基于第一批经典名方的分析与思考
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摘要
经典名方是我国医学先贤留给后人的宝贵财富,也是我国中医药宝库的重要组成部分,在我国有悠久丰富的人用历史,在维护人民健康方面发挥着重要作用。2018年国家中医药管理局公布了《古代经典名方目录(第一批)》,激发了中药生产企业研究古代经典方剂、开发经典名方复方制剂的热情。该文基于公布的第一批经典名方,从剂型、经方来源、处方组成、煎煮程度、有毒药使用及炮制方法6个方面进行综述。发现该批经典名方大部分剂型为汤剂及煮散,散剂和膏剂仅4首,皆源自历代有代表性的典籍;汤剂的每服剂量和煎煮程度较煮散大,汉唐时期的用药量与煎煮程度和明清时期接近,高于宋金时期,汉代方剂平均使用药味数最少;有毒中药的使用以汉代最为频繁,出现最多的有毒中药是半夏;炮制方法丰富多样,包括净制、切制、炒制、炙法和烘焙等。该文同时对传统膏剂所属剂型类别、古代煎药的时间概念、传统炙法、有毒药物炮制方法等方面进行讨论,以期为经典名方的深入开发提供思路与参考。
Classical prescriptions are precious wealth left by ancient Chinese medical scientists. Moreover,they are also the important part of the treasure-house in Chinese medicine. Classical prescriptions have a long and rich history for human-use in China and play an important role in keeping people healthy. The state administration of traditional medicine of China published the Catalogue of Classical Prescriptions(first batch) in 2018. This measure has inspired the enthusiasm of Chinese medicine manufacturers to study ancient classical prescriptions and develop classical compound prescriptions. Based on the first batch of classical prescriptions, the dosage forms, sources, prescription components, decocting degree, use of toxic drugs and processing methods of classical prescriptions. The results showed that most of the classical prescriptions in the first batch were decoction and boiled powder,while only four of them were powder and paste forms,all of which were originated from representative classics in the past dynasties. The dosage and decocting degree of decoction were greater than those of boiled powder. The dosage and decocting degree of decoction in Han and Tang Dynasties was close to that in Ming and Qing Dynasties,higher than that in Song and Jin Dynasties. Moreover,the average number of herbs in the prescriptions in Han Dynasty was the smallest. The use of toxic traditional Chinese medicine was the most frequent in Han Dynasty, and Pinellia ternata was the most common toxic medicine. There were various processing methods, including cleansing, cutting, stir-frying, roasting and so on. In this paper, the dosage forms of traditional paste, the time concept of decoction in the ancient times, the traditional roasting method and the processing method of toxic drugs were summarized to provide ideas and reference for further development of classical prescriptions.
Classical prescriptions are precious wealth left by ancient Chinese medical scientists. Moreover,they are also the important part of the treasure-house in Chinese medicine. Classical prescriptions have a long and rich history for human-use in China and play an important role in keeping people healthy. The state administration of traditional medicine of China published the Catalogue of Classical Prescriptions(first batch) in 2018. This measure has inspired the enthusiasm of Chinese medicine manufacturers to study ancient classical prescriptions and develop classical compound prescriptions. Based on the first batch of classical prescriptions, the dosage forms, sources, prescription components, decocting degree, use of toxic drugs and processing methods of classical prescriptions. The results showed that most of the classical prescriptions in the first batch were decoction and boiled powder,while only four of them were powder and paste forms,all of which were originated from representative classics in the past dynasties. The dosage and decocting degree of decoction were greater than those of boiled powder. The dosage and decocting degree of decoction in Han and Tang Dynasties was close to that in Ming and Qing Dynasties,higher than that in Song and Jin Dynasties. Moreover,the average number of herbs in the prescriptions in Han Dynasty was the smallest. The use of toxic traditional Chinese medicine was the most frequent in Han Dynasty, and Pinellia ternata was the most common toxic medicine. There were various processing methods, including cleansing, cutting, stir-frying, roasting and so on. In this paper, the dosage forms of traditional paste, the time concept of decoction in the ancient times, the traditional roasting method and the processing method of toxic drugs were summarized to provide ideas and reference for further development of classical prescriptions.
引文
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[41] 杨昌林,黄志芳,张意涵,等.蒸制和烘制对附子生物碱成分含量的影响研究[J].中国中药杂志,2014,39(24):4798.
[42] 邓亮.《伤寒杂病论》中半夏用法的相关研究[D].太原:山西中医学院,2014.
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[44] 王晖,马慧芬,徐赟晟,等.炮制对半夏淀粉基础物理化学性质的影响[J].中国实验方剂学杂志,2017,23(22):32.
[2] 全国人民代表大会.中华人民共和国中医药法[EB/OL].(2016-12-25)[2018-12-10].http://www.npc.gov.cn/npc/xinwen/2016-12/25/content_2004972.htm.
[3] 食品药品监管总局办公厅.总局办公厅公开征求《中药经典名方复方制剂简化注册审批管理规定(征求意见稿)》及申报资料要求(征求意见稿)意见[EB/OL].(2017-10-09)[2018-12-10].http://www.sda.gov.cn/WS01/CL0778/178324.html.
[4] 国家中医药管理局.关于发布《古代经典名方目录(第一批)》的通知[EB/OL].(2018-04-13)[2018-12-10].http://kjs.satcm.gov.cn/zhengcewenjian/2018-0416/7107.html.
[5] 陶弘景.本草经集注[M].高志钧,尚元胜辑校.北京:人民卫生出版社,1994.
[6] 苏轼,沈括.苏沈良方[M].北京:人民卫生出版社,1956.
[7] 太平惠民和剂局.太平惠民和剂局方[M].北京:人民卫生出版社,2007.
[8] 李睿,翟华强,田伟兰,等.中药煮散的历史源流及其与现代配方颗粒的对比性分析[J].中国中药杂志,2016,41(5):965.
[9] 穆兰澄,曹京梅,李冀湘,等.中药煮散的历史沿革与现代研究概述[J].中国实验方剂学杂志,2008,14(7):74.
[10] 袁冰,石东平,宋延青.略论宋代的煮散[J].中华中医药杂志,2005(10):585.
[11] 郑慧玲,张永臣.《理瀹骈文》外治思想探析[J].针灸临床杂志,2017,33(5):78.
[12] 艾青华.中医古籍体例沿革与学术发展的关系研究概论[D].北京:中国中医科学院,2012.
[13] 赵健,严季澜,李柳骥.运用中医医史文献学研究方法探讨方剂学发展史[J].北京中医药大学学报,2013,36(2):77.
[14] 赵志恒,张赫然.《千金方》中续命汤类方治证用药探析[J].辽宁中医药大学学报,2018,20(4):190.
[15] 李成文,马艳春,王琳.宋金元时期方剂学发展特点探讨[J].中华中医药杂志,2011,26(3):437.
[16] 张会永,杨关林.从《小儿药证直决》谈钱乙重视脾胃学术思想[J].辽宁中医药大学学报,2017,19(9):71.
[17] 祝小云,张翼宙.《妇人大全良方》和《傅青主女科》调经特色比较探析[J].黑龙江中医药,2016,45(4):2.
[18] 万迁迁,郑昱.李东垣《兰室秘藏》学术思想[J].长春中医药大学学报,2018,34(3):409.
[19] 王晓鹏,陈腾飞,张乃方,等.《景岳全书》对中医急诊重症学科的贡献[J].北京中医药大学学报,2018,41(8):626.
[20] 赵志恒,穆超超,张赫然.基于数据挖掘探析《外科正宗·肿疡主治方》用药规律[J].中国中医基础医学杂志,2018,24(6):832.
[21] 刘景源,赵进喜,李建民,等.吴鞠通承叶氏之学,自成体系;《温病条辨》创三焦辨证,方药周详[J].环球中医药,2018,11(4):534.
[22] 张文娴.《傅青主女科》调经方剂的组方规律及用药思路研究[J].辽宁中医杂志,2018,45(9):1863.
[23] 林伟刚.《医宗金鉴》对四物汤及其加减方的应用[J].湖北中医杂志,2018,40(8):40.
[24] 仝小林,刘文科,焦拥政.论精方与围方[J].时珍国医国药,2012,23(9):2293.
[25] 渠敬文.《伤寒论》方药剂量古今折算考[J].南京中医药大学学报,1999(2):42.
[26] 傅延龄,陈传蓉,倪胜楼,等.论方寸匕、钱匕及其量值[J].中医杂志,2014,55(7):624.
[27] 王奕博,刘冬涵,黄特辉,等.从古今麻黄汤中麻黄剂量及炮制方法探讨其安全使用[J].辽宁中医药大学学报,2018,20(7):174.
[28] 刘恬佳,黄晓巍.古今中药煎煮方法的影响因素[J].长春中医药大学学报,2016,32(1):43.
[29] 张瑞贤,芦琴,张卫,等.宋代药物非衡量计量单位的考察[J].中国中药杂志,2008,33(21):2574.
[30] 颜文强.历代中药度量衡演变考论[J].老子学刊,2016(1):137.
[31] 吴忠义.《伤寒论》汤剂煎药时间探讨[J].中华中医药杂志,2018(10):4575.
[32] 朱琰,刘静,朱琦.“毒”和“药”——中医的药物安全观探讨[J].世界科学技术——中医药现代化,2018,20(6):990.
[33] 梁琦,谢鸣.中药毒性及其内涵辨析[J].中西医结合学报,2009,7 (2):101.
[34] 邹宜諠,陈云,邵蓉,等.浅谈中药炮制及其辅料的监管现状与完善[J].中国新药杂志,2018,27(20):2346.
[35] 叶定江.中药炮制原理新探索[J].中国医药学报,1990(1):76.
[36] 龚千锋.中药炮制学[M].北京:中国中医药出版社,2012.
[37] 中国药典.一部[S].2015.
[38] 高广生.古代煎药服药计时方法初探[J].山东中医杂志,2002(2):106.
[39] 王奇.《伤寒论》方中炙甘草炮制方法探析[J].河北中医,2013,35(11):1654.
[40] 张英栋.《伤寒论》“炙甘草”当为炒甘草[N].中国中医药报,2013-02-18(004).
[41] 杨昌林,黄志芳,张意涵,等.蒸制和烘制对附子生物碱成分含量的影响研究[J].中国中药杂志,2014,39(24):4798.
[42] 邓亮.《伤寒杂病论》中半夏用法的相关研究[D].太原:山西中医学院,2014.
[43] 袁海建,贾晓斌,印文静,等.炮制对半夏毒性成分影响及解毒机制研究报道分析[J].中国中药杂志,2016,41(23):4462.
[44] 王晖,马慧芬,徐赟晟,等.炮制对半夏淀粉基础物理化学性质的影响[J].中国实验方剂学杂志,2017,23(22):32.