仙方活命饮的古籍文献考证与现代临床应用  

Textual Research on Xianfang Huomingyin from Ancient Literature and Its Modern Clinical Application

作　　者：牛蔚露 王顺喜 吕承启 刘学伟[1,2] 苗明三[2] 李建伟[1] 王刚[1] 王宁丽 NIU Weilu;WANG Shunxi;LYU Chengqi;LIU Xuewei;MIAO Mingsan;LI Jianwei;WANG Gang;WANG Ningli(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)

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

出　　处：《中国实验方剂学杂志》2024年第19期180-189,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省卫生健康委国家中医临床研究基地科研专项(2022JDZX132,2022JDZX009,2022JDZX032);河南省科技攻关计划项目(212102311120);河南省中医药拔尖人才培养项目(2022ZYBJ04);河南省中医药科学研究专项(20-21ZY2185);河南省教育科学规划2023年度一般课题项目(2023YB0126)。

摘　　要：仙方活命饮被誉为“外科之首方”,又名神仙活命饮、真人活命饮。最早出自南宋杨士瀛的《仁斋直指》,由主流的13味药物白芷、贝母、防风、赤芍、当归尾、甘草、皂角刺、穿山甲、天花粉、乳香、没药、金银花、陈皮,以及加减的3味药物大黄、木鳖子、黄芪组成,具有清热解毒、消肿溃坚、活血止痛的功效,主要用于治疗阳证疮疡实证。该研究运用文献计量学方法,从历史沿革、方药组成、剂量、主治病证、煎煮方法、服用方法、药物炮制及古今应用等方面对仙方活命饮进行了系统考证。关于药物基原,穿山甲作基原与2015年版《中华人民共和国药典》(以下简称《中国药典》)中一致;其余药物的基原均与2020年版《中国药典》一致。经古今剂量换算确定各药用量如下:白芷、赤芍、浙贝母、甘草、天花粉、乳香各4.13 g,皂角刺、没药各2.07 g,当归尾(酒炙)、陈皮各6.2 g,防风(去芦)2.89 g,穿山甲(蛤粉炒)4.14 g,金银花12.39 g,或加大黄4.13 g,木鳖子(去壳)3.3 g,体虚则加黄芪4.13 g。将上述药物用黄酒450 mL煎至300 mL,每服1剂,日服3剂,餐前或餐后0.5 h温服,服1~6剂,中病即止。因本方易伤及脾胃,故不宜多服,后续应配合托里消毒散使用,并通过辨证加减使用进一步改善患者其他相关症状。本方功效消毒排脓、散瘀止痛,主治一切痈疽疔肿初起未溃,且为实证、热证者。现代应用多涉及皮肤科、周围血管科等多个科室的200余种以痈疽疔肿初起、热证、实证为主要辨证要点的疾病。该文通过仙方活命饮的文献研究,以期为其更广泛、深入的临床应用与开发研究提供依据。Xianfang Huomingyin is known as the first prescription of surgery,also known as Shenxian Huomingyin and Zhenren Huomingyin.The earliest one was from Renzhai Zhizhi in the Southern Song dynasty.It was composed of 13 mainstream medicines such as Angelicae Dahuricae Radix,Saposhnikoviae Radix,Paeoniae Radix Rubra,and three modified medicines such as Rhei Radix et Rhizoma,Momordicae Semen and Astragali Radix.It has the effects of clearing heat and detoxifying,detumescence and ulceration,promoting blood circulation and relieving pain,and is mainly used to treat Yang syndrome.In this study,the bibliometrics method was used to systematically study the historical evolution,prescription composition,dosage,indications,decocting methods,administration methods,drug processing and ancient and modern applications of Xianfang Huomingyin.As for the drug origin,pangolin is consistent with the 2015 edition of Chinese Pharmacopoeia,the origins of the remaining drugs are consistent with the 2020 edition of Chinese Pharmacopoeia.According to the ancient and modern dosage conversion,the dosage of each drug is as follows:Angelicae Dahuricae Radix,Paeoniae Radix Rubra,Fritillariae Thunbergii Bulbus,Glycyrrhizae Radix et Rhizoma and Trichosanthis Radix,Olibanum of 4.13 g,Gleditsiae Spina and Myrrha of 2.07 g,Angelicae Sinensis tail(stir-fried with wine)and Citri Reticulatae Pericarpium of 6.2 g,Saposhnikoviae Radix(removing reed)of 2.89 g,pangolin(stir-fried with clam powder)of 4.14 g,Lonicerae Japonicae Flos of 12.39 g,or adding Rhei Radix et Rhizoma of 4.13 g and Momordicae Semen(shelled)of 3.3 g,adding Astragali Radix of 4.13 g for body deficiency.The above medicines were decocted with 450 mL of yellow rice wine to 300 mL,1 dose for each time,3 doses for each day,and warmed before or 0.5 h after meals,1-6 doses,and discontinue medication as soon as get effect.Because this formula is easy to hurt the spleen and stomach,it should not be taken more.In the follow-up,it should be used in conjunction with Tuoli Xiaodusan,and other related s

关 键 词：仙方活命饮 真人活命饮 神仙活命饮 古籍 历史沿革 现代临床应用 文献考证 

分 类 号：R22[医药卫生—中医基础理论] Z126.27[医药卫生—中医学] R28[文化科学] R931