汪文绮《杂症会心录》产后病用药特色探析

Medications characteristics for postpartum diseases in WANG Wenqi’sRecords of Insights into Miscellaneous Diseases

目的 采用数据分析方法,探析新安医家汪文绮治疗产后病的用药特色及规律,以拓宽产后病临证用药思路。方法 整理汪文绮《杂症会心录》中涉及妇人产后病的10篇各论中的附录方剂,提取处方药物,查询药物归经、性味、功效分类等,统计相应的频次、频率等。结果 汪文绮在产后病的治疗中共用基础方28首,其中使用最为频繁的是生化汤加减方,使用频率为15.6%;共使用药物60味,总用药频次307次,常用药物有甘草、人参、当归、茯苓、熟地黄等;60味中药按功效分为13大类,其中补虚药的使用频率最高;药物属性以温、平性及甘、辛、苦味为主,主要归脾、心、肾经。结论 汪文绮治疗妇人产后诸病,以气血两虚为诸症之本,以重补气血为基本治疗大法;基于妇人产后多虚、多瘀的体质特点,攻邪、补元并施,重视脾、肾二脏,重温补,扶元阳。

Objective To explore the medications characteristics and rules of Xin’an doctor WANG Wenqi in the treatment of postpartum diseases by using data analysis method,whereby broadening the clinical medication ideas for them.Methods The appendix prescriptions in the 10 monographs involving women with postpartum di⁃seases in Records of Insights into Miscellaneous Diseases by WANG Wenqi were sorted out,the prescriptions and me⁃dicinals therein were extracted,the meridian tropism,property,taste and efficacy classification of medicinals were searched,and the corresponding frequency,number of frequencies etc.were counted.Results WANG Wenqi used 28 basic prescriptions to treat postpartum diseases,among which modified Shenghua Tang(生化汤)was used most frequently,with a frequency of 15.6%.Totally 60 flavors of medicinals were used,with the total medication frequen⁃cy of 307 times,the commonly used ones therein were Glycyrrhizae Radix,Ginseng Radix,Angelicae sinensis Radix,Poria,Rehmanniae preparata rhizoma,etc.The 60 flavors of Chinese materia medica were divided into 13 categories according to their efficacy,among which the most frequently used were those for reinforcing deficiency.The proper⁃ties thereof were mainly warm,mild,sweet,pungent and bitter.Its main meridian tropism were the spleen,heart and kidney meridians.Conclusion WANG Wenqi’s treatment of women with postpartum diseases takes the deficiency of qi and blood as the root of all the diseases,and takes heavily invigorating qi and blood as the basic therapeutic method.Based on the physical characteristics of postpartum women with more deficiency and stasis,he simulta⁃neously uses the medicals with attacking pathogenic factors and invigorating primordial qi,gives consideration to both spleen and kidney viscera,focusing on warming and invigorating as well as strengthening primordial yang.