经典名方大秦艽汤的历史沿革与关键信息考证  

Textual Research on Historical Evolution and Key Information of Classical Famous Formula of Da Qinjiaotang

作　　者：李娜 白建英 李付平 张秀芬 芦迪 白祎硕 王翠香[4] 苏坤 LI Na;BAI Jianying;LI Fuping;ZHANG Xiufen;LU Di;BAI Yishuo;WANG Cuixiang;SU Kun(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050200,China;Shijiazhuang School of Angel Nurses,Shijiazhuang 050200,China;Hebei University of Chinese Medicine,Shijiazhuang 050200,China;Shijiazhuang Institute of Technology,Shijiazhuang 050200,China)

机构地区：[1]河北省中医院,石家庄050200 [2]石家庄天使护士学校,石家庄050200 [3]河北中医药大学,石家庄050200 [4]石家庄理工职业学院,石家庄050200

出　　处：《中国实验方剂学杂志》2025年第7期201-211,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科研计划项目(2020060);河北省中医药康养照护研究重点实验室项目(SZX2021025);河北省自然科学基金项目(H2015423040);河北省中医药管理局科研计划项目(Z2022007)。

摘　　要：大秦艽汤是《古代经典名方目录(第一批)》百首中的第54首,来源于金代医家刘完素《素问病机气宜保命集》,由秦艽、甘草、川芎、当归、白芍、细辛、羌活、防风、黄芩、石膏、白芷、白术、生地黄、熟地黄、茯苓及独活16味中药组成,是治疗中风的常用经典方剂,现代临床应用亦较广泛,用于缺血性脑卒中、周围性面神经麻痹、颈椎病、风湿性关节炎及神经性皮炎等多系统疾病。故笔者遵从《古代经典名方关键信息考证原则》,采用文献计量学的方法,搜集记载大秦艽汤的中医古籍文献,筛选出有效数据共177条,涉及中医古籍100部。从大秦艽汤历史沿革、组成用量、制法用法及各药物基原炮制等进行挖掘梳理及系统研究,发现在175条主治病证记载中,中风(144)最多,占总病证的82.29%,后世多遵刘完素大秦艽汤治疗“血弱不能养筋”所致中风“手足不能运动、舌强不能言语”其说,并补充了其治疗中风所见的口眼㖞斜、半身不遂、肢体麻木、偏枯疼痛及酸厥等其他症状,治疗疾病亦有所扩展,用于筋燥、瘛疭、痉证及痹证等。同时发现,后世医家对大秦艽汤治疗的中风属于“内风”还是“外风”存在争议,刘完素认为中风由内引发,创立火热中风学说,大秦艽汤治疗“内风”,后世医家多认为主治“内虚邪中”之“外风”。有药物组成的有效数据共76条,其中59条各药物皆有剂量,建议使用原方的现代折算用量,每服41.30 g,煮散,用水600 mL煎至300 mL,煎煮1次,去渣,温服,不计时候。通过对记载大秦艽汤的古籍文献分析研究,厘清其历史沿革,确定其关键信息,以期为经典名方大秦艽汤的研发上市和更好的临床应用提供古代文献证据。Da Qinjiaotang is the 54th formula of the 100 formulas in the Catalogue of Ancient Classical Formulas(the first batch),and it originated from the Collection of Writings on the Mechanism of Disease,Suitability of Qi,and Safeguarding of Life Discussed in Plain Questions.Da Qinjiaotang is composed of Gentiana macrophylla,Glycyrrhizae Radix et Rhizoma,Ligusticum chuanxiong,Angelica sinensis,Paeonia lactiflora,Asari Radix et Rhizoma,Notopterygium incisum,Saposhnikoviae Radix,Scutellariae Radix,Gypsum,Angelica dahurica,Atractylodis Macrocephalae Rhizoma,Rehmanniae Radix,Rehmanniae Radix Praeparata,Poria,and Angelicae Pubescentis Radix.It is a classical formula for treating strokes.Da Qinjiaotang is widely used in modern clinical practices for treating ischemic stroke,peripheral facial paralysis,cervical spondylosis,rheumatic arthritis,neurodermatitis,and other multisystem diseases.Therefore,following the Principles of Textual Research on the Key Information of Ancient Classical Famous Formulas,the authors collected the ancient Chinese medical literature of Da Qinjiaotang by the method of bibliometrics and screened out 177 valid data,involving 100 ancient books of traditional Chinese medicine.Based on the historical evolution,composition,dosage,method of preparation,and preparation of the original medicinal materials of Da Qinjiaotang,a systematic study was carried out.It was found that among the 175 records of the main diseases and syndromes,stroke(144)was the most,accounting for 82.29%of the total diseases and syndromes.Later generations mostly followed the practice of LIU Wansu in using Da Qinjiaotang to treat stroke caused by"weak blood and inability to nourish tendon",featuring"hands and feet cannot move,stiff tongue hinders speaking",as well as other symptoms,such as slant of the mouth,hemiplegia,numbness of the limbs,paroxysmal pain,and acerbic syncope.The treatment scope was expanded,covering tendon dryness,clonic convulsion,spasm syndrome,and arthralgia syndrome.At the same time,it was found that there was a co

关 键 词：经典名方 大秦艽汤 历史沿革 关键信息 文献考证 

分 类 号：R289[医药卫生—方剂学] R287[医药卫生—中药学] G254[医药卫生—中医学]