张仲景运用黄芩的规律研究
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摘要
黄芩为多年生草本植物黄芩的干燥根,主要分布于北方各省区,其中热河黄芩最负盛名;黄芩始载于《神农本草经》,列为中品。曰:“黄芩味苦,平。主治诸热,黄疸,肠澼泄痢,逐水,下血闭,恶疮,疽蚀,火疡。”现代药理研究证明黄芩具有解热抗炎镇痛作用、抗变态反应作用,有较广的抗菌、抗病毒谱,能抑制多种微生物,抗肿瘤作用,免疫作用,还有降压、利尿、利胆、镇静等作用,并且毒性极低。
     黄芩是临床常用的药物,先师张仲景的在《伤寒杂病论》中,根据辨证论治原则,运用黄芩配伍组方者众多,为求完美展现仲景黄芩的用药规律,本论文选取了《伤寒论》、《金匮要略》中所有含黄芩的方剂,附方除外。
     《伤寒论》和《金匮要略》中用黄芩共25首方剂,其中汤剂20首,丸剂2首,散剂3首。主要相关条文记载有50条。
     1.性味归经、功效、主治:性寒味苦,归肺胆、脾胃、大肠、小肠经。其功效有五:清热燥湿,代表方剂:葛根芩连汤;清热养阴,代表方剂:黄连阿胶汤;泻火解毒止血,代表方剂:大黄黄连泻心汤;利膈消痰,代表方剂:泽漆汤,清热安胎,代表方剂:当归散。
     2.配伍规律:《伤寒杂病论》中25首有关黄芩方剂中使用65种药物,其中频率十次及以上的药物有5种,包括:甘草16次、半夏12次、芍药11次、人参11次、大枣10次;五次及以上的药物有6种:生姜9次、干姜9次、黄连8次、柴胡7次、桂枝7次、大黄6次。
     《伤寒杂病论》中,与黄芩剂量比为1:1的药物频次分别是:半夏10次、人参9次、甘草7次、芍药6次、桂枝5次、干姜5次、生姜4次、黄连4次、大黄2次
     3.黄芩的剂量规律:《伤寒杂病论》中的黄芩剂量最常用的是三两,也是黄芩汤剂中的最大量,共12首黄芩方剂,占25首黄芩方剂的48%。用量最小的是王不留行散为二分,汤剂中黄芩最小量是麻黄升麻汤中十八株;用量最多的是当归散为一斤。
     4.黄芩方剂的主治规律:通过分析25首黄芩方剂所涉及的50条《伤寒论》和《金匮要略》原文,统计出黄芩的主治频次主要为:吐利证12次、寒热类10次、心区证8次、情志类6次、胸胁腹部病6次、血证4次、饮食二便4次、四肢、头面、颈项、身4次、汗证3次、咳喘2次等。
     5.黄芩汤的煎服法
     25首黄芩方剂中有6首方剂去滓再煎,使药性更加醇和,有利于调和脾胃,和解表里。6首方剂分别是:三首柴胡剂和半夏、生姜、甘草三泻心汤,均是煮取六升,去滓,再煎取三升。温服一升,日三服。最终都是煮取三升,温服一升,其不同的是最初的加水量,20首汤剂中,有17首方剂一次服药量是一升。泽漆汤一次服药为五合,黄连阿胶汤一次服药量为0.7升,黄土汤一次服药量为1.5升。大黄黄连泻心汤、附子泻心汤两方,煎法是只用沸水冲泡,取其轻扬之气,迅泄心下热结。
     6.后世医家在经方运用黄芩的基础上,加减成方者数不胜数,如:黄芩清肺饮、蒿芩清胆汤、黄芩黄连汤、芍药汤、黄连解毒汤、清胃散、甘露消毒丹、黄芩滑石汤、黄芩泻肺汤、黄芩泻白散等。
The herb Huangqin is the dry root of huangqin, which is widely distributed in northern provinces, in which the most famous one is in Rehe. Huangqin is firstly written in "Shen Nong's Herbal Classic". It is said that Huangqin has the characteristic of flavor bitterness, functioning as clearing the heat syndrome, curing jaundice, loose stool, the edema and bleeding, et, al. Modern pharmacological research proved that Huangqin has the effect of antipyretic anti-inflammatory analgesia, anti-allergic, antibiosis, depressurization, diuresis, cholagogic, depressant and low toxicity.
     Huangqin is commonly used in clinic, in Treatise on Cold Pathogenic Diseases, the use of Huangqin to make compatibility is seen many times. This study is to show the perfect law of Huangqin application. The formulae with Huangqin in Treatise on Cold Pathogenic Diseases and Synopsis of Golden Chamber are chosen to be studied.
     A total of25formulae with Huangqin are found in Treatise on Cold Pathogenic Diseases and Synopsis of Golden Chamber, including20decoction,2pills and3powder,, There are50records of Huangqin in the both books.
     1. The tropism of taste:bitter, cold. In the lung and gallbladder, spleen and stomach, large and small intestine. The5functions are clearing heat and moistening dryness with the representative decoction of Gegen qinlian decoction, and indications of Huangqin.; nourishing yin and clearing heat with the representative decoction of Huanglian ejiao decoction; clearing heat, removing toxic substance and stop bleeding with the representative decoction of Dahuang huanglian xiexin decoction; removing the phlegm with the representative decoction of Zexie decoction and clearing heat to preventing miscarriage with the representative decoction of Danggui powder,,
     2. The compatibility law.
     The25decoctions with Huangqin used65kinds of drugs, including5kinds of drugs which were used more than ten times, that is, Gancao,16times; Banxia,12times; Shaoyao,11times; Renshen,11times; Dazao,10times; and6kinds with more than5times:Shengjiang,9times; Ganjiang,9times; Huanglian,8times; Chaihu,7times; Guizhi,7times; Dahuang,6times. In Treatise on Cold Pathogenic Diseases and Synopsis of Golden Chamber, the frequency of the compatibility ratio1:1with Huangqin is:Banxia,10times; Renshen,9times; Gancao,7times; Shaoyao,6times; Guizhi,5times; Shengjiang,4times; Huanglian,4times; Dahuang,2times.
     3. The dose law of Huangqin.
     The mostly used dose of Huangqin in Treatise on Cold Pathogenic Diseases and Synopsis of Golden Chamber is san Hang, which is also the maximum dose in the decoctions with Huangqin. There are12decoctions of such dose, accounting for48%of the decoctions with Huangqin. The minimum dose is er fen in Wangbu liuxing powder, and in decoctions, the minimum dose is shiba zhu in Mahuangshenma decoction, the maximum use is one jin in Dangdui powder.
     4. The indication law of Huangqin.
     The indications are:vomiting and diarrhea,12times; cold and heat syndrome,10times; the heart problems,8times; the emotional problems,6times, bleeding syndrome,4times; cough,2times; sweating,4times, et, al.
     5. The decoction method of the decoctions with Huangqin.
     There are6decoction in25decoction with Huangqin require" qu za zai jian", which can be benefit for the regulating the spleen and stomach and reconciling exterior and interior. The6decoctions are:three decoctions with Chaihu and three xiexin decoctions.
     There are17decoctions in20decoctions require the taken-dose of yi sheng, it is wu he in Zexie decoction,2/3sheng in Huanglian ejiao decoction,3/2sheng in Huangtu decoction. In Dahuang huanglian xiexin decoction and Fuzi xiexin decoction, the decoction method is brewed with boiling water in order to clear the heat quickly.
     6. There are large numbers of the doctors born after Zhongjing who add or subtract drugs on the basis of using Huangqin, such as:Qingjin pill, Huangqin qingfei yin, Haoqin qingdan decoction, Huangqin huanglian decoction, Shaoyao decoction, Huanglian jiedu decoction, Sanhuang pill, Qingwei powder, Qianghuo huangqin decoction, Ganlu xiaodu dan, Huangqin huashi decoction, Huangqin xiefei decoction and Huangqin xiebai powder, et, al.
引文
[1]魏·吴普等述,清·孙星衍,孙冯翼辑.神农本草经[M].北京:人民卫生出版社,1984:69
    [2]梁·陶弘景集,尚志钧辑校名医别录[M].北京:人民卫生出版社,1986: 115
    [3]明·李明珍.本草纲目(上册)[M].北京:人民卫生出版社,1982: 780
    [4]清·杨时泰辑.本草述钩元[M].上海:科技卫生出版社,1958: 125
    [5]宋·唐慎微撰(尚志钧等校点).重修政和经史证类备用本草[M].北京:华夏出版社1993:40
    [6]肖培根.新编中药志(第1卷)[M].北京:化学工业出版社,2002:862
    [7]宋·苏颂.皖南医学科学院科研所辑校.本草图经[M].合肥:安徽科技出版社,1983:58
    [8]明·陈嘉谟撰(王淑民校点).本草蒙筌[M].北京:人民卫生出版社,1988: 80
    [9]清·吴其澹.植物名实图考[M].上海:商务印书馆,1957: 165
    [10]明·刘文泰等撰.本草品汇精要[M].北京:人民卫生出版社,1982: 309
    [11]中科院中国植物志编辑委员会.中国植物志(第65卷,第2分册)[M].北京:科学出版社,1997:136
    [12]楼之岑,秦波.常有中药材品种整理和质量研究(第2卷)[M].北京:北京医科大学联合出版社,1995:795
    [13]国家药典委员会.中华人民共和国药典2005年版(一部)[S].北京:化学工业出版社,2005:211
    [14]黄金玲,陈澄.叶天士运用泻心法经验探析.安徽中医学院学报,1999,18(5):2627
    [15]刘桂珍,朱胜利.丁甘仁温病透法六种.河北中医,1998,20(2):97
    [16]黄宫绣.本草求真.北京:中国中医药出版社,1997
    [17]邹澎.本经疏证.上海:上海科技出版社,1957
    [18]张璐.本经逢原.北京:中国中医药出版社,1996:45
    [19]张景岳.景岳全书·本草正.北京:人民卫生出版社,1993:1180
    [20]李中梓.本草通玄.上海广益书局,1916
    [21]肖森茂,彭永开,编.百家配伍用药经验采普.北京:中国中医药出版社,1992:248
    [22]陈嘉漠.本草蒙签.见,张瑞贤,主编.本草名著集成.北京:华夏出版社,1998:99
    [23]日华子诸家本草.上海科学技术出版社,1984
    [24]贾所学.药品化义.北京:人民卫生出版社,1984
    [25]吕景山编著,施今墨对药,北京:人民军医出版社,1996:61-62
    [26]明·倪朱谟 撰,本草汇言[M].北京:人民卫生出版社,2005:32
    [1]清·顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002: 151.
    [2]兰茂著,滇南本草[M].云南:云南人民出版社,1959:466
    [3]梁·陶弘景著,尚志钧辑较,名医别录[M].北京:人民卫生出版社.1986:115
    [4]金·张元素原著,任应秋点校,医学启源[M].北京:人民卫生出版社,1978:162
    [5]杨士瀛 著,盛维忠等校注仁斋直指方[M].福州:福建科学技术出版社,1989:50
    [6]明·倪朱谟 撰,本草汇言[M].北京:人民卫生出版社,2005:32
    [7]成无己著,伤寒明理论(唐宋金元名医全书大成)[M].北京:中国中医药出版社,2004:185
    [8]清·柯琴撰,伤寒来苏集[M].北京:中国中医药出版社,1998:129
    [9]金·成无己注,注解伤寒论[M].北京:人民卫生出版社,2009:104
    [10]清·张璐撰,本经逢原[M].北京:中国中医药出版社,1996:46
    [11]尤在泾 篆注,金匮要略心典[M].山西:山西科学技术出版社,2008:35
    [12]梁·陶弘景著,尚志钧等辑较,本草经集注[M].北京,人民卫生出版社.1994:264
    [13]尤在泾 篆注,金匮要略心典[M].山西:山西科学技术出版社,2008:59
    [14]清·周岩著,本草思辨录[M].北京:人民卫生出版社,1960:43
    [15]金·成无己注,注解伤寒论[M].北京:人民卫生出版社,2009:114
    [16]明·李时珍著,本草纲目[M].北京:人民卫生出版社,1982:781
    [17]清·陈修园著,伤寒论浅注[M].福州:福建科学技术出版社,1987:144
    [18]明·张志聪著,本草崇原[M].北京:中国中医药出版社,1992:79
    [19]清·严洁施雯洪伟著, 得配本草[M].北京:中国中医药出版社,1997:48
    [20]清·陈修园著,肖钦朗校注,神农本草经读[M].福州:福建科学技术出版社,1982:68
    [21]汉·张仲景撰,何任何若平整理,金匮要略[M].北京:人民卫生出版社,2005:64
    [22]尤在泾 编著,张立平校注伤寒贯珠集[M].北京:学苑出版社,2009:49
    [23]清·钱潢 著,伤寒溯源集[M].上海:上海卫生出版社,2009:99
    [24]尤在泾 编著,张立平校注伤寒贯珠集[M].北京:学苑出版社,2009:48
    [25]尤在泾 编著,张立平校注伤寒贯珠集[M].北京:学苑出版社,2009:50
    [26]吴谦医宗金鉴[M].北京:人民卫生出版社,1982: 166.
    [27]李培生,伤寒论(第2版)[M].北京:人民卫生出版社,2007: 196
    [28]熊曼琪主编, 伤寒论(第2版)[M].北京:人民卫生出版社,2000:358
    [29]清·柯琴撰,伤寒来苏集[M].北京:中国中医药出版社,1998:65
    [30]陆渊雷编著,鲍艳举等点校,伤寒论今释[M].北京:学苑出版社,2008:450
    [31]黄斌等校注,雷公药性赋[M].北京:中国中医药出版社,1996:43
    [32]晋·王叔和撰,贾君郭君双整理脉经[M].北京:人民卫生出版社,2007:23
    [33]清·严洁施雯洪伟著, 得配本草[M].北京:中国中医药出版社,1997:48
    [34]唐宗海原著,欧阳兵等点校血证论[M].天津:天津科学技术出版社,2003:66
    [35]尤在泾 篆注,金匮要略心典[M].山西:山西科学技术出版社,2008:48
    [36]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:32
    [37]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:113
    [38]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:230
    [39]柯雪帆伤寒及金医(现代中医药应用与研究大系)[M].上海:上海中医药出版社1995:133-147.
    [40]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:141
    [41]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:29
    [42]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:99
    [43]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:132
    [44]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:64
    [45]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:137
    [46]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:84
    [47]清.顾观光辑,杨鹏举校注神农本草经[M].北京:学苑出版社,2002:232
    [48]肖相如著,肖相如论伤寒[M].北京:中国中医药出版社,2009:390
    [49]肖相如著,肖相如论伤寒[M].北京:中国中医药出版社,2009:389
    [50]肖相如著,肖相如论伤寒[M].北京:中国中医药出版社,2009:394
    钱超尘、郝万山整理伤寒论[M].北京:人民卫生出版社,2009:
    何任、何若苹整理金匮要略[M].北京:人民卫生出版社,2010:

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