摘要
经方麦门冬汤出自汉代张仲景《伤寒杂病论》,由麦门冬、半夏、人参、甘草、粳米、大枣6味药物组成,主治虚热肺痿之“大逆上气,咽喉不利”。汉代以后,张仲景《伤寒杂病论》中《金匮要略》的内容部分失传,因此,麦门冬汤的主治沿革在魏晋南北朝至宋金元时期有断代现象,主要见于清代医籍,亦与当时疫病横行,温病学派兴起关系密切。在《中华医典》中以“麦门冬汤”为关键词进行检索,时间设定为汉代至近代,共查找到327条关于麦门冬汤的记载,以组方完全相同为标准,共得到符合标准的经方麦门冬汤文献数据53条。除去无法复核考证的文献及日文文献,最终纳入37篇文献。明清时期,以喻昌为代表的医家提出麦门冬汤清肺降气,滋阴润燥,是治疗“胃中津液干枯,虚火上炎之证”的“治本之良法”,其制方初衷重在补肺,组方经典之处是麦冬和半夏配伍,佐以人参,以补肺为最终目标,培土(滋养胃阴)是手段。麦门冬汤延用至今,目前归为滋润内燥剂,主治从肺痿衍变为呕吐。
The classical formula Ophiopogon Decoction(Maimendong Tang),originating from Treatise on Cold Dam⁃age and Miscellaneous Diseases(Shanghan Zabing Lun)by Zhang Zhongjing in the Han Dynasty,comprises six herbal components:Maimengdong,Banxia,Renshen,Gancao,Jingmi,and Dazao.It was originally indicated for deficiency-heat pulmonary flaccidity,characterized by“severe rebellious qi ascending upward and throat discomfort”.After the Han Dynasty,portions of Essential Prescriptions of the Golden Coffer(Jingui Yaolve)within Zhang′s treatise were lost,leading to fragmented documentation of Ophiopogon Decoction′s clinical applications during the Wei Jin Southern and Northern Dynasties,Song-Jin-Yuan periods.Its revival occurred primarily in Qing Dynasty medical texts,coinciding with prevalent epidemics and the rise of Warm Disease theory.A search of Chinese Medical Classics(Zhonghua Yidian)using“Ophiopogon Decoction”as the keyword,spanning Han to modern eras,yielded 327 records.Screening for identical compositions identified 53 entries meeting criteria.After excluding uncorroborated and Japanese texts,37 sources were analyzed.During the Ming-Qing period,physicians like Yu Chang emphasized the formula′s action in“clearing the lung and descending qi,nourishing yin and moistening dryness,”deeming it a“fundamental therapeutic approach”for“syndromes of depleted stomach-fluid and ascendant deficiency-fire.”The original formulation prioritized lung supplementation,with the combination of Maimendong and Banxia as its classic feature,assisted by Renshen with the ultimate aim of supplementing the lung—where fortifying earth(nourishing stomach-yin)served as the means.Today,Ophiopogon Decoction remains classified as an interior-moistening formula,its primary indication having evolved from pulmonary flaccidity to vomiting.
作者
陈侣华
王馨瑶
倪文婷
Chen Lvhua;Wang Xinyao;Ni Wenting(Shanhai University of Traditional Chinese Medicine,Shanghai 201203)
出处
《山西中医药大学学报》
2025年第8期833-837,共5页
Journal of Shanxi University of Chinese Medicine
基金
国家自然科学基金项目(81973554)。
关键词
麦门冬汤
主治
历代沿革
ophiopogon decoction
indications
historical evolution
