经典名方旋覆代赭汤历史沿革探析

Historical evolution of Xuanfu Daizhe Decoction

经典名方旋覆代赭汤首见于东汉张仲景《伤寒论》,原方由旋覆花、甘草、人参、生姜、代赭石、半夏、大枣7味药组成,用于治疗伤寒发汗误治后心下痞硬、噫气不除。旋覆代赭汤的历代医籍记载和论述丰富,后世医家对该方进行了广泛的临床应用,不断拓展了该方的方义及其功能主治。该文全面收集整理了经典名方旋覆代赭汤的古今文献记载,从处方来源、方剂组成、药物剂量、药味炮制、临床应用、方义方解、煎煮法等方面对旋覆代赭汤进行系统的梳理和分析,发现历代记载的旋覆代赭汤药味组成及其炮制方法较为一致,临床处方用量呈现逐渐减少的趋势,古代临床中主要用于治疗反胃、呕吐、呃逆、便秘等疾病,而现代临床主要用于治疗反流性食管炎、胃炎等消化系统疾病,古今临床应用广泛。通过对旋覆代赭汤历史沿革的探析和考证,可以明确该方的药味组成、处方剂量、药味炮制、方义衍变及煎煮方法,为经典名方旋覆代赭汤的复方制剂研发提供思路。

Xuanfu Daizhe Decoction,first seen in Zhang Zhongjing′s Treatise on Cold Damage Diseases,was composed of seven medicinal materials:Inulae Flos,Glycyrrhizae Radix,Ginseng Radix,Zingiberis Rhizoma Recens,Haematitum,Pinelliae Rhizoma and Jujubae Fructus.It was used to treat gastric fullness and hardness and belching due to the wrong treatment of typhoid fever and sweating.With detailed records and description in ancient medical books,Xuanfu Daizhe Decoction was widely adopted in clinical practice by physicians of later generations,which expanded its main therapeutic functions.By comprehensive collation of ancient and modern literature on Xuanfu Daizhe Decoction,this paper systematically explored the historical evolution of the prescription from the source,composition,dosage,processing,clinical application,function interpretation and decocting method.It was found that the composition and processing method of the prescription in the past dynasties were relatively consistent,and there was a gradual decrease in dosage in clinical application.In ancient times,Xuanfu Daizhe Decoction was mainly used to treat nausea,vomiting,hiccups,constipation,etc.,while modern clinicians mainly used it for digestive diseases such as reflux esophagitis and gastritis.Through the analysis and textual research,the composition,dosage,processing,function evolution and decocting method of this prescription were determined,which provided reference for the research and development of compound preparations of Xuanfu Daizhe Decoction.