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作 者:王双瑛 杨子婧 孟宇航 杨卫彬[2] WANG Shuang-ying;YANG Zi-jing;MENG Yu-hang;YANG Wei-bin(Graduale School,Beijing Universily of Chinese Medicine,Beijing 100029,China;.2.Graduate School,China Academy of Chinese Medical Sciences,Bejing 100700,China;Bejing North Medical District,Chinese PLA General Hospital,Bejjing 100094,China)
机构地区:[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院研究生院,北京100700 [3]解放军总医院京北医疗区,北京100094
出 处:《中国中药杂志》2022年第14期3956-3962,共7页China Journal of Chinese Materia Medica
基 金:国家自然科学基金面上项目(82074584)。
摘 要:乌梅丸出自《伤寒论》,该文考证共收集古代文献128条,涉及102本古籍,现代相关临床研究110条,涉及病种48种。对收集到的文献数据从处方源流、处方组成、处方方义、主治病证、药物剂量、药物炮制、制备及服法、服药禁忌、现代临床应用等进行分析,发现乌梅丸由乌梅、细辛、干姜、黄连、当归、附子、蜀椒、桂枝、人参、黄柏10味药组成,其主治范围随历代衍变有所扩展,对于证属寒热错杂,肝旺脾虚所致的腹泻、下痢、烦呕、胸痛、咳嗽、气从少腹上冲、手足厥冷等均可应用。现代文献记载其临床应用涉及消化系统、神经系统、内分泌与代谢系统等,常用于治疗溃疡性结肠炎、腹泻、失眠、2型糖尿病。在综合考证的基础上认为,乌梅丸使用剂量从汉代到清代逐渐减少,但药物之间的比例基本未变;方中附子、蜀椒需炮制,其余药物使用生品即可;药物选用方面,花椒的可考性更高,药品处方倾向于选用花椒;方中细辛系马兜铃科植物,具有一定的肝肾毒性,需注意用量安全。以上表明乌梅丸具有很大的临床应用价值,通过系统整理分析乌梅丸相关的古今文献,梳理乌梅丸的历史发展脉络,为后续深入研发及临床合理应用提供一定的文献证据。Wumei Pills originates from Treatise on Cold Damage. A total of 128 records on it were screened out, involving 102 ancient books, 110 modern clinical studies, and 48 diseases. According to the records, the prescription origin, prescription composition, prescription explanation, main indications, dosage, medicinal processing, preparation, and usage, contraindications, and mo-dern clinical applications were analyzed. The result shows that Wumei Pills is composed of Mume Fructus, Asari Radix et Rhizoma, Zingiberis Rhizoma, Coptidis Rhizoma, Angelicae Sinensis Radix, Aconiti Lateralis Radix Praeparata, Zanthoxyli Pericarpium, Cinnamomi Ramulus, Ginseng Radix et Rhizoma, and Phellodendri Chinensis Cortex. The main indications expand over time, and it can be applied to diarrhea, dysentery, retching, chest pain, cough, Qi ascending from lower abdomen, and reversal cold of hands and feet with the syndromes of cold and heat in complexity and hyperactivity of liver Yang and spleen deficiency. According to modern clinical records, it is mainly used for the treatment of diseases in the digestive system, nervous system, endocrine system, metabolic system, etc., such as ulcerative colitis, diarrhea, insomnia, and type 2 diabetes mellitus. The dosage of Wumei Pills has gradually reduced from the Han Dynasty to the Qing Dynasty, but the proportions of the medicinals has remained basically unchanged. In this prescription, Aconiti Lateralis Radix Praeparata and Zanthoxyli Pericarpium need to be processed, while the rest medicinals are used in raw form. As for the medicinal selection, Zanthoxyli Pericarpium is examinable. Asari Radix et Rhizoma is derived from Aristolochiaceae, which is toxic to the liver and kidney, so the dosage should be kept in a safe range. In summary, Wumei Pills has great clinical value. The textual research on Wumei Pills helps clarify the development of Wumei Pills, which provides evidence in-depth research and development and rational clinical application of Wumei Pills.
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