桃核承气汤与桃仁承气汤差异探析  

An Analysis of Differences Between Peach Kernel Qi-Guiding Decoction and Semen Persicae Qi-Guiding Decoction

作　　者：宋慧荣[1] 罗亚敏[1] 李冉 高明慧 李龙梅[1] 杨学琴[1] 陶晓华[1] SONG Hui-rong;LUO Ya-min;LI Ran;GAO Ming-hui;LI Long-mei;YANG Xue-qin;TAO Xiao-hua(Beijing University of TCM, Beijing, China, 100029)

机构地区：[1]北京中医药大学,北京100029

出　　处：《河南中医》2018年第6期824-827,共4页Henan Traditional Chinese Medicine

基　　金：北京中医药大学研究生自主课题(编号:2018-JYBZZ-XS043)

摘　　要：桃核承气汤首见于《伤寒论》,桃仁承气汤首见于《温疫论》,二者方名相似,又同为治疗蓄血证之方,后世医家不免将其混称,出现一方多名、同名异方的情况。桃核承气汤主治太阳蓄血证;温疫病胃腑实热当下而未下,温病热毒内陷血分形成瘀血,血分热瘀俱重,用桃仁承气汤深入血分,化瘀清热,瘀热共去。采用Jaccard相似度计算桃核承气汤和桃仁承气汤两个方剂药物组成的相似度,桃核承气汤与桃仁承气汤并非一方,药物组成方面的相似度为37.5%,药物剂量方面的相似度为54.37%。《伤寒论》之桃核承气汤非温病之桃仁承气汤,二者在方名、源流、药物组成及剂量和用药特点等方面皆有差异,故临床上有关蓄血证辨证用药时要审度病机,辨证施治。Peach Kernel Qi-Guiding Decoction was first seen in Treatise on Cold Damage Diseases,while Semen Persicae Qi-Guiding Decoction was first seen in Treatise on Warm-Heat Pestilence. The names of the two prescriptions are similar,and both of them are the prescriptions for treating blood-retention syndrome. Later generations of doctors can not avoid mixing their names with the same prescription,or different prescriptions with the same name. Peach Kernel Qi-Guiding Decoction is mainly used to treat Yaiyang blood-retention syndrome. In terms of accumulated excess heat in the stomach due to Warm-Heat Pestilence,blood stasis due to noxious heat sinking into xuefen,severe heat and blood stasis in xuefen,Semen Persicae Qi-Guiding Decoction is often used to remove both heat and blood stasis. The similarity degree in drug composition between Peach Kernel Qi-Guiding Decoction and Semen Persicae Qi-Guiding Decoction was calculated by Jaccard similarity,which showed that they are not the same prescription;the similarity of drug composition was 37. 5%,and the similarity of drug dose was 54. 37%. There are differences in the name,origin,composition of medicine,dose and characteristics of drugs between Peach Kernel Qi-Guiding Decoction in Treatise on Cold Damage Diseases and Semen Persicae Qi-Guiding Decoction in Treatise on Warm-Heat Pestilence. Therefore,it is necessary to examine the pathogenesis and adopt syndrome differentiation for the syndrome of blood-rention syndrome in clinical practice.

关 键 词：桃核承气汤 桃仁承气汤 蓄血证 相似度 药物组成 药物剂量 《伤寒论》 《温疫论》 张仲景 

分 类 号：R222.16[医药卫生—中医基础理论]