经典名方托里消毒散的古籍文献与现代临床应用分析  

Analysis of Ancient Literature and Modern Clinical Application of Tuoli Xiaodusan

作　　者：王顺喜 牛蔚露 刘学伟[1,2] 耿菁珂 李萌月 WANG Shunxi;NIU Weilu;LIU Xuewei;GENG Jingke;LI Mengyue(Henan University of Chinese Medicine,Zhengzhou 450046,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学,郑州450046 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中国实验方剂学杂志》2024年第8期176-186,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2018YFC1705301);河南省科技攻关课题(212102311120);河南省中医药拔尖人才培养项目(豫卫中医函[2023]2号);河南省中医药科学研究专项(2019JDZX2037,2022JDZX009);河南省中医药文化与管理研究专项(TCM2021009)。

摘　　要：托里消毒散是《古代经典名方目录(第一批)》中的第65首方剂,笔者运用文献计量学方法,从历史源流、方药组成与剂量、主治病证、煎法服法、药物炮制等方面将有关托里消毒散的古籍总结梳理和考证。据考证研究,托里消毒散具体成方年代未有定论,最早可追溯至明代薛己《立斋外科发挥》,其流传广泛,处方组成版本较多,现代影响力较大的版本出自明代陈实功的《外科正宗》,由人参、川芎、白芍、黄芪、当归、白术、茯苓、金银花、白芷、甘草、皂角刺、桔梗12味药组成;其药物基原基本与2020年版《中华人民共和国药典》一致,其中白芷推荐使用杭白芷Angelica dahurica var.formosana,甘草推荐使用豆科植物甘草Glycryyhiza uralensis,所有药味均建议生用;药物剂量建议每服人参、川芎、白芍、黄芪、当归、白术、茯苓、金银花各3.73 g,白芷、甘草、皂角刺、桔梗各1.87 g;制用法建议水煎服,加水400 mL,煮取160 mL,每日2~3服;该方具有益气养血、托毒透脓之功,在古代主要用于治疗疮疡类疾病的正虚邪实证,在现代其治疗病症十分广泛,涉及皮肤及软组织、五官、骨骼、消化、泌尿生殖、乳腺及肛肠等诸多系统病症,也同样主要用于正虚邪实之证。该研究经考证,总结了托里消毒散的古今应用,确定了其关键信息,为其更广泛地临床运用、深入研究及制剂开发提供了依据。Tuoli Xiaodusan is the 65th formula in the Catalogue of Ancient Famous Classical Formulas(First Batch).In this study,the bibliometric method was used to summarize and verify the ancient books about Tuoli Xiaodusan in terms of its historical origin,composition and dosage of the formula,indications,decoction and administration method,and processing,etc.According to the research,there is no definite date of the formation of Tuoli Xiaodusan,the earliest can be traced back to Lizhai Waike Fahui in Ming dynasty,which has been widely circulated,with many versions of prescription composition,and the modern influential version is from Waike Zhengzong in Ming dynasty,which is made up of 12 Chinese herbs including Ginseng Radix et Rhizoma(3.73 g),Chuanxiong Rhizoma(3.73 g),Paeoniae Radix Alba(3.73 g),Astragali Radix(3.73 g),Angelicae Sinensis Radix(3.73 g),Atractylodis Macrocephalae Rhizoma(3.73 g),Poria(3.73 g),Lonicerae Japonicae Flos(3.73 g),Angelicae Dahuricae Radix(1.87 g),Glycyrrhizae Radix et Rhizoma(1.87 g),Gleditsiae Spina(1.87 g),Platycodonis Radix(1.87 g).The herb origins almost follow the 2020 edition of Chinese Pharmacopoeia,except that Angelica dahurica var.formosana is only recommended as the origin of Angelicae Dahuricae Radix,and Glycryyhiza uralensis is only recommended as the origin of Glycyrrhizae Radix et Rhizoma.All the herbs are recommended to be used in the raw products.As for the preparation method,it is recommended to decoct with water,add 400 mL of water,boil until 160 mL,and take 2-3 times a day.The formula has the functions of nourishing Qi and nourishing blood,detoxifying and draining pus,and was mainly used to treat ulcerative diseases with the syndrome of syndrome of healthy Qi deficiency and pathogenic factors excess in ancient times,and in modern times,it is used for a wide range of treatment,involving the skin and soft tissues,bones,digestion and many other systemic diseases,and is also mainly used for syndrome of healthy Qi deficiency and pathogenic factors excess.In this study,the ancien

关 键 词：经典名方 托里消毒散 中医古籍 历史沿革 现代临床应用 文献研究 关键信息 

分 类 号：R22[医药卫生—中医基础理论] R28[医药卫生—中医学] R24[文化科学—图书馆学] G254