儿科经典名方消乳丸的古代文献考证

Pediatric Classic Prescription Xiaoruwan Based on Ancient Literature

消乳丸是2022年国家中医药管理局公布的《古代经典名方目录(第二批儿科部分)》中的儿科经典名方之一,临床疗效确切,但当前暂未转化为中成药制剂。笔者采用文献计量学的方法,搜集消乳丸相关古籍文献数据共173条,筛选出有效数据99条,涉及中医古籍46部,该研究从消乳丸的方源方名、组方剂量、药物基原、制法用法、主治功效等方面进行梳理分析,考证结果显示消乳丸可能出自宋代医家汤民望的《婴孩妙诀论》,在历代古医籍记载中有消食丸、杨氏消乳丸、快膈消食丸等异名,但主要以消乳丸之名记载在册,该方由香附、砂仁、陈皮、神曲、麦芽及甘草6味药组成,炮制方法为香附、神曲、麦芽炒用,甘草炙用,砂仁、陈皮生用,功效为温中快膈,止呕吐,消乳食,主治乳食积滞所致的呕吐、泄泻、夜啼等诸多病证。历代古籍记载中使用最多的组方剂量折算成现代用量为香附41.30 g、砂仁20.65 g、陈皮20.65 g、神曲20.65 g、麦芽20.65 g、甘草20.65 g,制剂为丸剂,在服用方法上主张以温开水或姜汤送下,服药时间为食后。通过对消乳丸古籍文献的挖掘梳理,确定其关键信息,以期为经典名方的临床应用及研发申报提供参考。

Xiaoruwan is one of the classic prescriptions included in the Catalogue of Ancient Classic Prescriptions(the Second Batch of Pediatrics)published by the National Administration of Traditional Chinese Medicine(TCM)in 2022 with definite clinical efficacy,but it has not been converted into Chinese patent medicine preparations.The authors collected 173 pieces of data based on ancient literature on Xiaoruwan by the method of bibliometrics and selected 99 pieces of effective data,involving 46 ancient books of TCM.The study analyzed the historical development origin,prescription names,formulation rules,dosage,drug origin,preparation method and usage,indications and functions,and other aspects of Xiaoruwan.The results showed that Xiaoruwan was presumably derived from Ying Hai Miao Jue Lun(《婴孩妙诀论》)written by TANG Minwang,a doctor in the Song Dynasty.In the records of ancient medical books,there are names such as Xiaoshiwan,Yangshi Xiaoruwan,and Kuaige Xiaoshiwan,but they are mainly recorded in the name of Xiaoruwan.The prescription was composed of Cyperi Rhizoma,Amomi Fructus,Citri Reticulatae Pericarpium,Massa Medicata Fermentata,Hordei Fructus Germinatus,and Glycyrrhizae Radix et Rhizoma.In terms of processing method,Cyperi Rhizoma,Massa Medicata Fermentata,and Hordei Fructus Germinatus are fried,Glycyrrhizae Radix et Rhizoma is processed,and raw materials of Amomi Fructus and Citri Reticulatae Pericarpium are used directly.In terms of function,it is effective in warming the middle,improving digestion,stopping vomiting,and digesting milk and food.The main indications include vomiting,diarrhea,night crying,and other diseases caused by milk and food stagnation.The dosage of the most used prescription in the records of ancient books is Cyperi Rhizoma 41.30 g,Amomi Fructus 20.65 g,Citri Reticulatae Pericarpium 20.65 g,Massa Medicata Fermentata 20.65 g,Hordei Fructus Germinatus 20.65 g,and Glycyrrhizae Radix et Rhizoma 20.65 g,which are prepared into pills.In the taking method,it is recommended to take it with warm boiled water or ginger soup after meals.The study summarized the historical evolution of Xiaoruwan and identified the key information,with a view to providing a reference for the modern development and research of Xiaoruwan.