熟地滋腻碍胃辨析
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摘要
熟地黄是地黄加工炮制的产物,在其蒸煮过程中,性味、功效发生了改变。对此历代医家认识不一,最大的争议就是熟地是否滋腻碍胃,这也影响了熟地的临床运用,使其不能更好地发挥临床疗效。通过剖析有关地黄加工炮制、临床运用的代表著作,梳理其制用源流与相应的功效变化,着眼于临证之用分析对比代表医家的不同学术观点,能够对熟地是否滋腻碍胃有深入客观的认识,从而纠正观点之偏颇,并指导临床,使熟地之用尽其全能。
Cooked Rehmannia is the processed product of rehmannia. During cooking process,its flavor and effect has changed. The ancient physicians of different ages had different opinions of it. The biggest controversy is that whether cooked rehmannia can affect the transportation of spleen and stomach. Because of the controversy,the clinical use of cooked rehmannia was influenced. We analyzed the representative books on rehmannia processing,clinical application,and distinguished corresponding changes between cooked rehmannia and rehmannia. Besides,we focused on comparing the clinical use and views of different famous ancient physicians and modern physicians. So that we can not only correct the opinion of bias and guide the clinical practice,but also let rehmannia be used better.
Cooked Rehmannia is the processed product of rehmannia. During cooking process,its flavor and effect has changed. The ancient physicians of different ages had different opinions of it. The biggest controversy is that whether cooked rehmannia can affect the transportation of spleen and stomach. Because of the controversy,the clinical use of cooked rehmannia was influenced. We analyzed the representative books on rehmannia processing,clinical application,and distinguished corresponding changes between cooked rehmannia and rehmannia. Besides,we focused on comparing the clinical use and views of different famous ancient physicians and modern physicians. So that we can not only correct the opinion of bias and guide the clinical practice,but also let rehmannia be used better.
引文
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[2]陶弘景.名医别录[M].北京:中国中医药出版社,2013:20.
[3]边宝林.地黄专论[M].北京:中医古籍出版社,2010:9,18.
[4]孙思邈.千金翼方[M].北京:人民卫生出版社,1998:221-222.
[5]唐慎微.重修政和经史证类备用本草[M].北京:人民卫生出版社,1955:149.
[6]刘丽娜,崔瑛,李寅超,等.地黄制用源流[J].中医研究,2006,19(9):20-22.
[7]李娴,卫向龙,庄蕴丁,等.比较熟地黄不同炮制品引起大鼠滋腻碍胃现象的实验研究[J].中国临床药理学杂志,2017,33(14):1336-1339.
[8]张景岳.景岳全书[M].太原:山西科学技术出版社,2006:619-620.
[9]孟祥龙,马俊楠,张朔生,等.熟地黄炮制(九蒸九晒)过程中药效化学成分量变化及炮辅料对其影响研究[J].中草药,2016,47(5):752-759.
[10]陈嘉谟.本草蒙筌[M].北京:中医古籍出版社,2013:8.
[11]杨时泰.本草述钩元[M].太原:山西科学技术出版社,2009:325.
[12]陈修园.医学从众录[M].北京:中国中医药出版社,2016:16.
[13]陈修园.医学三字经[M].北京:中国中医药出版社,2016:2.
[14]王少华.张景岳用熟地发微(上)[J].浙江中医杂志,2001(5):28-30.
[15]王少华.张景岳用熟地发微(下)[J].浙江中医杂志,2001(6):26-27.
[16]幺士焕.叶天士喜用熟地[J].中医杂志,1998,39(11):699-700.
[17]裘沛然.从来此事最难知———兼论张熟地[J].上海中医药杂志,1984(6):32-33.
[18]陈姼姼,郭喆千,吕振羽,等.颜新教授运用金水六君煎举隅[J].广州中医药大学学报,2011,28(5):539-540.
[19]盛阳.金水六君煎治痰新识[J].河南中医,2013,33(4):552.
[20]朱凤华.重用熟地治疗脾胃血虚之胃脘痛36例[J].安徽中医临床杂志,1998,10(5):286.
[21]汤伟.自拟熟地二香煎联合黛力新治疗功能性消化不良疗效观察[J].内蒙古中医药,2009,28(16):3-5.
[22]刘睿,冯昌汉,张国梁.冯昌汉运用熟地黄治疗进食不下案二则[J].浙江中医杂志,2017,52(8):616.