枳实薤白桂枝汤的历史源流考证及临床应用探析

Research on the Historical Origin and Clinical Application of Zhishi Xiebai Guizhi Decoction

枳实薤白桂枝汤是国家中医药管理局公布的第一批百首经典名方之一。对该方的历史源流、发展、认识以及临床运用做了系统的梳理。该方散见于晋唐时期医家的著作中,但该方的名称以及药物组成存在混乱的情况。魏晋至唐宋时期,对枳实薤白桂枝汤的认识和运用,多侧重从风、寒二邪立论;金元时期对胸痹则实现了向内因立论的突破;明清之后对该方的认识和运用多从气机逆乱立论。近代以来,该方的应用扩展至17个病种,涉及循环系统、消化系统、呼吸系统等多个系统疾病。主治为循环系统疾病中的心绞痛,其次为心肌梗死、心肌缺血。

Zhishi Xiebai Guizhi Decoction(ZXGD)is one of the first hundred classic prescriptions published by the National Administration of Traditional Chinese Medicine.A systematic review was conducted on the historical origin,development,understanding,and clinical application of this formula.ZXGD is scattered in the works of medical experts during the Jin and Tang dynasties,but there is a confusion in the name and composition of the prescription.From the Wei and Jin dynasties to the Tang and Song dynasties,the understanding and application of ZXGD mainly focused on discussing the two pathogens of wind and cold;during the Jin and Yuan dynasties,there was a breakthrough in the argument towards internal causes of chest pain;after the Ming and Qing dynasties,the understanding and application of this decoction were mostly based on the theory of qi inversion disorder.Since modern times,the application of ZXGD has expanded to 17 diseases,involving multiple systemic diseases such as the circulatory system,digestive system,and respiratory system diseases.The main treatment is angina in circulatory system diseases,followed by myocardial infarction and myocardial ischemia.