通腑活血法及其类方研究初探

Preliminary Research on Fu-organs-purging and Blood-activating Therapy and Its Analogous Prescriptions

通腑活血法临床应用广泛,其类方亦疗效显著,值得深入系统规范化研究。通腑活血法奠基于汉代张仲景,发展于金元时期张从正,完善于明清时期吴有性及吴鞠通,发扬于近现代诸多医家。收集整理历代通腑活血方剂46首,根据通腑、活血逐瘀、攻补之力、轻重缓急不同,可分为逐瘀泄热桃核承气汤类21首,泻热破瘀大黄牡丹汤类11首,破血逐瘀抵当汤(丸)、下瘀血汤类7首。祛瘀扶正大黄虫丸类7首;统计通腑活血方药物使用频次,提示大黄与桃仁分别为泻下通腑药与活血化瘀药中的高频药物,是通腑活血方常用药对。

Fu-organs-purging and blood-activating therapy is widely used in clinic. Its analogous prescriptions are also effective in treatment. They are worthy of in-depth, systematic and standardized research. Fu-organs-purging and blood-activating therapy was started from ZHANG Zhongjing in Han Dynasty, developed by ZHANG Congzheng in Jin and Yuan dynasties, and improved by WU Youxing and WU Jutong in Ming and Qing dynasties, advanced by many doctors of modern times. This research analyzes 46 formulas for Fu-organs-purging and blood-activating from the ancient medical literature. These formulas can be divided into 21 analogous prescriptions of Taohe Chengqi Decoction （桃核承气汤） of stasis-expelling and heat-reducing, 11 analogous prescriptions of Dahuang Mudanpi Decoction （ 大黄牡丹汤） of heat-purging and stasis-breaking, 7 analogous prescriptions of Didang Wan （抵当汤, in pills or decoctions）, Xiayuxue Tang （下淤血汤） and Dahuang Chong Wan （大黄[庶虫]虫丸）, according to differentiation in degree of Fu-organs-purging, blood-activating and stasis-dispelling, and purgation-tonifying, By counting frequency of herbs in formulas for Fu-organs-purging and blood-activating, it is indicated that Dahuang （Chinese rhubarb） is the most frequently used herb in purging and Fu-organs-purging herbs, and Taoren （Semen Persicae） is the most frequently used one in blood-activating and stasis-expelling herbs. These two herbs are the frequently-used herbal pair in Fu-organs- purging and blood-activating formulas.