经典名方麻黄汤的处方考证及历史沿革分析

Analysis on Prescription Research and Historical Evolution of Mahuangtang

通过系统梳理麻黄汤的中医古籍及现代临床文献,对其出处、组成、基原、炮制要求、剂量、制法用法、功能主治等历史沿革进行考证,发现麻黄汤存在基原品种、饮片炮制、剂量折算等疑义。在充分考虑经典名方制剂开发实际需求及现代临床实践使用习惯的基础上,笔者得出的开发建议为麻黄选用草麻黄Ephedra sinica不去节,桂枝选用肉桂Cinnamomum cassia,甘草当用乌拉尔甘草Glycyrrhiza uralensis蜜炙,苦杏仁选用燀苦杏仁;剂量选择遵循变迁现象和规律以一两=3 g折算得处方总剂量为24 g;制法用法为取水1.8 L,先加入麻黄煎煮,蒸发掉水400 mL,去上沫后加入其他3味药,煮取500mL,过滤去渣,分3次服用,1次温服160mL左右;该方古籍记载主治外感风寒表实证,经后世医家临证灵活应用,常用于治疗感冒、急性支气管炎、支气管哮喘等疾病。

Based on the ancient Chinese medical literature and modern clinical application literature,Mahuangtang was systematically analyzed,including its origin,composition,processing requirements and others,in order to provide support for the development of this famous classical formula. It was found that there were some doubts about Mahuangtang,such as the original variety,the processing of decoction pieces,and the dose conversion ratio. On the basis of fully considering the actual needs of the development of famous classical formula preparations and the usage habits of modern clinical practice,the development suggestions of the author were as follows:Ephedrae Herba should be selected Ephedra sinica without removing knots,Cinnamomi Ramulus should be selected from Cinnamomum cassia, Glycyrrhizae Radix et Rhizoma should select Glycyrrhiza uralensis and be roasted with honey,and Armeniacae Semen Amarum should be selected as Danprocessed products. The total dose of Mahuangtang was 24 g after conversion according to 1 Liang equal to 3 g as following the transition phenomenon and law. The preparation and usage method was as follows:took 1.8 L of water,first added Ephedrae Herba in water for decocting,evaporated 400 mL of water,removed the upper foam,then added the other three drugs,cooked over gentle heat to 500 mL,filtered the residue,took three times a day,about 160 mL warm decoction once. The major function recorded of Mahuangtang in ancient books was exterior sthenia syndrome of exogenous wind cold,it often used in the clinical treatment of cold,acute bronchitis,bronchial asthma and other diseases through the flexible application of the later doctors.