经典名方茵陈蒿汤的关键信息考证

Textual Analysis of Classic Formulas Yinchenhao Tang Based onAncient and Modern Literature

茵陈蒿汤临床疗效确切,自东汉《伤寒论》至今广为流传记载,是一首被历代医家推崇的清热、利湿、退黄经典名方,收录于2023年国家中医药管理局公布的《古代经典名方目录(第二批汉族医药)》。笔者采用文献计量学的方法,搜集茵陈蒿汤相关古籍文献数据共801条,筛选出有效数据36条,涉及中医古籍36部。从茵陈蒿汤的方源方名、组成、功效、方义分析、药物基原、剂量、制法用法、主治及现代临床应用等方面进行梳理分析。笔者建议茵陈蒿汤现代用量及用法为茵陈82.8 g、栀子12.6 g、大黄27.2 g,煎服方法为茵陈先加水2 400 mL煮至约1 200 mL,再加入栀子和大黄煮取600 mL,去除药渣,每次温服200 mL,每日服用3次。茵陈蒿汤的功效为清热利湿退黄,主治病症以湿热发黄为主。方中茵陈蒿为君,主利湿退黄;栀子为臣,主清泄三焦利小便;大黄为佐,主泄热退黄。该方现代应用遍布肝胆系统、皮肤系统、内分泌系统、消化系统等,具体在黄疸、黄疸型肝炎、乙型病毒性肝炎更有优势。通过对茵陈蒿汤古籍文献的挖掘梳理,确定其关键信息,以期为经典名方的临床应用及新药研发提供科学参考。

Yinchenhao Tang has definite clinical efficacy.It has been inherited and documented since the ancestor of Shanghanlun in the Eastern Han dynasty and is a classical formulas for clearing away heat,promoting diuresis,and eliminating jaundice adopted by medical experts of successive generations.It has been included in the Catalogue of Ancient Classical Formulas(the Second Batch of Han Medicine)published by the National Administration of Traditional Chinese Medicine(TCM)in 2023.By means of bibliometrics,801 pieces of ancient literature data related to Yinchenhao Tang were collected,and 36 pieces of effective data were selected,involving 36 ancient books of TCM.The origin,name,composition,efficacy,formula and meaning analysis,drug origin,dosage,preparation method and usage,indications,and modern clinical application of Yinchenhao Tang were analyzed.It was suggested that the modern dosage and application of Yinchenhao Tang should be as follows:The 82.8 g of Artemisiae Scopariae Herba,12.6 g of Gardeniae Fructus,and 27.2 g of Rhei Radix et Rhizoma.The formulas was prepared by firstly adding 2400 mL of water into Artemisiae Scopariae Herba and boiling it to about 1200 mL,then adding Gardeniae Fructus and Rhei Radix et Rhizoma to boil it for 600 mL,and removing the residue.It could be orally taken for 200 mL each time in warm conditions,three times a day.Yinchenhao Tang has the effect of clearing away heat,promoting diuresis,and eliminating jaundice,and it mainly treats symptoms of hygropyretic jaundice.In the formulas,Yinchenhao Tang is the monarch drug,which is mainly to remove dampness and jaundice.Gardeniae Fructus is the ministerial drug,which is mainly responsible for clearing the triple energizer and facilitating urination.Rhei Radix et Rhizoma is an adjuvant,mainly responsible for clearing away heat and eliminating jaundice.The modern application of this formulas involves the hepatobiliary system,skin system,endocrine system,digestive system,etc.,and it has more advantages in treating jaundice,icteric hepatitis,and hepatitis B.In this study,the ancient literature related to Yinchenhao Tang was sorted out to determine its key information,so as to provide a scientific reference for clinical application of classic formulas and new drug development.