历代本草与方书视角下五味子的临床运用考证  

Textual study on clinical application of Schisandrae Chinensis Fructus from the perspective of various dynasties of herbs and prescription books

作　　者：刘韵雅 谢慧娟 林路洁 何志鲲 李化[2] 杨敏[3] 杨滨[2] Liu Yunya;Xie Huijuan;Lin Lujie;He Zhikun;Li Hua;Yang Min;Yang Bin(School of Acupuncture and Tuina,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs,Institute of Chinese Materia Medica,Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;State Key Laboratory of Southwestern Chinese Medicine Resources,School of Pharmacy/Institute of Innovative Industries,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;College of Clinical Medicine,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)

机构地区：[1]成都中医药大学针灸推拿学院,成都611137 [2]中国中医科学院中药研究所道地药材品质保障与资源持续利用全国重点实验室,北京100700 [3]成都中医药大学药学院/创新产业研究院西南特色中药资源国家重点实验室,成都611137 [4]成都中医药大学临床医学院,成都611137

出　　处：《国际中医中药杂志》2025年第3期298-305,共8页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82173964);中国中医科学院科技创新工程项目(CI2023E002、CI2021A04511);中央级公益性科研院所基本科研业务费专项资金项目(ZXKT20021);成都中医药大学“杏林学者”学科人才科研提升计划(KPZX2022009)。

摘　　要：纵观历代本草和方书,载有五味子的规格、炮制和临床运用。现五味子临床应用多集中于收敛固涩、益气生津、补肾宁心,五味子其他功用和使用注意的探究考证鲜有报道;目前含有五味子的经典名方在处方组成中亦未明确标注其具体规格和炮制;考证发现,五味子不同的炮制品致其临床疗效各有发挥,生用取轻剂更宜降逆下气,蒸制取轻剂增轻透之性,蜜制取平剂则长于润肺滋阴,酒蜜制取平剂可补虚兼顾活血,酒制可通经活络,醋制取重剂可加强酸收之力,建议对蒸制品、蜜制品和蜜酒制品进一步深入研究,拓宽临床运用选择,提高临床用药的精准性。五味子临床应用在不同朝代各有侧重与演变,唐代五味子可降逆上中下三焦之气,除虚热;五代时期五味子可益气明目,温中降逆;金元时期有五味子暖水脏、治霍乱转筋的应用;明代提出五味子降气强阴,治亡阴亡阳危重;清代五味子可预防暑气,外敷疮疡可收敛生肌,南五味子有散痰火、祛风邪的记载。对历代本草和方书中五味子相关记载进行梳理,归纳总结五味子不同炮制方式下的功效特点、历史演变下的临床运用和主要使用禁忌,提出五味子在经典名方和常用方剂中的应用建议,可为精准选择五味子和南五味子的不同规格及其炮制品提供科学依据,以及二者在药物研发中的合理应用提供科学指导。Various dynasties of herbs and prescription books recorded the specifications,processing,and clinical application of Schisandrae Chinensis Fructus.The clinical application of Schisandrae Chinensis Fructus mainly focuses on astringency,tonifying qi and generating fluids,nourishing the kidneys and calming the heart.There have been few reports on the exploration on textual study on other functions and usage precautions of Schisandrae Chinensis Fructus;at present,the classic prescriptions containing Schisandrae Chinensis Fructus do not clearly indicate their specific specifications and processing in the prescription composition.Textual study has found that different processed products of Schisandrae Chinensis Fructus have different clinical therapeutic effects.For raw use,it is more suitable to use light agents to bring adversely risen qi downward,steam to produce light agents to increase transparency,honey to produce leveling agents is better for moistening the lungs and nourishing yin,wine honey to produce leveling agents can supplement deficiency and promote blood circulation,wine to produce heavy agents can strengthen acid absorption.It is suggested further in-depth research on steamed products,honey products,and honey wine products to broaden clinical application options and improve the accuracy of clinical medication.The clinical application of Schisandrae Chinensis Fructus has different emphases and evolution in different dynasties.In the Tang Dynasty,Schisandrae Chinensis Fructus could reduce the qi of the upper,middle,and lower energizers,and eliminate deficiency heat;during the Five Dynasties period,Schisandrae Chinensis Fructus could nourish qi,improve eyesight,warm the middle,and bring adversely risen qi downward;During the Jin and Yuan dynasties,Schisandrae Chinensis Fructus was used to warm water and treat cholera,as well as to improve muscle function;in the Ming Dynasty,Schisandrae Chinensis Fructus was proposed to reduce qi and strengthen yin,treating the critical condition of yin and yang deficiency;

关 键 词：五味子 南五味子 经典名方 临床运用 使用注意 

分 类 号：R28[医药卫生—中药学]