基于猪膏解毒功效的《金匮要略》“诸黄,猪膏发煎主之”再认识  

Re-recognition of “Different Types of Jaundice Should be Treated with Zhugaofa Decoction” in “Synopsis of Prescriptions of the Golden Chamber” Based on the Detoxification Effect of Lard

作　　者：窦豆 许宗颖 邱旭东 徐爽 李志鸣 钟相根 DOU Dou;XU Zongying;QIU Xudong(School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing(100029),China)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《浙江中医药大学学报》2021年第3期232-235,共4页Journal of Zhejiang Chinese Medical University

基　　金：国家重点研发计划项目(2019YFC1709201);北京中医药大学教育科学研究课题项目(XJZX18007)。

摘　　要：[目的]对猪膏的功效和猪膏发煎的功能主治进行再认识。[方法]对比猪膏发煎的古今应用,重新挖掘本草古籍中对猪膏功效的记载,总结仲景治疗黄疸的思路,分析《金匮要略》黄疸病篇文本,归纳猪膏发煎的功效和主治范围。[结果]猪膏发煎在古代多有应用且疗效颇佳,但在近现代渐被遗忘。本草古籍记载猪膏具有解毒功效,且《金匮要略》黄疸病篇布局安排的内在逻辑和"诸黄"二字的字词含义均说明"猪膏发煎"的功效并非仅限于补虚润燥,而应是解毒、消瘀、通利,这也更符合仲景对黄疸病机和治则的基本认识。猪膏发煎的主治范围应包括多种原因引起的黄疸,尤其侧重于黄疸病篇前部未详及治法的各类少见黄疸,如各种动植物、矿物药的肝毒性诱发的黄疸等。[结论]"猪膏发煎"具有解毒、消瘀、通利的功效,应通过研究扩大该方的临床应用范围。[Objective] To re-recognize the effect and treatment scope of lard and "Zhugaofa decoction". [Methods] In this article, it compared the ancient and modern applications of "Zhugaofa decoction", re-excavated the records of the efficacy of lard in ancient books of Materia Medica, summarized Zhongjing’s thoughts on treating jaundice, and analyzed the text of the jaundice chapter of "Synopsis of prescriptions of the Golden Chamber".[Results]"Zhugaofa decoction" was widely used in ancient times with good effects, but it has been forgotten in modern times. The ancient books recorded that the lard had the effect of detoxification. The context of Jaundice chapter in "Synopsis of Prescriptions of the Golden Chamber" and the meaning of the words"different types of jaundice" also showed that the effect of "Zhugaofa decoction" was not limited to tonic deficiency and moisturize dryness, but to detoxify, remove blood stasis, and promote the bowel movement and urination. This was consistent with ZHANG Zhongjing ’s basic understanding of jaundice pathogenesis. The treatment scope of "Zhugaofa decoction" should include jaundice caused by various causes, especially on various types of rare jaundice that were not detailed and treated in the same chapter, such as jaundice induced by liver toxicity caused by various animals, plants and mineral drugs. [Conclusion] "Zhugaofa decoction" has the effects of detoxifying, removing blood stasis, and promoting effect of bowel movement and urination,and further research should focus on expanding the scope of clinical application of this prescription.

关 键 词：猪膏 解毒 诸黄 猪膏发煎 金匮要略 黄疸 肝毒性 

分 类 号：R221[医药卫生—中医基础理论]