《清宫医案集成》中外感热病治疗中成药的运用

Application of Chinese patent medicines for external-contraction febrile disease in Medical Records Integration of Palace in Qing Dynasty

该文通过收集和整理《清宫医案集成》运用中成药治疗外感热病的医案,统计病证、中成药种类、中成药类别、中成药剂型,得出外感热病医案的中成药使用概况。患者发病与体质、饮食、情志密切相关,故以感冒、暑温、冒暑等外感热病多见并常兼夹湿、积滞、痰、郁热等内因,而在用药上以益元散、六一散为代表的清热祛暑剂最多,其次是消食导滞剂、五官科和外科用药等。通过分析常用中成药的组成配伍及运用特点,将收集的中成药与2020年版《中国药典》中共有中成药进行对比,寻找异同点,对现今中成药的运用有启发作用。在中成药研究开发中,应重视炮制工序对成药功效的影响,充分挖掘经典古方的应用价值;研究传统配方中金石、矿物类药的配伍意义对于现代中成药组方优化和疗效提升非常重要。在临床运用方面,总结清朝宫廷中成药的适应症、服法和临床使用模式对于当今临床有重要借鉴意义。参考清朝宫廷的防疫政策并且发掘具有防疫功能的代茶饮,为疫病的防治提供思路。

Medical records in the treatment of external-contraction febrile diseases with Chinese patent medicines in Medical Records Integration of Palace in Qing Dynasty were collected and the syndromes of the diseases,and types,categories,and dosage forms of the medicines were summarized to analyze the use of Chinese patent medicines for the external-contraction febrile diseases.The incidence of the diseases is closely related to the constitution,dietary habit,and emotion of patients.Therefore,the diseases were mainly manifested as cold,warm disease in summer,and summerheat-caused affection,and they were also attributed to the internal causes such as dampness,indigestion,phlegm,and stagnated heat.Thus,heat-clearing and summerheat-expelling formulas represented by Yiyuan Powder and Liuyi Powder were most frequently used,followed by the formulas for promoting digestion and removing food stagnation and formulas of ophthalmology and otorhinolaryngology and surgery department.The composition and application of the most common Chinese patent medicines were analyzed,and the medicines which were also recorded in Chinese Pharmacopoeia(2020)were selected for further comparison to provide a reference for the current application of them.In the development of Chinese patent medicines,the influence of the processing on the efficacy should be emphasized and the application value of classical prescriptions should be further explored.It is of great significance for the composition optimization and efficacy improvement of modern Chinese patent medicines to study the compatibility of mineral medicinals in traditional formulas.When it comes to application in clinical settings,the indications,usage,and application modes of the Chinese patent medicines of Qing Dynasty are of reference value for modern application.Moreover,the anti-epidemic policies and anti-epidemic tea drinks in the records can serve as a reference for the prevention and control of pestilence diseases at present.