基于古今文献的经典名方大秦艽汤临床应用分析  

Clinical Application Analysis of Da Qinjiaotang Based on Ancient and Modern Literature

作　　者：赵辉 佟琳[2] 张磊[2] 刘思鸿[2] 曾子玲 李兵[3] 张华敏[3] ZHAO Hui;TONG Lin;ZHANG Lei;LIU Sihong;ZENG Ziling;LI Bin;ZHANG Huamin(Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700 [2]中国中医科学院中医药信息研究所,北京100700 [3]中国中医科学院中药研究所,北京100700

出　　处：《中国实验方剂学杂志》2023年第9期1-7,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院科技创新工程项目(CI2021A03702);国家药品监督管理局委托研究课题(古代经典名方目录关键信息考证示范性研究);国家中医药管理局委托办事经费项目(GZY-KJS-2019-011);中央级公益性科研院所基本科研业务费项目(ZZ13-YQ-131)。

摘　　要：大秦艽汤是治疗中风的常用经典方剂,出自刘完素所著《素问病机气宜保命集》,由秦艽、甘草、川芎、当归、白芍、细辛、羌活、防风、黄芩、石膏、白芷、白术、生地黄、熟地黄、茯苓及独活16味药组成。历代医家对该方的组方原理及主治中风属于“内风”还是“外风”存在争议,该文通过整理和分析记载大秦艽汤主治的相关古今文献,厘清经典名方大秦艽汤的证治源流。刘完素原著辨析大秦艽汤为治疗“内风”之方,方中秦艽、羌活、独活等风药可宣通郁滞,开通玄府,使气血经络畅行,而后世受“外风”思想影响,认为该方为治“外风”方剂。古代医家逐步补充了大秦艽汤主治中风所见口眼斜、半身作痛、肢体麻木等症状,并将大秦艽汤扩展用于筋燥、瘛疭、痉证、痹证等疾病;现代医家对本方病机的阐述仍以“外风”立论为主,为经络空虚、风邪入中,功效为疏风清热、养血活血。临床上多将大秦艽汤用于神经系统疾病中的脑血管疾病和周围性面神经麻痹,亦可用于风湿免疫系统的痛风性关节炎、风湿性关节炎以及皮肤性疾病等,以上分析结果将为经典名方大秦艽汤的研发提供参考依据。Da Qinjiaotang is a common classical prescription for the treatment of stroke.It originates from Collection of Writings on the Mechanism of Disease,Suitability of Qi,and the Safeguarding of Life as Discussed in the Basic Questions(《素问病机气宜保命集》)by physician LIU Wansu,and is composed of Gentianae Macrophyllae Radix,Glycyrrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Paeoniae Radix Alba,Asari Radix et Rhizoma,Notopterygii Rhizoma et Radix,Saposhnikoviae Radix,Scutellariae Radix,Gypsum Fibrosum,Angelicae Dahuricae Radix,Atractylodis Macrocephalae Rhizoma,Rehmanniae Radix,Rehmanniae Radix Praeparata,Poria,and Angelicae Pubescentis Radix.Doctors of all dynasties have disputed the composition principle of the prescription and argued whether its treatment of stroke belongs to the theory of"internal wind"or"external wind".Through collating and analyzing ancient and modern literature related to the indications of Da Qinjiaotang,this paper was dedicated to the origin of syndrome differentiation and treatment of Da Qinjiaotang.According to LIU Wansu's original works,Da Qinjiaotang is a prescription for the treatment of"internal wind",and in the prescription,wind medicinal herbs such as Gentianae Macrophyllae Radix,Notopterygii Rhizoma et Radix and Angelicae Pubescentis Radix removes stagnation,clears sweat pore,and makes qi and blood channels flow smoothly.However,later generations,affected by the idea of"external wind",believe that this prescription is used for the treatment of"external wind".Ancient physicians gradually supplemented the symptoms of stroke,such as wry eye and mouth,hemibody pain and limb numbness,which were treated by Da Qinjiaotang,and Da Qinjiaotang was also applied to the treatment of other diseases,such as tendon dryness,convulsion and arthralgia.Modern doctors still explain the disease pathogenesis from the theory of"external wind"as deficiency in channels and collaterals and the entry of pathogenic wind,and the prescription has the effect of dispersing wind,c

关 键 词：大秦艽汤 经典名方 文献研究 证治源流 临床应用 

分 类 号：R285[医药卫生—中药学] R289[医药卫生—中医学] R287R22R2-031R33R24