经典名方泻白散的源流及古今应用考究

Literature Research on Origin and Application of Classical Prescription Xiebaisan

泻白散作为国家公布的百首经典名方之一,其复方制剂研发逐渐成为热潮。经典名方研发首先应从中医理论与临床实际出发,夯实研发基础,基于以上思考,该研究采用溯源法和文献计量学方法对泻白散方源、病机、功效、方义、临床应用等方面进行考辨分析,以进一步推进该方的文献考究工作。考辨结果表明泻白散组方源头可追溯到《银海精微·卷上》中的"泻肺汤"一方,后世发展的泻白散同名方虽多达20余首,但为体现后世医家对钱乙组方思想的继承和发展,或仅取方名的"泻白"之意两个方面。泻白散主治病机可概括为肺热气逆,方中以桑白皮、地骨皮甘寒性降,清肺降逆,可使肺热清、逆气降而咳喘自止;辅以甘草、粳米健脾益气,寓有培土生金之义,全方配伍可清泻肺热,止咳平喘,培土生金而治疗肺热喘咳。古籍记载的泻白散主治病证虽广涉内、外、妇、儿等各科病证,但论其病机总属"肺热气逆"。泻白散现代临床应用集中在呼吸系统、皮肤及皮下组织系统、耳鼻喉系统、消化系统、眼科系统等,具体地在治疗肺炎、咳嗽、支气管炎、鼻衄、痤疮、支气管扩张症、感染后咳嗽、便秘等病证更有优势。上述病证辨证符合以肺热为主要病理因素的相关证型,即可酌情加减运用该方。

Xiebaisan is one of the 100 classical prescriptions published by the state,and the research and development of its compound preparation has gradually become an upsurge. The research and development of classical prescriptions should start from the theory of traditional Chinese medicine and clinical practice,laying a solid foundation for research and development. Based on the above thinking,this study adopts the methods of traceability and bibliometrics to analyze the source,pathogenesis,efficacy,Fangyi and clinical application of Xiebaisan in order to further promote its literature research work. The results show that the origin of Xiebaisan can be traced back to the prescription of Xiefeitang in Yinhai Jingwei(Volume 1). Although there are more than20 prescriptions with the same name of Xiebaisan developed in later generations, they either reflect the inheritance and development of Qian Yi’s thought of composing prescriptions,or only the meaning of "Xiebai" in the name of the prescription. The main pathogenesis of Xiebaisan is adverse lung Qi of heat. Mori Cortex and Lycii Cortex are sweet and cold,which can clear away lung heat and reduce adverse Qi,and then cough and asthma can stop. Supplemented with Glycyrrhizae Radix et Rhizoma and japonica rice,which are endowed with the meaning of nourishing earth and generating gold,to invigorate spleen and replenish Qi. The compatibility of Xiebaisan can clear away lung heat,relieve cough and asthma,and norish erath and generate gold to treat lung heat,asthma and cough. Although the main treatment of Xiebaisan recorded in ancient books involves various diseases and syndromes of internal,external,gynecology and pediatrics,the pathogenesis of Xiebaisan is "adverse lung Qi of heat". Modern clinical application of Xiebaisan focuses on the respiratory system,skin and subcutaneous tissue system,ear,nose and throat system,digestive system,ophthalmic system,etc.,and it has more advantages in the treatment of pneumonia, cough, bronchitis, epistaxis, acne, bronchiectasis,postinfectious cough,constipation and other diseases. The syndrome differentiation of the above diseases is in accordance with the relevant syndrome types with lung heat as the main pathological factor,so we can modify and apply the prescription appropriately.