基于《名医类案》系列医籍的历代矿物药应用调研——以石膏为例  

Historical Application of Mineral Drugs Based on the Classified Case Records of Famous Physicians:A Case Study of Gypsum Fibrosum

作　　者：迟莉[1] 陈婷[1] 王伽伯 CHI Li;CHEN Ting;WANG Jiabo(School of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学中医药学院,北京100069

出　　处：《世界中医药》2024年第24期3815-3819,3826,共6页World Chinese Medicine

基　　金：国家社会科学基金项目(24BZS120)。

摘　　要：矿物类中药是中药三大来源之一,然而目前矿物药的临床应用品种呈下降趋势。为了中药资源的合理继承,本研究拟调研矿物药临床应用的历史变迁情况。医案是药物应用情况的真实记载,可以获取不同于本草类著作的信息。故以《名医类案》系列著作为主要依据,建立矿物药应用医案库,对57个常用矿物药的基本属性和历代应用情况进行调研。结果发现,这些矿物药绝大部分为金石玉类,所属类别最多的为安神药、攻毒杀虫止痒药、拔毒化腐生肌药及清热药,药性以温性和寒性为多,五味以辛、甘为多,有毒的药物约为30%,使用频次最高的为石膏、滑石、朱砂、芒硝。以石膏为例,通过医案可以清晰地认识其使用范围由一般的心肺热病扩大到外感热病、疫病及外科疾病、五官科疾病的过程。虽然该研究不能代表古代矿物药应用的全部情况,但仍可体现出矿物药应用的一般历史演变规律,为矿物药的毒理、药理以及临床研究提供依据。Mineral drugs are one of the three major sources of Chinese medicine.However,the clinical application of mineral drugs has been declining in recent years.To ensure the rational inheritance of Chinese medicine resources,this study aims to investigate the historical changes in the clinical application of mineral drugs.Medical case studies provide authentic records of drug applications,offering information distinct from classical pharmacopoeia texts.Therefore,based on the Classified Case Records of Famous Physicians series,a medical case database of mineral drugs was established to survey the basic properties and historical usage of 57 commonly used mineral drugs.The results show that the majority of these mineral drugs belong to the categories of metals,stones,and jade,with the most common categories being mind-tranquilizing drugs,antitoxic,insecticidal,and antipruritic drugs,detoxifying,necrotic tissue-removing,and granulation-promoting drugs,and heat-clearing drugs.The majority of these drugs have either a warm or cold nature,with the most common flavors being pungent and sweet.About 30%of the drugs are toxic,with the most frequently used being Gypsum Fibrosum,Talcum,Cinnabaris,and Natrii Sulfas.Taking Gypsum Fibrosum as an example,medical case studies clearly illustrate its expanded use,from general heart and lung heat diseases to external febrile diseases,epidemics,surgical diseases,and otolaryngological diseases.Although this study cannot represent all historical applications of mineral drugs,it reflects the general historical evolution of mineral drug usage,providing a foundation for the toxicological,pharmacological,and clinical research of mineral drugs.

关 键 词：矿物药 临床应用 名医类案 药性 演变 石膏 历史 功效 

分 类 号：R2-09[医药卫生—中医学]