宋本《伤寒论》中大黄“酒洗”考辨  

Research on the “Wine-washed” Dahuang(Radix et Rhizoma Rhei) in the Treatise on Febrile Diseases (《伤寒论》) Printed in the Song Dynasty

作　　者：李明 丁艳亭[2] 陶晓华 LI Ming;DING Yanting;TAO Xiaohua(School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing,100029;Taian Hospital of Traditional Chinese Medicine)

机构地区：[1]北京中医药大学中医学院,北京100029 [2]泰安市中医医院

出　　处：《中医杂志》2023年第16期1627-1631,共5页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2019YFC1709200、2019YFC1709201)。

摘　　要：通过梳理相关古籍文献并结合现代研究成果,对宋本《伤寒论》中大承气汤、小承气汤、调胃承气汤与抵当汤中大黄“酒洗”的沿革与机理进行探析。认为三承气汤与抵当汤中的大黄在唐代以前均以生品直接使用,在宋本《伤寒论》中开始“酒洗”入方应用。传统观点主张大黄“酒洗”可升提药性、引药入血、缓解苦寒败胃的弊端;现代研究表明,大黄泻下作用的主要成分不溶于酒,而抑制泻下的鞣质可溶于酒,“酒洗”后大黄的泻下作用增强。《伤寒论》中三承气汤与抵当汤所主治的病症急、病情重,其中大黄“酒洗”的目的当在于速下热结。By analyzing relevant ancient books and modern research literature,this paper discussed the evolu-tion and mechanism of “wine washed” Dahuang(Radix et Rhizoma Rhei) in Dachengqi Decoction (大 承 气 汤),Xiaochengqi Decoction (小承气汤),Tiaowei Chengqi Decoction (调胃承气汤) and Didang Decoction (抵当汤),recorded in the Treatise on Febrile Diseases (《伤寒论》) printed in the Song Dynasty.Before the Tang Dynasty,raw Dahuang was directly used in three Chengqi Decoction and Didang Decoction,but the “wine-washed” Dahuang was applied in Treatise on febrile diseases printed in the Song Dynasty.The traditional view holds that “wine-washed” Dahuang may improve medicinal properties,can introduce herbs into the blood and alleviate the disadvantages of the bitter-cold in damaging the stomach.Modern research showed that the main components related to Dahuang's purgative effect are insoluble in wine,while the tannins that inhibit the purgative effect can be better dissolved in wine.Therefore,after “wine washing”,the purgative effect of Dahuang is enhanced.In the Treatise on Febrile Diseases,three Chengqi Decoction and Didang Decoction are mainly used to treat acute and serious diseases,and the use of “wine-washed” Dahuang is to quickly clear heat knot.

关 键 词：大黄 酒洗 炮制 《伤寒论》 

分 类 号：R289.1[医药卫生—方剂学]