经典名方真武汤的历史沿革及临床应用规律

Historical evolution and clinical application law of Zhenwu Decoction

目的 考证真武汤的历史沿革和应用规律,为其深入研究提供精准的文献参考。方法 以真武汤为关键词,从《中华医典》检索、整理该方1991年1月以前的古籍。以真武汤、Zhenwu decoction、Zhenwu tang为主题词从中国知网、万方数据服务知识平台、维普网和Pub Med中获取2002年1月至2022年12月的临床研究文献。考证真武汤的处方来源、药物组成、剂量、炮制、功能主治、病证要素和应用规律。结果 纳入古籍92部,真武汤首载于《伤寒论》,由茯苓、芍药、白术、附子、生姜组成。剂量以茯苓三两、芍药三两、白术二两、附子一枚、生姜三两居多。在炮制方面,芍药以生白芍为主,白术以炒用为主,附子以熟附子为主。在应用规律方面,真武汤主要治疗少阴病和太阳病,涉及的症状有腹痛、小便不利、四肢疼痛、大便自利等,脾肾阳虚、阳虚水泛、心肾阳虚是临床应用真武汤的辨证要点。真武汤的应用涉及心血管、泌尿、消化等多系统,包括心力衰竭、糖尿病肾病、肾病综合征等疾病。结论本研究体现了真武汤的传承性、稳定性、有效性和安全性,为其研发提供了科学、客观的文献依据。

Objective To explore the historical evolution and clinical applications of Zhenwu Decoction,and provide more accurate literature reference for its in-depth study.Methods With Zhenwu Decoction as the key word,the ancient books before January 1991 related to this prescription were retrieved and sorted out from Chinese Medical Code.With Zhenwu Decoction,Zhenwu decoction,and Zhenwu tang as the main inscriptions,the clinical research literatures from January 2002 to December 2022 were obtained from CNKI,Wanfang Data,VIP,and PubMed.The prescription source,drug composition,dosage,processing,functional indications,disease and syndrome elements,and clinical applications of Zhenwu Decoction were studied.Results A total of 92 ancient books were included.Zhenwu Decoction was first published in Treatise on Cold Pathogenic Diseases.It was composed of Poria,Paeonia lactiflora Pall.,Atractylodis Macrocephalae Rhizoma,Aconiti Lateralis Radix Praeparata,and Zingiberis Rhizoma Recens.It was mainly composed of the dosage of three liang Poria,three liang Paeonia lactiflora Pall.,two liang Atractylodis Macrocephalae Rhizoma,one Aconiti Lateralis Radix Praeparata and three liang Zingiberis Rhizoma Recens.In terms of drug processing,Paeonia lactiflora Pall.was mainly raw,Atractylodis Macrocephalae Rhizoma was mainly stir-fried,and Aconiti Lateralis Radix Praeparata was mainly cooked.In terms of application law,Zhenwu Decoction could be used to treat Shaoyin disease and Taiyang disease,involving symptoms such as abdominal pain,urination disadvantage,limb pain,stool self-interest,and so on.Insufficiency of both the spleen and the kidney,edema syndrome due to yang deficiency,and heart and kidney yang deficiency were the key point of syndrome differentiation of clinical application of Zhenwu Decoction.The application of Zhenwu Decoction covered cardiovascular,urinary,digestive,and others.It could effectively treat heart failure,diabetic nephropathy,nephrotic syndrome,and other diseases.Conclusion This study reflects the inheritance,stability,effectiveness,and safety of Zhenwu Decoction,and provides scientific and objective literature basis for its research and development.