“有故无殒”思想指导下的古代妊娠疫病破禁用药分析  

Medication analysis of drug contraindicated in pregnancy in the treatment of pregnant patients with epidemic diseases under the guidance of the principle of‘medicine leads to no damage in sick condition’

作　　者：黄玉燕[1] 汤尔群[2] 卢红蓉[2] HUANG Yu-yan;TANG Er-qun;LU Hong-rong(Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100070,China)

机构地区：[1]中国中医科学院中医基础理论研究所中医经典与学术流派研究室,北京100070 [2]中国中医科学院中医基础理论研究所,北京100070

出　　处：《中华中医药杂志》2020年第9期4706-4708,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中央级公益性科研院所基本科研业务费中国中医科学院基础所自主选题项目(No.YZ-1712,No.YZ-1875)。

摘　　要：在"有故无殒"治则指导下,古代医家在治疗患有疫病的妊娠患者时,权衡去邪与安胎的关系,对一些妊娠慎用药破禁使用,对大热类、攻下类、清热类以及解表类药物的使用进行了重点探讨。在药证相符的情况下,当温则温,当下则下,当清则清,当散则散,若妊娠禁忌药使用得当,去邪即起到安胎的作用。破禁使用的同时,仍注意以"无殒"为目的而谨慎使用。如进一步区分攻下药中的大黄和芒硝的禁忌程度,有取大黄而舍芒硝之论。用大热类药物可通过加制约之药、药前试探、药后追踪等方式减少伤胎危险等。Under the guidance of the principle of‘medicine leads to no damage in sick condition’in the treatment of pregnant patients with epidemic diseases,ancient physicians found the best solution between removing pathogens and calming fetus.They focused on the use of drugs with character of great heat,cathartic drugs,heat-clearing drugs,and drugs for relieving exterior syndrome in contraindications for pregnancy.Under the condition that the medicine is consistent with the syndrome,if properly applied,those drugs contraindicated in pregnancy could calm fetus by removing pathogens.Use of some drugs should be used carefully during pregnancy,with the purpose of‘no damage’.For example,preferring rhubarb to mirabilite in the case cathartic drugs must be used,reducing the risk of fetal injury by means of adding drugs that restrict toxicity,pre drug testing and post drug tracking in the case drugs with great heat must be used and so on.

关 键 词：有故无殒 妊娠禁忌药 疫病 芒硝 

分 类 号：R271.4[医药卫生—中医妇科学]