经典名方达原饮的关键信息考证

Textual Research on Key Information of Ancient Classical Prescription Dayuanyin

达原饮是治疗湿邪伏于膜原证的代表方,首载于《温疫论》,为明代医家吴又可创制的治疫名方,在新型冠状病毒肺炎湿邪郁肺证的治疗中亦发挥重要作用。该文基于"中华医典(V5.0)"软件及"中医古籍数据库""国医典藏"数据库,以"达原饮""达原散"为检索词进行检索,对古籍原文进行标引整理、统计分析及考证,对"达原饮"从组成剂量、药味基原炮制、功能主治、制法服法及现代基础研究与临床应用等方面进行古今文献收集与分析,以期为达原饮的现代开发与临床应用提供文献参考依据。结果发现组成上,多数医籍依照原方药物组成,部分医籍在"芍药""草果"两味药的记载有区别;剂量上,总体变化不大,差异主要见于"草果"一味药;炮制上,历代文献记载本方组成药味均未明确特殊炮制要求,建议生品入药;制服法上,历代医籍大多遵原书,部分医籍记载以生姜为引,部分医籍在煎煮水量及服药时间上有变化;功效主治上,原书记载达原饮"使邪气溃败,速离膜原",后历代医籍记载治疗疾病包括"瘟疫""疫疟""温疫""时疫"等,主治主要围绕"疫病",以邪伏膜原为病机,以发热为表现的各类疾病;临床应用上,古代医家多以"发热""舌上白苔如积粉"为本方应用的重要指征,现代医家将达原饮广泛运用于发热及消化、呼吸、泌尿、内分泌等多个系统疾病及皮肤病、儿科疾病,同时对流感,严重急性呼吸综合征(SARS),禽流感等流行性传染病具有确切疗效。

Dayuanyin,a representative prescription for the treatment of dampness pathogen lodging in pleurodiaphragmatic interspace syndrome,was first recorded in Treatise on Pestilence(《温疫论》)by Wu Youke in the Ming Dynasty for dealing with pestilence,and it still plays an important role in the treatment of corona virus disease 2019(COVID-19)differentiated into dampness stagnating in lung syndrome.The related original ancient records were retrieved from the Chinese Classics of Traditional Chinese Medicine(Version 5.0),Fulltext Database of Ancient Chinese Medicine Books,and Ancient Books of Traditional Chinese Medicine Database(http://www.gydc.ac.cn:81/),with ’Dayuanyin’ and ’Dayuansan’ as the search terms,followed by statistical analysis and textual research.The composition,dosage,processing of original medicinal materials,efficacy,indications,processing and administration methods,modern basic research,and clinical applications of Dayuanyin were summarized,so as to provide literature reference for its modern development and clinical application.The findings demonstrated that the composition in most medical records was identical with that of the original prescription,except that some records concerning Angelicae Dahuricae Radix and Tsaoko Fructus differed.In terms of dosage,it did not change much,with the only difference observed in Tsaoko Fructus.The processing methods of medicinal materials in Dayuanyin were not specified in historical records,so the raw medicinal materials were recommended.The processing and administration methods in the original record were basically followed in the later generations,except that some medical records chose Zingiberis Rhizoma Recens as the guide and changed the decocting amount and administration time.In terms of efficacy and indications,Dayuanyin was originally developed for dispelling pathogenic Qi away from the pleurodiaphragmatic interspace,but later employed for the treatment of such diseases as ’pestilence’,’epidemic malaria’,and ’seasonal epidemic’.It was mainly indicated to ’epidemic diseases’ with latent pathogen in pleurodiaphragmatic interspace as the pathogenesis and fever as the manifestation.In modern clinical application,ancients physicians considered ’fever’and ’powder-like tongue coating’ as the important signs for this prescription.Modern physicians have utilized Dayuanyin for treating fever,diseases in the digestive,respiratory,urinary,and endocrine systems,skin diseases,pediatric diseases,as well as epidemic diseases like influenza,severe acute respiratory syndrome(SARS),and avian flu due to its good effects.