脾胃病经典名方黄土汤历史沿革与关键信息考证  

Textual Research on Historical Evolution and Key Information on the Classic Formula Yellow Earth Decoction for Spleen and Stomach Diseases

作　　者：王浩婷 李德杏[1] 李卫强[2] 李嫚 WANG Haoting;LI Dexing;LI Weiqiang;LI Man(College of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin,China,301617;College of Traditional Chinese Medicine,Ningxia Medical University,Yinchuan,Ningxia,China,750004;The Affiliated Traditional Chinese Medicine Hospital of Ningxia Medical University,Wuzhong,Ningxia,China,751100)

机构地区：[1]天津中医药大学中医学院,天津301617 [2]宁夏医科大学中医学院,宁夏银川750004 [3]宁夏医科大学附属中医医院,宁夏吴忠751100

出　　处：《河南中医》2025年第1期40-50,共11页Henan Traditional Chinese Medicine

基　　金：国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023208);2022年度国家社科基金冷门绝学研究专项项目(22VJXT010)。

摘　　要：目的:系统梳理与考证《金匮要略》脾胃病经典名方黄土汤古代文献,厘清其历史源流,为其现代研究与临床应用奠定理论基础。方法:基于东汉至中华人民共和国成立以前的相关古医籍,对黄土汤的历史源流、药物组成、功效主治、药物基原、炮制方法、剂量、煎煮服用法等进行全面统计与分析。结果:纳入有效数据83条,涉及78部中医古籍。黄土汤首载于《金匮要略》,历代文献对于其药物组成、基本方义、功效主治等无较大争议,由灶心黄土(以下简称黄土)、甘草、干地黄、白术、炮附子、阿胶、黄芩7味药物组成;主治病症为便血、吐血、衄血,后世有所拓展,临证亦用于产后下痢、血崩、小便下血等。推荐剂量为黄土24 g,甘草9 g,干地黄9 g,白术9 g,附子9 g,阿胶9 g,黄芩9 g。结论:对黄土汤关键信息进行考证,可为该方的现代研究和临床应用提供文献支持。Objective:To systematically review and research on the related ancient literature on Yellow Earth Decoction,a classic formula for treating spleen and stomach diseases in Synopsis of the Golden Chamber,clarify its historical origin and development,and lay a theoretical foundation for its modern research and clinical application.Methods:Based on the relevant ancient medical books from the Eastern Han Dynasty to the Republic of China period in China,as well as those from Japan and Korea during the same period,a comprehensive statistical and analytical study was conducted on the historical origin,drug composition,therapeutic effects and main indications,drug sources,processing methods,dosages,and methods of decoction and administration of Yellow Earth Decoction.Results:A total of 83 valid data entries were included,involving 78 ancient Chinese medical books.Yellow Earth Decoction was first recorded in Synopsis of the Golden Chamber.There is no significant controversy in the literature throughout history,both domestic and foreign,regarding its composition,basic meaning,efficacy and main indications.It is composed of seven ingredients:stove heart yellow earth(hereinafter referred to as yellow earth),Gancao(Radix Glycyrrhizae),dried Dihuang(Radix Rehmanniae),Baizhu(Rhizoma Atractylodis Macrocephalae),processed Fuzi(Radix Aconiti Lateralis Preparata),Ejiao(Colla Corii Asini)and Huangqin(Radix Scutellariae).The main diseases it treats are hematochezia,hematemesis and epistaxis.Later,its application has been expanded and it can also be used in clinical practice for postpartum dysentery,menorrhagia and hematuria.The recommended dosage is 24 g of yellow earth,9 g of Gancao,9 g of dried Dihuang,9 g of Baizhu,9 g of Fuzi,9 g of Ejiao and 9 g of Huangqin.Conclusion:There is no significant divergence among medical practitioners of all dynasties regarding its efficacy and main indications,and it is commonly used to treat conditions such as bleeding during pregnancy,postpartum dysentery,metrorrhagia,hematuria,and relapsing dysente

关 键 词：黄土汤 脾胃病 经典名方 《金匮要略》 张仲景 

分 类 号：R289.5[医药卫生—方剂学]