金匮肾气丸历史演变考证

Historical Evolution and Textual Study of Jingui Shenqi Pill(金匮肾气丸)

查阅历代医方著作、本草典籍,对金匮肾气丸名称以及药物组成演变进行考证。考证发现:金匮肾气丸因出自《金匮要略》而得名,其组成应为八味。在元代时期有部分医家认为金匮肾气丸组成为六味,并将其与六味地黄丸等同,显然这种认识是错误的。明清时期有部分医家认为金匮肾气丸组成为十味,对现代制药产生了较大的影响,但经考证发现,现代十味药物组成的金匮肾气丸是由济生肾气丸演变而来,并非金匮肾气丸原方。所以现在《中药成方制剂》规定金匮肾气丸药物组成为十味并不合理。历代医方著作所载金匮肾气丸多以八味肾气丸、八味丸、桂附地黄丸等名称出现,其药物组成中“地黄”经历了“地黄→熟干地黄→熟地黄”的变化,“桂”经历了“桂→桂心→肉桂”的变化,体现了历代医家中药炮制技术以及中药材分部位用药认识的进步。

The name of Jingui Shenqi Pill(金匮肾气丸)and the evolution of the composition were verified by consulting the medical works and herbal classics of the past dynasties.The textual study found that Jingui Shenqi Pill was named because it came from Synopsis of the Golden Chamber,consisting of eight Chinese medicinals.Some doctors in the Yuan Dynasty believed that Jingui Shenqi Pill was composed of six Chinese medicinals,equal to Liuwei Dihuang Pill(六味地黄丸),which was obviously wrong.During the Ming and Qing Dynasties,some doctors believed that Jingui Shenqi Pill was composed of ten Chinese medicinals,which had a great impact on modern pharmacy.However,through textual study,it was found that the Jingui Shenqi Pill consisting of ten Chinese medicinals was evolved from the Jisheng Shenqi Pill(济生肾气丸),instead of the original formula of Jingui Shenqi Pill.Therefore,it is unreasonable to stipulate that Jingui Shenqi Pill is composed of ten Chinese medicinals in the National Standard for Chinese Pantent Drugs.The Jingui Shenqi Pill recorded in the medical books of the past dynasties mostly appeared in the names of Bawei Shenqi Pill(八味肾气丸),Bawei Pill(八味丸)and Guifu Dihuang Pill(桂附地黄丸),etc..In its medicinal composition,Dihuang(Rehmannia Radix)experienced the changes of“Dihuang(Rehmannia Radix)→prepared and dried Dihuang→Shudihuang(Rehmanniae Radix Praeparata)”,and Gui experienced the changes of“Gui→Guixin→Rougui(Cinnamomi Cortex)”,which reflected the progress of the physicians of the past dynasties in processing technology and understanding of medication parts of Chinese medicinal materials.