《金匮要略》等五书中枳实薤白桂枝汤的文献考证  

Textual research on Zhishi Xiebai Guizhi Decoction based on the five medical books

作　　者：张林 曾凤 ZHANG Lin;ZENG Feng(School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;School of Chinese Classics,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 [2]北京中医药大学国学院,北京100029

出　　处：《长春中医药大学学报》2022年第4期370-373,共4页Journal of Changchun University of Chinese Medicine

基　　金：国家社会科学项目(21BTQ026);北京中医药大学孙思邈研究院项目(SSMYJY-2-2021-17);北京中医药大学孙思邈研究院科研项目(SSMYJY-1-2020-01)。

摘　　要：通过对枳实薤白桂枝汤在宋校《金匮要略》《外台秘要》《备急千金要方》文献记载的对校研究,参考《新雕孙真人千金方》《医心方》相关内容,发现该方在汉唐五部医书中主要有两个版本:“薤白半斤”“水五升”煎煮时间短、服用量小的枳实薤白桂枝汤适用于“心中痞”的轻症胸痹,以《金匮要略》《外台秘要》中的该方为代表;“薤白一斤”“水七升”煎煮时间长、服用量大的枳实薤白桂枝汤适用于“心中坚痞急痛”的重症胸痹,以新雕本《千金方》《医心方》中的该方为代表。而通行本宋校《备急千金要方》中该方用量用法与主治不相符,推测为宋人所改。提示:要充分认识宋校医书的复杂性与不确定性,对方剂关键信息的研究考证,切忌局限于某一文本以偏概全,而是应当以方剂文献为切入点,探讨北宋校正医书局中医古籍整理的指导思想、基本原则、具体做法及其对后世的影响,扎实做好基础性考证,是当今方剂研究特别是古方开发利用的前提条件。Based on the comparative study of Zhishi Xiebai Guizhi Decoction recorded in Jingui Yaolüe(Synopsis of Golden Chamber),Waitai Miyao Fang(Arcane Essentials from the Imperial Library)and Beiji Qianjin Yao Fang(Essential Recipes for Emergent Use Worth A Thousand Gold)revised in the Song Dynasty,referring to the relevant contents in Newly Carved Qian Jin Fang by Saint Sun and Yi Xin Fang,it is found that the prescription mainly has two versions in the five medical books of the Han and Tang Dynasties.One version,suitable for the mild chest painful impediment with a syndrome of chest depression and represented by the formulas in Jingui Yaolüe and Waitai Miyao Fang,is made up of 250 grams of longstamen onion bulb and five liters of water,and should be decocted for a shorter time and administered at a smaller dosage.While the second version,suitable for the severe chest painful impediment with a syndrome of severe chest depression and acute pain,represented by the formulas in the newly carved Qian Jin Fang and Yi Xin Fang,is made up of 500 grams of longstamen onion bulb and seven liters of water,and should be decocted for a longer time and administered at a larger dosage.However,the dosage and usage in the current edition of Beiji Qianjin Yao Fang revised in the Song Dynasty are not consistent with its indications,which is speculated to have been changed by the people of the Song Dynasty.Accordingly,it is suggested that we should fully understand the complexity and uncertainty of the text materials in the medical books revised in the Song Dynasty,and the research and verification of the key information in prescriptions should not be limited to the overgeneralization of a certain text,but should be based on a thorough understanding of the relevant literature.Taking the prescription literature as the breakthrough point,this paper discusses the guiding ideology,basic principles,specific practices and their influence on the later generations performed by the Office of Revising Medical Books of the Song Dynasty in its colla

关 键 词：枳实薤白桂枝汤 金匮要略 宋校医书 文献研究 经典古方 

分 类 号：R222[医药卫生—中医基础理论]