薯蓣丸古籍文献与现代临床应用研究  

Ancient Literature and Modern Clinical Application of Shuyu Pills

作　　者：骆小珊 谢甦 冯豆豆 蒙雁云 赵晶哲 凌湘力 LUO Xiaoshan;XIE Su;FENG Doudou;MENG Yanyun;ZHAO Jingzhe;LING Xiangli(Guizhou Medical University,Guiyang 550004,China;Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学,贵阳550004 [2]贵州医科大学附属医院,贵阳550004

出　　处：《世界中医药》2024年第24期3820-3826,共7页World Chinese Medicine

基　　金：国家自然科学基金项目(82460883);贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2023-001);贵州省科技计划项目(黔科合基础-ZK〔2024〕一般204,黔科合基础-ZK〔2022〕一般442);凌湘力全国名中医传承工作室建设项目(国中医药办人教函〔2022〕245号)。

摘　　要：薯蓣丸是《金匮要略》中治疗虚劳的经典名方,药物组成有21味,是张机鲜见的“大方”。薯蓣丸原文记载简要且立方病机不明,后世医家补充薯蓣丸的记载虽多,但在药物衡重单位和阐释立方病机等方面存在争议。对薯蓣丸古今文献系统考证发现,薯蓣丸可查阅到的古籍记载以清代著作最多,药物组成历代医家记载差异不大,制法用法基本遵照张机原方,应用剂量则按“4分=1两”进行折算比较合理。后世医家对薯蓣丸立方病机的阐释侧重点并不统一。清代医家高学山认为薯蓣丸立方病机一是由于脾胃中虚,水谷精微运化及散布失司,不能上输于肺,肺之卫表失职,而易受“外风”侵犯;二是中焦脾土虚损,母病及子致肺金虚弱,肺金不能克肝木,肝木肆意而生“内风”的观点。最切张机组方之意且可涵盖众医家之说。薯蓣丸的现代临床应用涉及肿瘤、呼吸内科、神经内科、皮肤科、儿科等多学科多疾病,涉及病种虽广泛,但终不离薯蓣丸“虚劳诸不足,风气百疾”之总病机。Shuyu Pills are a classic formula in Synopsis of the Golden Chamber used to treat consumptive disease,composed of 21 drugs,making it one of ZHANG Zhongjing′s rare“large prescriptions”.The original text of Shuyu Pills is brief,with unclear explanations of the underlying disease mechanisms.Although later practitioners have supplemented the description of Shuyu Pills,there remains debate regarding the balance weight of the drugs and the elucidation of its disease mechanisms.A systematic investigation of both ancient and modern literature on Shuyu Pills reveals that the most comprehensive records are found in Qing dynasty texts.The medicinal composition has been largely consistent across different historical periods,with preparation and usage methods generally following ZHANG Zhongjing′s original prescription.The modern clinical dose conversion is reasonably calculated as“4 Fen=1 Liang”.Later generations of practitioners have not reached a consensus on the interpretation of the formula′s underlying disease mechanism.Qing dynasty physician GAO Xueshan proposed that the disease mechanism of Shuyu Pills was primarily caused by spleen and stomach deficiency,which led to the inability to properly transform and distribute water and essence,resulting in insufficient upward transport to the lungs,causing the lung′s defense function to fail and becoming susceptible to“external wind”.Additionally,a deficiency in the middle energizer spleen earth weakened the lung metal,which made lung metal fail in constraining liver wood,causing the liver wood to flourish and generate“internal wind”.This interpretation aligns well with ZHANG Zhongjing′s original intent and encompasses the various theories proposed by other physicians.The modern clinical applications of Shuyu Pills span multiple disciplines,including oncology,respiratory medicine,neurology,dermatology,and pediatrics.Despite its broad range of applications,the formula always addresses the central pathology of“deficiency of consumptive diseases and wi

关 键 词：薯蓣丸 经典名方 虚劳 中医古籍 文献分析 数据挖掘 剂量考证 临床应用 

分 类 号：R289.1[医药卫生—方剂学]