桂枝人参汤
(证附 表未解而里虚) 外证未除数下之,里虚热利痞成时,参姜术桂兼甘草,补正攻邪妙法施。
大黄黄连泻心汤
(证附 表解里实上有热) 汗下亡阳病象彰,恶寒仍服桂枝汤,嗣经表解方攻痞,渍用黄连与大黄。
附子泻心汤
(证附 表解里实下有寒) 心下痞生辨要详,恶寒汗出是亡阳,重煎附子专温里,
轻渍芩连合大黄。
(表解而里有水) 表解旋惊里未和,内停水饮病偏多,头疼胁痛兼干呕,心下痞成总不瘥。
十枣汤
表寒解后水邪伤,开痞先煎十枣汤,大戟芫花甘遂入,消除积饮此方良。
(表解而里有痞) 痞气凌心硬不移,胃生干噫食消迟,水停胁下成留饮,腹作雷鸣
泄利时。
生姜泻心汤
半夏生姜降浊阴,欲清心胆用连芩,汗伤中气宜温补,甘草干姜枣合参。
(表解而里有痞) 下利日经数十行,腹停水谷作雷鸣,心烦干呕复攻痞,因致胃虚客气生。
甘草泻心汤
补脾草枣有专长,降逆温寒用夏姜,再入芩连清上热,胃虚痞甚力能匡。
赤石脂禹余粮汤
(证附 里湿而便滑) 已服泻心与理中,谁知治利尚无功,下焦滑脱宜收涩,赤石余粮力独雄。
桂枝人参汤
(证候附注:表证未解而里气虚弱)
外感表证尚未解除,多次使用攻下法,导致里气虚弱、发热下利并出现痞满。此时应同时使用人参、干姜、白术、桂枝和甘草,这是扶正祛邪的巧妙治法。
大黄黄连泻心汤
(证候附注:表证已解,里实且上部有热)
发汗或攻下导致阳气耗伤,病象显著。若仍有恶寒症状,仍应服用桂枝汤;待表证完全解除后,方可攻治痞满。采用浸泡法使用黄连和大黄。
附子泻心汤
(证候附注:表证已解,里实且下部有寒)
心下痞满的症状需要仔细辨别。恶寒且出汗是阳气亡失的表现。附子需单独重煎以专门温补里阳,黄连、黄芩和大黄则轻浸取汁,二者合用。
(证候附注:表证已解而里有水饮)
表证解除后心中惊悸,体内尚未调和,内停水饮的病证较多见。伴有头痛、胁痛及干呕,心下痞满始终不愈。
十枣汤
表寒解除后,水邪伤人。治疗痞满应先煎煮十枣汤。方中大戟、芫花、甘遂加入其中,此方消除积滞水饮效果良好。
(证候附注:表证已解而里有痞满)
痞气侵犯心脏部位,硬满不移。胃气上逆产生干噫,食物消化缓慢。水液停滞在胁下形成留饮,腹部发出雷鸣般的声音,伴随泄利。
生姜泻心汤
半夏和生姜能降泄浊阴之气。若要清泄心胆之热,需用黄连和黄芩。因发汗损伤中气,适宜温补,使用甘草、干姜、大枣合用人参。
(证候附注:表证已解而里有痞满)
腹泻每日达数十次,腹中水谷停留发出雷鸣声。心烦、干呕,再次攻治痞满,导致胃气虚弱,客气(邪气)内生。
甘草泻心汤
补益脾胃以甘草和大枣见长。降逆气、温寒气需用半夏和生姜。再加入黄芩、黄连清泄上部之热,对于胃虚导致的严重痞满,此方有力匡扶正气。
赤石脂禹余粮汤
(证候附注:里湿且大便滑脱不禁)
已经服用过泻心汤与理中汤,谁知治疗腹泻仍无功效。下焦滑脱不禁宜用收涩法,赤石脂和禹余粮之力独强。
(证候附注:里湿且水液停聚 方剂见太阳本病章节)
攻下之后水液停聚是病根。服用泻心汤后痞满依然存在,更兼小便难通利,口渴且胸中烦躁不安。
Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction)
(Condition Note: Exterior syndrome unresolved with interior deficiency)
When the exterior symptoms persist and purgatives have been administered repeatedly, resulting in interior deficiency, feverish diarrhea, and fullness (pi), one should simultaneously employ Ren Shen (Ginseng Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gui Zhi (Cinnamomi Ramulus), and Gan Cao (Glycyrrhizae Radix et Rhizoma). This constitutes an ingenious method of supporting the healthy qi while attacking the pathogenic factor.
Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Decoction for Draining the Epigastrium)
(Condition Note: Exterior syndrome resolved, interior excess with heat above)
Sweating or purging may lead to yang depletion, manifesting prominently in pathological signs. If chills persist, Guizhi Tang (Cinnamon Twig Decoction) should still be administered. Only after the exterior syndrome is completely resolved should the fullness be treated by attacking it. Huang Lian (Coptidis Rhizoma) and Da Huang (Rhei Radix et Rhizoma) are used via infusion/steeping.
Fuzi Xiexin Tang (Aconite Decoction for Draining the Epigastrium)
(Condition Note: Exterior syndrome resolved, interior excess with cold below)
The occurrence of epigastric fullness (pi) requires careful differentiation. Chills accompanied by sweating indicate yang depletion. Fu Zi (Aconiti Lateralis Radix Praeparata) should be decocted separately and heavily to specifically warm the interior, while Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Da Huang (Rhei Radix et Rhizoma) are lightly infused. The two preparations are then combined.
(Condition Note: Exterior syndrome resolved with water retention in the interior)
After the exterior syndrome resolves, palpitations arise due to internal disharmony. Conditions involving retained fluid and phlegm are common. Symptoms include headache, hypochondriac pain, and dry retching, with epigastric fullness remaining unrelieved.
Shizao Tang (Ten Jujube Decoction)
After the exterior cold resolves, water pathogens injure the body. To treat fullness, Shizao Tang (Ten Jujube Decoction) should be decocted first. Da Ji (Euphorbiae Pekinensis Radix), Yuan Hua (Genkwa Flos), and Gan Sui (Kansui Radix) are added; this formula is excellent for eliminating accumulated fluids.
(Condition Note: Exterior syndrome resolved with interior fullness)
Fullness invades the heart region, causing hardness that does not shift. Stomach qi rebels causing belching without food odor, and digestion is slow. Water stagnates under the hypochondrium forming retained fluid, while the abdomen makes rumbling sounds accompanied by diarrhea.
Shengjiang Xiexin Tang (Fresh Ginger Decoction for Draining the Epigastrium)
Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens) descend turbid yin. To clear heat from the heart and gallbladder, Huang Lian (Coptidis Rhizoma) and Huang Qin (Scutellariae Radix) are used. Since sweating damages middle qi, warming and tonification are appropriate, employing Gan Cao (Glycyrrhizae Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), Da Zao (Jujubae Fructus), and Ren Shen (Ginseng Radix et Rhizoma).
(Condition Note: Exterior syndrome resolved with interior fullness)
Diarrhea occurs dozens of times a day. Water and food remain in the abdomen making rumbling sounds. Restlessness, dry retching, and repeated attempts to treat fullness lead to stomach deficiency and the generation of rebellious qi (pathogenic factors arising from deficiency).
Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium)
Tonifying the spleen is the specialty of Gan Cao (Glycyrrhizae Radix et Rhizoma) and Da Zao (Jujubae Fructus). Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens) are used to descend rebellion and warm cold. Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma) are added to clear upper heat. For severe fullness caused by stomach deficiency, this formula has the power to restore balance.
Chishizhi Yuyuliang Tang (Red Halloysite and Metastone Decoction)
(Condition Note: Interior dampness with slippery stool/incontinence)
Xiexin Tang (Decoctions for Draining the Epigastrium) and Lizhong Tang (Regulate the Middle Decoction) have already been taken, yet treating diarrhea remains ineffective. Slippery incontinence of the lower jiao requires astringent methods. Chishizhi (Halloysitum Rubrum) and Yuyuliang (Metastone) possess unique strength.
(Condition Note: Interior dampness with water retention - Formula see Sunyang Benbing Chapter)
Water retention after purgation is the root of the disease. Even after taking Xiexin Tang, fullness persists. Furthermore, urination is difficult, thirst is present, and restlessness occurs in the chest.