经典名方温脾汤历史沿革与关键信息考证

Textual Research on the Historical Evolution and Key Information of the Classic Formula Wenpi Decoction

  • 摘要: 温脾汤为《古代经典名方目录(第一批)》发布的经典名方,通过整理、分析温脾汤的古今文献, 系统考证温脾汤的源流、药物组成、功能、剂量、炮制、煎服法、方义、主治、临床应用等方面的关键信息,共获得相关古代文献数据165条,现代临床文献114篇,涉及中医古籍66部。分析发现温脾汤首见于东晋《小品方》,唐代孙思邈将其纳入《备急千金要方》中,现行版以《备急千金要方》卷十五“脾脏热痢”的温脾汤为主流。其组方为大黄、人参、甘草、干姜、附子,药用基原遵循2020版《中国药典》,其中大黄、人参、干姜用生品,蜜炙甘草甘味大于炒甘草,性温不燥,缓和之性进一步增强,符合温脾汤功效,附子应选用炮附片;药物用量方面,大黄18.40 g,人参9.20 g,甘草9.20 g,干姜9.20 g,附子5.00 g;制法服法为加水1 400 mL, 煎取600 mL,分3次温服。该方古代常用于治疗痢疾、霍乱等病症,经后世医家临证发挥,现亦用于治疗胃肠道、肾功能衰竭、高血压及失眠症等疾病。该研究可为温脾汤中成药的研发和后续的研究提供参考依据。

     

    Abstract: Wenpi decoction is a classic prescription published in the Catalogue of Ancient Classic Prescriptions (First Batch). By sorting out and analyzing the ancient and modern literature on Wenpi decoction, the key information of Wenpi decoction in terms of its origin, drug composition, function, dosage, processing, preparation method, decoction method, prescription meaning, main indications, and clinical application was systematically verified. A total of 165 relevant ancient literature data, 114 modern clinical literature, and 66 ancient Chinese medical books were obtained. The inductive analysis found that Wenpi decoction was first seen in the Excerpts of prescriptions of the Eastern Jin Dynasty, and Sun Simiao of the Tang Dynasty included it in the Important Formulas Worth a Thousand Gold Pieces for Emergency. The current version is based on the Wenpi decoction in Volume 15 of Important Formulas Worth a Thousand Gold Pieces for Emergency, Spleen Heat Dysentery. The formula is composed of rhubarb, ginseng, licorice, dried ginger, and aconite. The medicinal origin follows the 2020 edition of the Chinese Pharmacopoeia, with raw products of rhubarb, ginseng, and dried ginger, stir fried licorice, and dried aconite slices being used; in terms of drug dosage, rhubarb is 18.40 g, ginseng is 9.20 g, licorice is 9.20 g, dried ginger is 9.20 g, and aconite is 5.00 g; the preparation method is to add 1400 mL of water, decoct 600 mL, and take it warm in 3 times. This prescription was often used in ancient times to treat dysentery, cholera and other diseases. After being developed by doctors in later generations, it is now also used to treat gastrointestinal diseases, renal failure, hypertension, insomnia and other diseases. The above research results can provide a reference for the development and subsequent research of Wenpi decoction.

     

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