经典汉方通脉四逆汤古今文献分析及关键信息考证

Textual and Key Information Research of Classical Prescription Tongmai Sini Decoction(通脉四逆汤)Based on Ancient and Modern Literature

目的系统梳理古今文献中关于通脉四逆汤的条文及研究,考证分析通脉四逆汤的古代文献及现代临床应用,为通脉四逆汤的现代临床应用以及制剂研发提供科学依据。方法采用文献计量学方法整理“通脉四逆汤”的主治病证、药物组成、炮制法、用药剂量、煎服法等信息的条文及有关临床研究,依据纳、排标准进行筛选,纳入书名、主治、药物及剂量、煎服法等,以考证通脉四逆汤的关键信息。结果共搜集892条数据,最终筛选纳入通脉四逆汤相关条文52条,涉及古籍46本。通脉四逆汤首载于汉代张仲景《伤寒论》,由生附子、干姜、炙甘草组成。以汉代度量衡为标准将药物剂量换算至现代,建议附子用量15 g,干姜41.4 g,炙甘草27.6 g,以水600 mL,煎至240 mL,温服,去渣,日2次。古代所治主要病证为霍乱、少阴下利、手足厥逆等。共纳入27篇现代文献,分析通脉四逆汤的现代临床应用,主要用于治疗心血管系统疾病、肌肉骨骼系统及结缔组织系统疾病、泌尿生殖系统疾病等。结论通过古今文献考证分析发现,通脉四逆汤在后世流传中其药物组成、用药剂量、主治病证、煎服方法等均未有大的变化。通脉四逆汤的现代临床应用促进了中医药的传承发展,并为其药物研发提供科学依据。

Objective To systematically review documents and researches of Tongmai Sini Decoction(通脉四逆汤)in ancient and modern literature,analyze ancient documentation and modern clinical applications of Tongmai Sini Decoction,and provide scientific reference for the clinical application and new drugs development.Methods Using the the method of bibliometrics,the indications,drug composition,processing methods,drug dosage,decocting methods and other information of Tongmai Sini Decoction extracted from ancient Chinese medical texts and relevant clinical studies were analyzed,selected and screening according to certain inclusion and exclusion criteria.The information including book name,indications,herbs and dosage,decocting methods were included to research and obtain the key information of Tongmai Sini Decoction.Results A total of 892 pieces of publications were collected.After screening,52 pieces of relevant documents were included involving 46 ancient books.Tongmai Sini Decoction was first recorded in the Treatise on Cold Pathogenic Disease,which were composed of unprocessed Fuzi(Aconm Lateralis Radix Praeparaia),Ganjiang(Zingiberis Rhizoma)and Zhigancao(Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle).Converted to modern measurement from the original measurement of the Han Dynasty,the recommended dosage and decocting method was unprocessed Fuzi(Aconm Lateralis Radix Praeparaia)15 g,Ganjiang(Zingiberis Rhizoma)41.4 g,Zhigancao(Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle)27.6 g were decocted with 600 mL of water to 240 mL,taken warm and twice daily,abandon slag.Ancient indications of this prescription are cholera,diarrhea in Shaoyang meridian,reversal cold of the extremities and other diseases.27 pieces of modern research articles were included to analyze the modern application of Tongmai Sini Decoction.This prescription was mainly used in treating cardiovascular system diseases,musculoskeletal system and connective tissue diseases,genitourinary system diseases and etc.Conclusion Textual research of ancient and modern literature showed that herb composition,dosage,indications,processing and decocting methods of Tongmai Sini Decoction are consistent with the original record in the successive generations.The modern clinical application of Tongmai Sini Decoction has promoted inheritance and development of Chinese medicine,and have served as a scientific reference for developing new drugs.