复感,
或因肺虚不能生水,以致阴火上炎。治法当用补中益气汤,以培土金,六味丸加五味,以生肾水为善。
宁肺止嗽散 治孕妇风寒咳嗽。
麦冬(二钱) 知母(一钱) 桔梗 紫苏(各五分) 杏仁(十粒去皮尖) 桑白皮(六分) 甘草(四分)
妊娠气喘不得卧,有因乍感风寒客邪为害者,宜发散自愈,参苏饮主之。若脾虚,四肢无力;肺
虚,不任风寒;肾虚,腰酸短气,不能行步。猝然气喘不息,此脾肺素亏,母虚子亦虚,肾气不归元而
上乘于肺也。生脉散、补中益气汤去升柴主之。丹溪云∶火动作喘,此胎前最多,苏桔汤可加减,用之获效。
参苏饮 人参 紫苏 干葛 前胡 制夏 茯苓 陈皮(各等分) 枳壳(麦炒) 桔梗 木香
甘草(各减半)
苏桔汤 治孕妇风寒咳嗽,并治火动作喘。
天冬(六分去心) 桔梗(一钱五分) 紫苏 黄芩 贝母(去心各八分) 杏仁(十粒) 陈皮
知母 甘草(各四分)
妊娠泄泻,有风寒暑湿之外感,饮食生冷之内伤,病发一时,察其所因。如胃风,加味治中汤。
然又有由脾肾二脏虚者,不可不知。夫血统于脾,血壅胎元,则脾阴虚而食不运化,脾主健运,下焦
壅滞,而清气难舒,于是水谷难消而作泻。或因胎系于肾,胎窃其气以拥护,而肾气既弱,命门火
衰,不能上蒸脾土,此皆妊娠泄泻之由也。如脾虚内伤,用加味六君子汤,随所因而加之。命门火衰,
加益智以助之。至于妊娠久泻,元气下陷,发热作渴,肢体倦怠,用补中益气汤。
加味治中汤 治饮食过多,脾胃之气不足运化而作泻。
人参 白术(土炒) 炮姜 甘草(各一钱) 陈皮 青皮(各七分) 砂仁(五分)
水煎服。
妊娠期间出现咳嗽,多属于风寒所致。因为肺脏在体内主管气机,在体外主司皮毛;若皮毛腠理不致密,寒邪便会乘虚而入,导致咳嗽。咳嗽日久也可能导致胎元不稳而堕胎,因此宜使用宁肺止嗽散进行加减治疗。若有久咳不愈的情况,多因脾土虚弱不能滋生肺气,致使腠理不密,外邪再次侵袭;或因肺虚不能生肾水,导致阴火上炎。治疗方法应当使用补中益气汤以培补脾土(土)和肺金(金),配合六味丸加五味子以滋补肾水,这样较为妥当。
宁肺止嗽散:用于治疗孕妇的风寒咳嗽。
药物组成:麦冬(二钱)、知母(一钱)、桔梗、紫苏(各五分)、杏仁(十粒,去皮尖)、桑白皮(六分)、甘草(四分)。
妊娠期间气喘且无法平卧,有的因突然感受风寒客邪为害所致,适宜通过发散表邪使其自然痊愈,主方用参苏饮。若是脾气虚弱,则四肢无力;肺气虚弱,则不耐受风寒;肾气虚弱,则腰酸、短气,甚至无法行走。若猝然出现气喘不止,这是由于脾肺素来亏虚,母脏虚则子脏亦虚,肾气不能归元反而上乘于肺所致。可用生脉散、补中益气汤(去掉升麻、柴胡)主治。朱丹溪说:火动引起的气喘,这在胎前最为多见,可用苏桔汤加减治疗,往往能获效。
参苏饮:人参、紫苏、干葛、前胡、制半夏、茯苓、陈皮(以上各等分)、枳壳(麦麸炒)、桔梗、木香、甘草(以上各减半量)。
苏桔汤:用于治疗孕妇的风寒咳嗽,并治疗因火动引起的气喘。
药物组成:天冬(六分,去心)、桔梗(一钱五分)、紫苏、黄芩、贝母(去心,各八分)、杏仁(十粒)、陈皮、知母、甘草(各四分)。
妊娠期间出现泄泻,有因风寒暑湿等外感邪气,或饮食生冷等内伤因素所致,发病急骤,需审查其具体病因。如属胃风证,可用加味治中汤治疗。然而,又有由脾肾两脏虚弱引起的,这一点不可不知。血液统摄于脾,血壅滞于胎元,会导致脾阴虚而食物难以运化;脾主健运,若下焦壅滞,清气难以舒展,于是水谷难以消化而发生泄泻。又或因胎系于肾,胎儿窃取肾气以自保,导致肾气虚弱,命门之火衰微,不能上蒸温煦脾土,这些都是妊娠泄泻的原因。如果是脾虚兼内伤,使用加味六君子汤,并根据具体病因加以加减。若是命门火衰,加入益智仁以助阳。至于妊娠期间久泻,导致元气下陷,伴有发热、口渴、肢体倦怠等症状,应使用补中益气汤。
加味治中汤:用于治疗饮食过多,脾胃之气不足,运化失常而导致的泄泻。
药物组成:人参、白术(土炒)、炮姜、甘草(各一钱)、陈皮、青皮(各七分)、砂仁(五分)。
用法:水煎服。
Cough during pregnancy is attributed to wind-cold. The Lung organ governs Qi internally and controls the skin and hair externally; if the skin and pores are not dense, cold pathogenic factors will take advantage of this deficiency to cause cough. Prolonged coughing may also risk miscarriage, so Ningfei Zhisou San (Calming the Lungs and Stopping Cough Decoction) should be used with modifications. For chronic cough that does not heal, it is often due to Spleen Earth deficiency failing to generate Lung Metal, resulting in loose pores and susceptibility to external pathogens again; or due to Lung deficiency failing to generate Kidney Water, leading to the flaming up of Yin fire. The treatment method should employ Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to cultivate Spleen Earth and Lung Metal, combined with Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Wuweizi (Schisandra) to generate Kidney Water, which is preferable.
Ningfei Zhisou San (Calming the Lungs and Stopping Cough Decoction): Treats wind-cold cough in pregnant women.
Ingredients: Maidong (Ophiopogonis Radix, 2 qian), Zhimu (Anemarrhenae Rhizoma, 1 qian), Jiegeng (Platycodonis Radix), Zisu (Perillae Folium), Xingren (Armeniacae Semen Amarum, 10 grains, peeled and removed of tips), Sangbaipi (Mori Cortex, 6 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 4 fen).
Pregnancy-associated asthma with inability to lie flat can be caused by sudden contraction of wind-cold pathogenic factors; it is appropriate to resolve the exterior for self-healing, primarily using Shenru Yin (Ginseng and Perilla Drink). If there is Spleen deficiency, the limbs lack strength; if there is Lung deficiency, one cannot withstand wind-cold; if there is Kidney deficiency, there is soreness and weakness of the lower back, shortness of breath, and inability to walk. Sudden onset of incessant asthma is due to inherent deficiency of the Spleen and Lung, where maternal deficiency leads to fetal deficiency, and Kidney Qi fails to return to its origin but instead ascends to overwhelm the Lung. Shengmai San (Generate the Pulse Powder) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) removed should be used. Zhu Danxi stated: Asthma caused by Fire movement is most common before delivery; Sujie Tang (Perilla and Platycodon Decoction) can be used with modifications to achieve efficacy.
Shenru Yin (Ginseng and Perilla Drink): Renshen (Panacis Ginseng Radix), Zisu (Perillae Folium), Gange (Puerariae Radix), Qianhu (Peucedani Radix), Zhi Banxia (Pinelliae Rhizoma Preparatum), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium) (all equal parts); Zhiqiao (Aurantii Fructus, stir-fried with wheat bran), Jiegeng (Platycodonis Radix), Muxiang (Aucklandiae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (all halved in dosage).
Sujie Tang (Perilla and Platycodon Decoction): Treats wind-cold cough in pregnant women and asthma caused by Fire movement.
Ingredients: Tiandong (Asparagi Radix, 6 fen, heart removed), Jiegeng (Platycodonis Radix, 1.5 qian), Zisu (Perillae Folium), Huangqin (Scutellariae Radix), Beimu (Fritillariae Bulbus, hearts removed, 8 fen each), Xingren (Armeniacae Semen Amarum, 10 grains), Chenpi (Citri Reticulatae Pericarpium), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 4 fen).
Diarrhea during pregnancy can result from external contractions of wind, cold, summer-heat, and dampness, or internal injuries from consuming raw and cold food. The disease manifests suddenly, and the specific cause must be investigated. If it is Wei Feng (Stomach Wind), Jiawei Zhizhong Tang (Modified Regulate the Middle Decoction) should be added and used. However, it is important to know that diarrhea can also arise from deficiencies in the Spleen and Kidney organs. Blood is governed by the Spleen; when blood stagnates around the fetus, it causes Spleen Yin deficiency and failure of food transformation. The Spleen governs healthy transportation; if the lower jiao is obstructed, clear Qi struggles to diffuse, making digestion of water and grain difficult and leading to diarrhea. Alternatively, since the fetus is tied to the Kidney, the fetus may borrow Kidney Qi for protection, weakening Kidney Qi. When Mingmen Fire (Gate of Life Fire) declines, it cannot steam and warm the Spleen Earth from above; these are all causes of pregnancy-related diarrhea. If there is Spleen deficiency with internal injury, Jiawei Liujunzi Tang (Modified Six-Gentleman Decoction) should be used, modified according to the cause. If Mingmen Fire is deficient, Yizhi Ren (Alpiniae Oxyphyllae Fructus) should be added to assist. For prolonged diarrhea during pregnancy causing sinking of Yuan Qi (Primal Qi), accompanied by fever, thirst, and limb fatigue, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used.
Jiawei Zhizhong Tang (Modified Regulate the Middle Decoction): Treats diarrhea caused by excessive eating and insufficient Spleen-Stomach Qi to transform and transport.
Ingredients: Renshen (Panacis Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth), Pa Jiang (Zingiberis Rhizoma Preparatum), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian); Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride, each 7 fen); Sharen (Amomi Fructus, 5 fen).
Administration: Decoct in water and drink.