经典名方济川煎的古代文献考证

Jichuanjian:A Literature Review

济川煎出自《景岳全书》(明·张景岳),是国家中医药管理局2018年公布的《古代经典名方目录(第一批)》中的经典名方之一。笔者采用文献计量学方法,收集了相关古籍数据43条,涉及中医典籍26部,系统地梳理了济川煎的历史源流、主治病证、组成及方义衍变、剂量、炮制、煎服方法等,为经典名方的研发和临床应用提供了古代文献证据支持。归纳分析发现济川煎历代主治病证有所扩展,除原方记载的虚秘、产后便秘、气瘕之外,此方还可用于燥结、血瘕、阴结、小儿大便闭结、目病及肺(肠)。其方证的适应人群从成人、产妇扩展到了小儿,病证范围也从内科、妇产科延展到了儿科、五官科等。虽然历代医家记载了济川煎加减方,但当归、牛膝、肉苁蓉、泽泻、升麻、枳壳的配伍组成、相对恒定,煎服法也多沿用了水煎,食前服;同时,清医家对其进行了大量的方义论述,但鲜有争议。

Jichuanjian,a famous classical formula with definite clinical efficacy in Jingyue Quanshu(《景岳全书》)by ZHANG Jing-yue in the Ming Dynasty,was included in the Catalogue of Ancient Famous Classical Formulas(The First Batch)published by the National Administration of Traditional Chinese Medicine(TCM)in 2018.By means of bibliometrics,43 relevant ancient book data were collected,including 26 ancient books of TCM. The historical origin and development,main indications and symptoms,composition and prescription,dosage,processing,and decoction and administration methods of Jichuanjian were systematically summarized to provide literature support for the development and clinical application of famous classic formulas.It was found that the main symptoms of Jichuanjian were expanded in the past dynasties from deficiency constipation,postpartum constipation,and qi stagnation recorded in the original formula to additional dryness accumulation,blood stasis,Yin constipation,infantile constipation,and lung(intestine)diseases induced by eye diseases. The applicable population of Jichuanjian was extended to children in addition to puerpera and adults,and the disease scope was extended to pediatrics,ophthalmology,and otorhinolaryngology in addition to internal medicine,gynecology and obstetrics. Although Jichuanjian was modified by doctors in the past dynasties,the compatibility of Angelicae Sinensis Radix,Achyranthis Bidentatae Radix,Cistanches Herba,Alismatis Rhizoma,Cimicifugae Rhizoma and Aurantii Fructus has been constant. The decoction and administration methods basically remained unchanged,i. e.,water decoction and administration before meals.Meanwhile,doctors in the Qing Dynasty made a lot of general comments on this formula with little controversy.