古代经典名方养胃汤历史溯源与考证

Historical Tracing and Textual Research on Ancient Classic Prescription Yangwei Decoction(养胃汤)

养胃汤收录于《古代经典名方目录(第一批)》中的第68首。采用文献计量学方法,利用中华医典检索软件,从养胃汤的历史沿革、方义功用、主治病证、药物基原、剂量及煎服法等方面进行文献梳理、分析考证。共收集文献121条,涉及古籍42部。结果发现养胃汤方源最早可追溯至宋代《太平惠民和剂局方》,而非《古代经典名方目录(第一批)》所界定的明代《证治准绳》,且方名为人参养胃汤。养胃汤的方剂组成历代较为统一,在药物用量上稍有差异,根据文献考证建议临床该方参考剂量为半夏、厚朴、苍术各41.3 g,藿香叶、草果、茯苓、人参各20.65 g,甘草8.26 g,橘红28.91 g。对养胃汤药物基原和炮制进行了界定,其中半夏、厚朴、苍术的炮制存在不同认识,建议选择清半夏、姜厚朴和漂苍术。养胃汤功用为“燥湿运脾,解表和中”,主治病证涉及饮食停滞、身痛、泄泻、疟疾、产后类疟、小儿吐乳、痘疮等,治疗病证虽广,但需把握“湿滞脾胃,外受风寒”的基本病机。通过对养胃汤的古代文献进行梳理,以期对养胃汤后续研究及成方制剂提供理论参考。

Yangwei Decoction(养胃汤)is the 65th recipe in the Catalogue of Ancient Famous Classical Formulas(First Batch).This paper adopted bibliometrics method and used Chinese medical dictionary software to search.To analyze Yangwei Decoction in terms of history,explanation of the formula,efficacy of prescriptions,indications,the original variety,dosage and usage.A total of 121 publications were included,involving 42 ancient books.It was found that Yangwei Decoction first appeared in the Taiping Huimin Heji Jufang in the Song Dynasty.It is not recorded in the Catalogue of Ancient Famous Classical Formulas(First Batch)from the Zhengzhi Zhunsheng in Ming Dynasty and the name of the formula is Renshen Yangwei Decoction(人参养胃汤).The composition of Yangwei Decoction were unified in past dynasties.There is a slight difference in dosage.According to the textual research,it is suggested that the reference dosage of this prescription in clinical practice is 41.3 g for Banxia(Pinelliae Rhizoma),Houpo(Magnoliae Officinalis Cortex),and Cangzhu(Atractylodis Rhizoma),20.65 g for Huoxiangye(Pogostemonis Herba),Caoguo(Tsaoko Fructus),Fulingpi(Poriae Cutis),and Renshen(Ginseng Radix Et Rhizoma),8.26 g for Gancao(Glycyrrhizae Radix Et Rhizoma)and 28.91 g for Juhong(Citri Exocarpium Rubrum).Analyzed the origin variety and the processing of the drugs.There are different viewpoints on the preparation of Banxia(Pinelliae Rhizoma),Houpo(Magnoliae Officinalis Cortex),and Cangzhu(Atractylodis Rhizoma).It is recommended to choose Banxia(Pinelliae Rhizoma)soaked in alum water,stir fry Houpo(Magnoliae Officinalis Cortex)with ginger juice and Cangzhu(Atractylodis Rhizoma)soaked in rice water.The effect of Yangwei Decoction are not only remove spleen dampness and restore spleen health but also relieve external cold and harmonize spleen and stomach.The main treatment symptoms include retention of food,generalized pain,diarrhea,malaria,postpartum symptoms similar to malaria,vomiting of milk in infants,smallpox and so on.Although there are many diseases to be treated,it is necessary to know that the causes of the disease are spleen dampness and affected by the cold.The textual research of Yangwei Decoction is expected to provide a theoretical reference for the future research and formulation.