中医外治法防治疫病特色探析

吴承艳; 施庆武; 吴承玉

doi:10.14148/j.issn.1672-0482.2022.1000

中医外治法防治疫病特色探析

doi: 10.14148/j.issn.1672-0482.2022.1000

1.
南京中医药大学中医药文献研究所, 江苏南京 210023
2.
南京中医药大学中医学院·中西医结合学院，江苏南京 210023

基金项目:

国家社科基金冷门绝学研究专项 20VJXG032

2021年中医药古籍文献和特色技术传承专项 GZY-KJS-2021-031

详细信息

作者简介:
吴承艳, 研究员，博士生导师。中医文献研究所方剂研究室主任，兼任中华中医药学会名医学术研究分会常务委员，中华中医药学会外治分会常务委员，世界中医药学会联合会中医治未病专业委员会和中医药文献与流派研究专业委员会常务理事，江苏省中医药学会名医流派专业委员副主任委员等。从事中医药科研、教学、临床工作30多年，致力于中医方剂文献整理挖掘和中医流派学术思想研究。主持课题18项, 发表论文90余篇, 主编著作10部, 点校著作9部, 主持或参加课题获国家及省厅级奖13项，获国家发明专利2项。
吴承艳，女，研究员，博士生导师，主要从事中医方剂文献整理和中医流派学术思想的研究，E-mail：chengyanwu1999@163.com

通讯作者:
吴承玉，女，教授，博士生导师，主要从事藏象辨证体系规范的研究，E-mail：chengyu720@163.com

中图分类号: R244
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出版历程
- 收稿日期: 2022-08-11
- 发布日期: 2022-11-10

Exploration on the Characteristics of Chinese Medicine External Treatment Method to Prevent and Treat Epidemic Diseases

1.
Institute of Literature in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
2.
School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China

摘要

摘要: 中医药在历代疫病防治中积累了大量经验，形成了完整的疫病防治体系，而外治法在其中更是独具特色。纳入防治疫病外治方剂75首，有如下特色：①命名特色，多以“避瘟”“杀鬼”等为名，突出其预防疫疠邪气之作用；②剂型特色，剂型多达11种，除常见的丸剂、散剂、汤剂外，还有锭剂、艾条剂、线香剂、饼剂等多种剂型；③用法特色，用法包括熏烧、佩戴、涂敷、粉身、吹鼻、取嚏、药浴、点眼等多种外用方法；④用药特色，涉及用药共176味，其中用药频次≥5的药物共24味，性味以辛、温为主，且以金石类药物和芳香类药物的使用为特色。此外，还有部分稀见特色用药，值得进一步研究与利用。
- 外治法 /
- 瘟疫 /
- 疫病 /
- 防治特色
Abstract: Chinese medicine has accumulated rich experience in the prevention and treatment of epidemic diseases over the ages, and has formed a complete system for it, among which the external treatment method is a distinctive aspect. This study incorporates a total of 75 formulae on external treatment for the prevention and treatment of epidemic diseases, which have the following characteristics: ①Naming mostly featured by "bi wen (preventing plague)" and "sha gui (killing ghosts)" to highlight the role in preventing epidemic diseases; ②Formulation featured by lozenge, moxa stick, joss stick, medicinal cake, and other 11 types in addition to the common pill, powder and decoction; ③Application method featured by fumigation, wearing, coating, powdering, nose blowing, sneezing, bathing, eye dropping, and other external methods; ④Medication featured by mainly pungent and warm medicines with a medication frequency above 5 out of 24 medicines, metal and stone medicines, aromatic medicines, and other 176 medicines. In addition, there are also some rare medicines, which are worthy of further study and utilization.
- external treatment /
- plague /
- epidemic disease /
- prevention and treatment characteristics

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表 1 75首外治方剂型分布

Table 1. Distribution of 75 external prescriptions

序号	剂型	数量
1	散剂	32
2	丸剂	20
3	生药剂	11
4	膏剂	4
5	汤剂	2
6	艾条剂	2
7	线香剂	2
8	锭剂	2
9	搽剂	1
10	擦剂	1
11	饼剂	1

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表 2 鼻疗法及相关方剂

Table 2. Nasal therapy and related prescriptions

鼻疗法	方名	来源	组成	用法	功用或主治
吹鼻法	赤散方	《肘后备急方》^[12]⁷²	牡丹五分，皂荚(炙)五分，珍珠四分，踯躅四分，附子三分，干姜三分，细辛三分，肉桂二分	捣筛为散。初觉头强邑邑，便以少许纳鼻中，吸之取吐。温酒服方寸匕。覆眠得汗，即差。晨夜行及视病，亦宜少许以内鼻、粉身佳	瘴气、疫疠、温毒
	吕祖师清瘟神方	《卫生鸿宝》卷一引《鲍问梅手抄方》^[16]¹⁷	细辛、白芷、藜芦、延胡、川芎各一两，牙皂(去子弦)五钱，朱砂一钱，雄黄二钱	为细末。吹鼻	一切瘟疫
敷鼻法	无	《古今医鉴》^[7]	雄黄、苍术	为细末，香油调敷鼻内	虽与病人同卧，亦不相染
	无	《古今医鉴》^[7]	雄黄末	水调鼻内	虽与病人同卧，亦不相染
塞鼻法	辟疫丹	《赤水玄珠》^[36]	雄黄末一钱，麝半分	用黑枣肉捣为丸，枣核大，硃砂为衣。绵包塞入鼻中，男左女右	入病家不染疫气
	张三丰方	《温疫萃言》^[17]	孩儿菊(俗名醒头草)	取叶塞鼻中，秽气不染	天时瘟疫疠气
	无	《温疫萃言》^[17]	苏叶	挼塞鼻中	天时瘟疫疠气
搐鼻法	行军散	《霍乱论》^[37]	西牛黄、当门子、真珠、梅冰、蓬砂各一两, 明雄黄(飞净)八钱, 火硝三分, 飞金二十页	八味各研极细如粉，再合研匀，瓷瓶密收，以蜡封之。搐鼻	辟时疫之气
取嚏法	透顶清神散	《敖氏伤寒金镜录》^[38]	猪牙皂角、细辛、白芷、当归	上为细末。各等分，和匀。病人先噙水一口，以药少许吹鼻内，吐出水，取嚏为度；如未嚏，仍用此药吹入	凡瘟疫之家，不拘已未患者，皆宜用之
	无	《百效内科全书》^[39]	麻油、雄黄	以麻油调雄黄为末，涂鼻孔中，预饮雄黄烧酒一二杯，然后入病家则不相传染。既出，则以纸捻探鼻深入，令喷嚏为妙	预防瘟疫
	辟秽散	《瘟疫论》^[40]	川芎、藿香、藜芦各三钱，牡丹皮、玄胡各二钱，朱砂(水飞)一钱，雄黄(水飞)、白芷、牙皂各四钱	共为极细末，每早晚或看病出房，先噙水口中，吸些许入两鼻取嚏，出清涕为佳，再减去皂角，以为小丸，亦可噙嚼。牲畜受瘟者，以末吹入两鼻即愈	预防瘟疫
	无	《疫痧草》^[41]	雄黄酒、香油、雄黄、苍术	饮雄黄酒一杯，以香油调雄黄末、苍术末，涂鼻孔，则不染，出则以纸撚探鼻中，得嚏更好	辟疫
	卧龙丹	《卫生鸿宝》引《绛囊撮要》^[16]^8-9	犀黄、麝香、冰片各一钱，蟾酥钱半，闹羊花、猪牙皂各三钱，细辛二钱，灯草灰一两(取法：截竹筒将灯心装满捶结，塞口，糠火内煨存性，去竹取灰用)，金箔一百张	研匀，瓷瓶收贮。遇急症，吹鼻取嚏	一切痰厥气闭，时疫痧胀，诸般急症

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表 3 75首方剂中用药频次≥5的药物统计

Table 3. Statistics of drugs with frequency ≥ 5 in 75 prescriptions

序号	药名	用药频次	性味
1	雄黄	27	辛，温；有毒
2	苍术	26	辛，苦，温
3	细辛	19	辛，温
4	朱砂	15	甘，微寒；有毒
5	白芷	15	辛，温
6	皂荚	14	辛, 咸，温
7	川芎	12	辛，温
8	大黄	10	苦，寒
9	甘松	10	辛, 甘，温
10	降香	10	辛，温
11	麝香	9	辛，温
12	雌黄	8	辛, 平；有毒
13	鬼箭羽	8	辛, 苦，寒
14	虎骨	7	辛，温
15	鬼臼	7	苦, 辛，凉；有毒
16	肉桂	7	辛, 甘，大热
17	白术	7	甘, 苦，温
18	乳香	7	辛, 苦，温
19	附子	6	辛, 甘，大热；有毒
20	甘草	6	甘, 平
21	干姜	5	辛，热
22	乌头	5	辛, 苦，热
23	藁本	5	辛，温
24	山柰	5	辛，温

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