经典名方柴胡加龙骨牡蛎汤古今剂量考略与思辨

Verification and speculation on ancient and modern dosages of classic famous formula Chaihu Jia Longgu Muli Decoction

以“古-今”“宏观-微观”为轴,系统检索古今文献,考略柴胡加龙骨牡蛎汤本原剂量与配比,梳理古今剂量演变规律,归纳现代临床应用特点,总结剂量相关实验研究进展。研究显示原方剂量约为柴胡62.5 g,半夏33.5 g,大黄31.3 g,龙骨、牡蛎、黄芩、生姜、铅丹、人参、桂枝、茯苓均约为23.4 g,大枣24 g,配比接近8∶4∶4∶3∶3∶3∶3∶3∶3∶3∶3∶3;当今常用剂量约为原方的1/2,并伴随大黄比例的降低及龙骨、牡蛎比例的提高。柴胡加龙骨牡蛎汤古今剂量使用差异明显,当代临床实践中不宜“盲目照搬、拘泥于古”,又不可“擅自斟酌、自由加减”,因此在精研典籍的基础上“求古今之同、辨古今之异”,深入开展“古方今用”的现代化研究任重道远。

Taking"ancient-modern"and"macro-micro"as axes,the system retrieves literature from ancient to modern times.It considers the original dose and ratio of Chaihu Jia Longgu Muli Decoction,reviews the evolution of doses over time,summarizes the characteristics of modern clinical applications,and consolidates the progress of dose-related experimental research.The study shows that the original dose of the formula is approximately 62.5 g of Bupleuri Radix(Chaihu),33.5 g of Pinelliae Rhizoma(Banxia),31.3 g of Rhei Radix Et Rhizoma(Dahuang),approximately 23.4 g each of Ossa Draconis(Longgu),Ostreae Concha(Muli),Scutellariae Radix(Huangqin),Zingiberis Rhizoma Recens(Shengjiang),Plumbum Rubrum(Qiandan),Ginseng Radix Et Rhizoma(Renshen),Cinnamomi Ramulus(Guizhi)and Poria(Fuling),along with 24 g of Jujubae Fructus(Dazao).The ratio is close to 8∶4∶4∶3∶3∶3∶3∶3∶3∶3∶3∶3.The commonly used modern dose is about half of the original dose,accompanied by a decrease in the proportion of Dahuang and an increase in the proportions of Longgu and Muli.There are significant differences in the usage dosages of Chaihu Jia Longgu Muli Decoction between ancient and modern times.In contemporary clinical practice,it is neither advisable to"blindly follow and adhere rigidly to ancient prescriptions"nor to"make arbitrary modifications and adjustments."Therefore,based on a thorough study of classical texts,it is crucial to"seek the commonalities and discern the differences between ancient and modern times."The modernization research of"ancient prescriptions for modern use"still has a long way to go.