经典名方五虎汤的关键信息考证与现代临床应用

Historical Evolution and Modern Clinical Application of Wuhutang

五虎汤是《古代经典名方目录(第二批)》汉族医药方剂的第51首,来源于宋代杨士瀛《仁斋直指方》,由麻黄、苦杏仁、甘草、茶叶、石膏5味药物组成,主治喘急痰气。笔者遵从《古代经典名方关键信息考证原则》,采用文献计量学方法,搜集记载五虎汤的中医古籍文献,筛选出有效数据53条,涉及古籍41部。从五虎汤历史沿革、药物组成、主治病证、药物用量、制法用法、药物基原与炮制等方面进行挖掘梳理及系统研究。结果显示,在药物组成上,后世除遵原方之说外,有所加减,其中加用桑白皮的频数最多;治疗病证上,多继承原方主治喘证,还散见于治疗哮病、咳嗽等其他肺系病证;在药物用量与制法用法上,建议继承原方记载,剂型为汤剂,每服各药物用量为麻黄2.89 g、苦杏仁4.13 g、甘草1.65 g、茶叶3.30 g、石膏6.20 g,白水煎服;药物基原上,麻黄选用麻黄科植物草麻黄Ephedra sinica的干燥草质茎,苦杏仁选用蔷薇科植物山杏Prunus armeniaca的干燥成熟种子,甘草选用豆科植物甘草Glycyrrhiza uralensis的干燥根和根茎,茶叶选用山茶科植物茶Camellia sinensis的芽叶,石膏选用硫酸盐类矿物石膏族石膏。同时,对五虎汤现代临床应用文献搜集整理,获得73条有效文献,皆是治疗呼吸系统疾病,尤见于小儿肺炎、哮喘,多属“痰热壅肺证”。通过对记载五虎汤的古籍与现代应用文献的分析研究,厘清其历史沿革和处方衍变,确定其关键信息,以期为经典名方五虎汤的研发上市和合理加减应用提供更精准的参考。

Wuhutang is the 51st Chinese medicine prescription of Han ethnic group on in the catalogue of ancient classical prescriptions(the second batch),which originated from Renzhai'Straight Diections Prescriptions(《仁斋直指方》)by YANG Shiying in the Song dynasty,it is composed of 5 medicines,including Ephedrae Herba,Armeniacae Semen Amarum,Glycyrrhizae Radix et Rhizoma,tea and Gypsum Fibrosum.It treats shortness of breath and phlegm.Following the principle of textual research on the key information of ancient classical famous prescriptions,the author collected and recorded the ancient books of traditional Chinese medicine of Wuhutang with the method of Bibliometrics,and screened out 53 valid data,involving 41 ancient books.Based on the historical evolution,drug composition,main treatment of disease and syndrome,drug dosage,method of preparation and usage,drug origin and processing,the author conducted a dig and a systematic study of Wuhutang.The results show that:in the later generations,besides inheriting the original prescription,the composition of medicine was added or subtracted,and the frequency of addition of Mori Cortex was the most;in the treatment of disease and syndrome,most of them inherited the original prescription mainly treating asthma syndrome,also see in the treatment of asthma,cough and other lung disease,in the drug dosage and method of use,it is suggested to inherit the original prescription,the dosage of each medicine is:Ephedrae Herba 2.89 g,Armeniacae Semen Amarum 4.13 g,Glycyrrhizae Radix et Rhizoma 1.65 g,tea 3.30 g,Gypsum Fibrosum 6.20 g,decoction,take warm clothes before eating;on the source of medcine,ephedra is made from the dried herbaceous stems of Ephedra sinica(Ephedraceae),bitter almond is made from the dried and mature seeds of Prunus armeniaca(Rosaceae),Licorice is made from the dried roots and rhizomes of Glycyrrhiza uralensis(Legumes),tea is made from the buds leaves of Camellia sinensis(Camellia),plaster is made from Gypsum Fibrosum of sulfate mineral gypsum family.At the same time,we collected and sorted the modern clinical application literature of Wuhutang,and obtained 73 effective literatures,all of which are for the treatment of respiratory system diseases,especially for children's pneumonia and asthma,and mostly belong to"phlegm-heat obstructing the lung syndrome".Through the analysis and study of ancient books and modern applied literature,the historical evolution and prescription evolution of Wuhutang are clarified,and its key information is determined,in order to provide more accurate reference for the research and development of the classic Wuhutang and the rational addition and subtraction of the application.