基于历史文献考证温胆汤的主治病证规律  

Textual research on the rule of main diseases and syndromes of Wendan Decoction based on historical documents

作　　者：林元媛 孟庆鸿 王晋邦 付筱童 贺缤嫣 宋月晗 王娣[4] LIN Yuanyuan;MENG Qinghong;WANG Jinbang;FU Xiaotong;HE Binyan;SONG Yuehan;WANG Di(The First School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing100007,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing102401,China;School of Acupuncture,Moxibustion,and Tuina,Beijing University of Chinese Medicine,Beijing102401,China;Integrated Traditional Chinese and Western Medicine Ward,Beijing Anding Hospital,Capital Medical University,Beijing100088,China)

机构地区：[1]北京中医药大学第一临床医学院,北京100007 [2]北京中医药大学中医学院,北京102401 [3]北京中医药大学针灸推拿学院,北京102401 [4]首都医科大学附属北京安定医院中西医结合病房,北京100088

出　　处：《中国医药导报》2022年第28期111-114,共4页China Medical Herald

基　　金：国家自然科学基金面上项目(81874427)。

摘　　要：温胆汤为经典名方,一直备受医家重视。本文对该方在历史文献中的药物组成、剂型、方义、医案等内容进行梳理,探讨其主治病证的演变规律。结果发现,温胆汤起源于南北朝时期,初为治疗胆虚寒、痰饮内生所引起的不寐,至宋朝,陈无择于原方加茯苓、大枣,提出其主治病机为“痰气郁结”“心胆气虚”,金元医家用实践验证了此思想。明清时期认为温胆汤组方为二陈汤加枳实、竹茹,亦可主治“痰火”为患,随症加减拓展其应用于神志病、消化病。温病学家提出“分消走泄”的思想,广泛应用其于湿热证。在温胆汤的演变过程中,其药物组成的改变及加减化裁是其主治病证变化的关键。Wendan Decoction is a famous classic prescription,which has always been valued by doctors.This paper combs the drug composition,dosage form,formula meaning,and medical records of the prescription in the historical documents,and discusses the evolution law of its main diseases and syndromes.The results show that Wendan Decoction originated in the Northern and Southern Dynasties.At the beginning,it was used to treat insomnia caused by gallbladder coldness and phlegm-fluid retention.In the Song Dynasty,Chen Wuze added Poria and Jujubae Fructus in the original prescription,and proposed that its chief indications was“phlegm-qi stagnation and binding”and“heart-gallbladder qi deficiency”.Based on this,doctors in Jin Yuan verified this idea with practice.In the Ming and Qing Dynasties,it was considered that Wendan Decoction was composed of Erchen Decoction plus Aurantii Fructus Immaturus and Bambusae Caulis In Taenias,which could also be used to treat“phlegm-heat”.with the increase and decrease of specific decocting pieces,it was applied to mental diseases and digestive diseases.Experts on warm disease put forward the idea of“elimination of pathogens through purgation and diuresis”,which is widely used in damp-heat syndrome.In the process of the evolution of Wendan Decoction,the change of its drug composition,increase,decrease are the key to the change of its main diseases and syndromes.

关 键 词：温胆汤 经典名方 历史文献 主治病证 

分 类 号：R283[医药卫生—中药学]