《神农本草经》与经方应用之地黄篇

Shennong’s Classic of Materia Medica and Dihuang(Rehmannia Radix)in Application of Classic Formulas

《神农本草经》(简称《本经》)记载“干地黄,味甘寒,主治折跌绝筋,伤中,逐血痹,填骨髓,长肌肉。作汤除寒热积聚,除痹。生者尤良”。以《本经》功效为纲,归类分析《伤寒论》《金匮要略》中相关方证,探讨地黄的实际临床功效,拓展地黄的临床应用范围。炙甘草汤之地黄,续绝筋;大黄蛰虫丸之地黄,逐血痹;肾气丸之地黄,填骨髓;薯蓣丸之地黄,长肌肉;百合地黄汤之地黄,除寒热积聚。除《本经》所载功效外,张仲景及后世医家运用地黄还有新发展:《金匮要略》之黄土汤、《温病条辨》之清营汤、《伤寒总病论》之大黄散、《石室秘录》之两地丹、《圣惠方》之地黄酒、《金匮翼》之小蓟饮子皆可体现地黄滋阴凉血止血作用;《金匮要略》之防己地黄汤、时方之大定风珠皆可体现生地黄滋阴养血息风之义;增液汤、益胃汤、一贯煎、百合固金汤之生地黄养阴生津以速救脏腑内燥。从《本经》原文内容出发,推演经方的用药配伍,探讨地黄的实际临床功效,有利于拓展地黄的临床应用范围。

It was recorded in Shennong’s Classic of Materia Medica that“Gandihuang(Rehmannia Radix),sweet in taste and cold in property,was mainly used to treat fracture of bones and sinews due to falling and visceral injury,to expel blood impediment,to enrich marrow,and promote growth of muscles.When made into decoction,it could eliminate accumulation of cold and heat and impediment syndrome.The therapeutic effect of raw Dihuang was better than the processed one.”Taking the efficacy of Dihuang Recorded in Shennong’s Classic of Materia Medica as the framework,the relevant formulas in Treatise on Cold Damage Diseases and Synopsis of the Golden Chamber were classified and analyzed to investigate the actual clinical efficacy of Dihuang and expand the scope of clinical application.Dihuang in Zhigancao Decoction(炙甘草汤)could treat fracture of bones and sinews.Dihuang in Dahuang Zhechong Pill(大黄蛰虫丸)could expel blood impediment.Dihuang in Shenqi Pill(肾气丸)could enrich marrow.Dihuang in Shuyu Pill(薯蓣丸)could promote growth of muscles.Dihuang in Baihe Dihuang Decoction(百合地黄汤)could eliminate accumulation of cold and heat.In addition to the efficacy contained in Shennong’s Classic of Materia Medica,ZHANG Zhongjing and later physicians made new development in the application of Dihuang:Huangtu Decoction(黄土汤)in Synopsis of the Golden Chamber,Qingying Decoction(清营汤)in Systematic Differentiation of Warm Diseases,Dahuang Powder(大黄散)in General Treatise on the Diseases of Cold Damage,Liangdi Elixir(两地丹)in Secret Records in a Stone Room,Dihuang Wine(地黄酒)in Formulas from Benevolent Sages and Xiaoji Drink(小蓟饮子)in Appendices to Synopsis of the Golden Chamber could all reflect the effect of Dihuang on nourishing yin,cooling blood and stanching bleeding.Both Fangji Dihuang Decoction(防己地黄汤)in Synopsis of the Golden Chamber and Dadingfeng Pill(大定风珠)in current formulas could reflect the Shengdihuang’s significance of replenishing yin,nourishing blood and extinguishing wind.Shengdihuang in Zengye Decoction(增液汤),Yiwei Decoction(益胃汤),Yiguang Decoction(一贯煎)and Baihe Gujin Decoction(百合固金汤)could nourish yin and promote fluid production to quickly cure the internal dryness of the viscera.Based on the original content of Shennong’s Classic of Materia Medica,the medication and compatibility of classic formulas were deduced to analyze the actual clinical efficacy of Dihuang,which was conducive to expanding the clinical application scope of Dihuang.