浅谈牵正散起源及其临床误用

Discussion on Origin and Clinical Misuse of Qianzheng Powder

从历代文献出发,剖析牵正散误用、滥用现象之根源,从牵正散原方药味配伍、牵正散组成同类相似方、《杨氏家藏方》原文、《杨氏家藏方》近时期古医籍中牵正散相关内容等多方面分析总结,认为牵正散设立之初的适应证应为中风伴见口眼歪斜之症,但手足、言语、神志兼症不明显,类似于现代医学之中枢性面瘫,而非周围性面瘫,故临床运用亦相应限于中枢性面瘫、面瘫后遗症伴见痉挛或风痰阻络型周围性面瘫,切忌见“口眼歪斜”之症则皆投之以牵正散,方可收良效。

Based on the literature of the past dynasties,this paper analyzes the course of the phenomenon of misuse and abuse of Qianzheng Powder,and summarizes from the aspects of Chinese herbs and compatibility of the original formula of Qianzheng Powder,similar formulas containing Qianzheng Powder,original text of Yang Shi Jia Cang Fang(Secret Formulas of the Yang Family)and contents related to Qianzheng Powder in ancient medical books around the period of Yang Shi Jia Cang Fang.It is believed that the initial indication of Qianzheng Powder was stroke complicated with otogenic facial palsy,but the comorbidity of the hands and feet,speech and conscious mind was not obvious,so it was more like the central facial paralysis rather than peripheral facial paralysis.Therefore,in clinical practice,its usage should be limited to central facial paralysis,sequelae of facial paralysis complicated with spasm or peripheral facial paralysis of wind-phlegm obstructing the collaterals.It is not suitable to irrationally use Qianzheng Powder when there is otogenic facial palsy,which can achieve good effect.