摘要
栀子大黄汤出自《金匮要略》,是张仲景所创治疗酒黄疸的传世经方,收录于《古代经典名方目录(第二批)——汉族医药》。该研究通过系统整理古籍与现代文献,对经典名方栀子大黄汤的源流与组成、药物基原与炮制、剂量、制法和用法、传统功能主治、现代临床应用及注意事项等关键信息进行考证。共收集栀子大黄汤相关古籍数据52条和现代临床研究8篇。考证显示,历代医家基本沿袭《金匮要略》栀子大黄汤之原貌,药物基原、剂量基本稳定。依据考证结果,建议该方药物为栀子为茜草科植物栀子G.jasminoides的干燥成熟果实,生品使用15.4 g,枳实选用芸香科柑橘属酸橙C.aurantium的干燥幼果,规格选用麸炒枳,使用69 g,大黄为蓼科植物掌叶大黄R.palmatum、唐古特大黄R.tanguticum或药用大黄R.officinale的干燥根和根茎,生品使用13.8 g,淡豆豉为豆科植物大豆G.max(L.)Merr.的干燥成熟种子(黑豆)的发酵加工品,生品用120 g,其中淡豆豉炮制方法建议辅料选用温性辅料,如紫苏叶、麻黄等。煎服法为加水1200 mL,放入栀子、大黄、枳实,淡豆豉干净纱布包好再入,煎取400 mL,每日分3次温服,不拘时。传统功能主治显示栀子大黄汤善治“酒疸”,亦可治疗重症黄疸,也多用来治疗宿食内积、谷疸腹痛、便秘及伤寒食复。现代临床多用其治疗黄疸等消化系统疾病,对冠心病、口腔溃疡等疾病亦有良好疗效。现代临床报道未见严重不良反应,但治疗酒疸时不可久服之,且孕妇、月经期、哺乳期及胃肠道疾病患者当慎用。厘清栀子大黄汤的发展脉络以及考证其关键信息,以为临床药剂研发提供借鉴。
Zhizi Dahuang Decoction(栀子大黄汤)originated from the Synopsis Golden Chamber,is a time-honored classic prescription created by ZHANG Zhongjing to treat alcoholic jaundice and and is included in the Catalogue of Ancient Classical Prescriptions(Second batch)of Han Medicine.In this study,the historic origins and composition,drug origins and processing methods,prescription dosage,preparation methods and decocting methods,ancient recorded indications,modern clinical application and other key information of Zhizi Dahuang Decoction were systematically collected and analyzed based on ancient documents and modern literature.A total of 51 pieces of relevant ancient documents and 8 modern clinical studies of Zhizi Dahuang Decoction were collected.Medical experts from successive generations had inherited the original composition of the prescription,and in application herb origin and dosage are basically clear.Based on the results,we recommended that Zhizi(Gardeniae Fructus),the dry ripe fruit of the Rubiaceae plant Gardenia jasminoides,is used for 15.4 g of its raw production;Zhishi(Aurantii Fructus Immaturus),the dry little fruit of phenethylamine alkaloid synephrine plant of Citrus aurantium L.is used for 69 g of its fired production;Dahuang(Rhubarb),the dry root and stem of palmatophyll plant Rheum palmatum L.or Rheum tanguticum Maxim.ex Balf.or Rheum officinale Baill.,is used raw for 13.8 g;Dandouchi(Sojae Semen Praeparatum),the fermented mature seed of Legume soybean Glycine mar(L.)Merr.,is used raw for 120 g.For the preparation methods of Dandouchi(Sojae Semen Praeparatum),it's recommended to use warm excipients,such as Zisuye(Perillae Fructus),Mahuang(Ephedrae Herb),etc.The decocting method of this prescription is:Zhizi(Gardeniae Fructus),Zhishi(Aurantii Fructus Immaturus)and Dandouchi(Sojae Semen Praeparatum)are decocted with 1200 mL of water.Before Decocting,Dandouchi(Sojae Semen Praeparatum)needs to be wrapped in clean cloth.And taken 400 mL for one prescription and taken warm 3 times a day at any time.The ancient indication of Zhizi Dahuang Decoction is specialized for alcoholic jaundice,and also can treat severe jaundice,and can be used in treating accumulation of food and lodging,cereal jaundice abdominal pain,constipation and typhoid fever.Modern clinical studies have showed it can be used in treating digestive system disorders like jaundice,and also showed great efficacy in coronary heart disease,mouth ulcers.No serious adverse reactions have been reported in modern clinical practice,but it should not be taken for a long time in the treatment of alcoholic jaundice,and should be used with caution in pregnant women,menstrual periods,lactating and patients with gastrointestinal diseases.To comprehensively analyze the historic evolution and key information of Zhizi Dahuang Decoction could serve as a scientific reference for clinical drug development.
作者
高乐乐
梁绿圆
曹佳蕾
魏炳琦
李维笑
吕星航
唐箐
李懿涵
党伟利
马丙祥
GAO Lele;LIANG Lyuyuan;CAO Jialei;WEI Bingqi;LI Weixiao;LYU Xinghang;TANG Jing;LI Yihan;DANG Weili;MA Bingxiang(Pediatrics Hospital of the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,Henan,China;Henan University of Chinese Medicine,Zhengzhou 450018,Henan,China;Henan LIANG Jishi Research Institute of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《辽宁中医药大学学报》
2025年第7期86-94,共9页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(82474569)
河南省特色骨干学科中医学学科建设项目(STG-ZYX06-202144STG-ZYXKY-2020023)
2023年度河南省中医学“双一流”创建科学研究专项课题(HSRP-DFCTCM-2023-3-06,HSRP-DFCTCM-2023-2-08)
河南省中医药科学研究专项课题(2023ZY2057)。
关键词
经典名方
栀子大黄汤
文献考证
关键信息
临床运用
classic prescription
Zhizi Dahuang Decoction(栀子大黄汤)
textual research
key information
clinical application
