经方中丸剂的制备与应用规律

Regularities in Preparation and Application of Pill Formulas in Classical Formulas

从组成、制备、服用与病症4个方面,考查《伤寒杂病论》中22首丸剂的应用规律,总结如下。①经方中土鳖虫等虫类药物主要用于丸剂和散剂,其在丸剂中的功效以活血化瘀为主,含虫类丸剂必配伍桃仁、大黄。②10首丸剂经方含有籽仁类药物;经方剂型改汤为丸时常需加入籽仁类药物,或将原方籽仁类药物加量,取其濡润之性,以化瘀、通下,兼具赋形剂的作用。③部分丸剂经方需煎煮。④丸剂经方治疗病症病位大多在里,病程较长;最常见的主治症状为腹部不适。⑤丸剂经方用于急重症、慢性发作性疾病,所治实证涉及的病理产物主要有瘀血和水饮。⑥12首丸剂经方中用到毒性药物,通过组方配伍、控制用量、制备过程中加热等方式减毒。⑦用于急重症的丸剂多含有毒性药物、虫类药物,药味数偏少,药丸重量较大,采用顿服或不下再服的方法,强调中病即止;缓图的丸剂补益药与活血行气药并行,药味数较多,药丸较小,服用时长可达数月。

From the aspects of composition,preparation,administration and symptoms,the application regularities of 22 pill formulas in Treatise on Cold Pathogenic and Miscellaneous Diseases are examined and summarized as follows.①In classical formulas,insect medicinals such as Tubiechong(Eupolyphaga Steleophaga)were mainly used in pill formulas and powder formulas.Their main effect in pill formulas was to promote blood circulation and remove blood stasis.Insect-containing pills must be compatible with Taoren(Persicae Semen)and Dahuang(Rhei Radix et Rhizoma).②Ten pill formulas contained seed medicinals;when changing from decoction to pills,it was often necessary to add seed medicinals or increase the amount of original seed medicinals to take advantage of their moistening property for removing blood stasis,increasing body fluid to lubricate bowels,as well as acting as a excipient.③Some pill formulas required boiling before administration.④Most of the diseases treated by pill formulas were located internally and had a relatively long duration.The most common symptom treated by pill formulas was abdominal discomfort.⑤Pill formulas were used for acute severe illnesses and chronic recur-rent diseases and the interior syndromes treated with pill formulas involved pathological products such as blood stasis and fluid retention.⑥Twelve pill formulas contained toxic medicinals,but their toxicity was reduced through prescription compatibility,dosage control,and heating during preparation process.⑦Pills used for acute severe illnesses included toxic medicinals and insect medicinals.They contained fewer types of medicinals,but each pill had a larger weight.Such pills were recommended to be taken once or again if not effective,with an emphasis on stopping medication when condition improves.Tonic pills,intended for gradual improvement,combined tonifying medicinals with blood-activating and qi-moving medicinals.They contained more types of medicinals but were smaller in size,making them suitable for several months of use.