小承气汤的古今文献分析

Textual Research on Ancient and Modern Literature of Xiao Chengqitang

小承气汤出自东汉时期张仲景所著的《伤寒论》,由大黄、厚朴和枳实3味药组成,主要用于治疗外感阳明腑实轻证。其已被收录在《古代经典名方目录(第一批)》,但由于原方记载的饮片炮制规格、剂量均与现代习惯用法有所出入,造成小承气汤颗粒剂的研发存在一定的困难。为明晰处方的历史沿革、剂量,以及药味的基原和炮制规格等关键信息,笔者拟对历代医学古籍和相关文献进行系统梳理和分析,并参考张仲景的生平相关经历,确定小承气汤的现代处方组成及煎煮方法为"酒洗大黄(药用大黄)55.2 g,姜厚朴(厚朴)27.6 g,清炒枳实(酸橙)39.0 g,加水800 mL,煎煮至240 mL,过滤,即得"。

Xiao chengqitang is recorded in Treatise on Febrile Diseases written by ZHANG Zhong-jing in the Eastern Han dynasty. It is composed of Rhei Radix et Rhizoma,Magnoliae Officinalis Cortex and Aurantii Fructus Immaturus,which is mainly used to treat mild exogenous Yangming Fu-viscera excess syndrome. This formula has been included in the Catalogue of Ancient Classical Prescription(The First Batch). However,the processing specifications and doses recorded in the original formula are different from the modern usage,which results in some difficulties in the research and development of Xiao Chengqitang granules. For clarifying the key information, such as historical evolution of prescription, dose conversion, the origin and processing specifications of each medicine in the prescription,the paper systematically analyzes the ancient medical books and related literature in the past dynasties and refers to the life experience of ZHANG Zhong-jing. Then the modern prescription and decocting methods of Xiao Chengqitang were determined as follows:composing 55.2 g of Rhei Radix et Rhizoma(Rheum officinale)washed with wine,27.6 g of Magnoliae Officinalis Cortex(Magnolia officinalis)processed with ginger and 39.0 g of stir-fried Aurantii Fructus Immaturus(Citrus aurantium),adding 800 mL of water,decocting to 240 mL and filtrating.