经典名方蠲痹汤的古代文献分析与考证

Textual Research on Classical Formula Juanbitang

该文展示蠲痹汤及其类方的历史沿革,厘清杨氏蠲痹汤和程氏蠲痹汤的流传脉络,并对程氏蠲痹汤的方义分析、药物基原、炮制、现代剂量及用法等关键信息进行逐一考证。通过系统整理蠲痹汤相关古籍文献,共收集相关文献信息267条,纳入53条有效数据。考证发现两首蠲痹汤同出于《备急千金要方》所载的独活寄生汤,结合清代医药度量衡“一钱约等于3.73 g”的标准折算,笔者认为程氏蠲痹汤中选用的药物及用量为羌活、独活、秦艽各3.73 g,当归、桑枝各11.19 g,川芎2.61 g,桂心、炒甘草各1.87 g,海风藤7.46 g,乳香、木香各2.98 g,服用时,以煎煮为宜,加水600 mL,同煎至300 mL,每日3次,饭前服用。蠲痹汤具有祛风除湿,蠲痹止痛的功效,可用于治疗身体烦疼、项背拘急、腰腿沉重等症状,是一首有效的治疗痹证的经典名方。现代研究表明,蠲痹汤可用于治疗类风湿性关节炎、膝关节骨性关节炎、肩周炎等疾病。上述研究结果为蠲痹汤后期开发研究提供了参考依据。

This paper discussed the historic evolution of Juanbitang and similar decoctions,clarified the historic development of Yangshi Juanbitang and Chengshi Juanbitang,and probed into the key information of the meaning,original plants,processing methods,and modern dosage and usage of Chengshi Juanbitang.A total of 267 pieces of relevant information were collected from ancient traditional Chinese medicine(TCM)books,among which 53 pieces of effective data were included in this study.The results showed that both Chenshi Juanbitang and Yangshi Juanbitang were originated from Duhuo Jishengtang recoded in the Important Prescriptions Worth a Thousand Gold for Emergency(Bei Ji Qian Jin Yao Fang).According to the standard of"1 qian roughly equals 3.73 g"in the measurement system of the Qing Dynasty,we suggest Chenshi Juanbitang is composed of 3.73 g Notopterygii Rhizoma et Radix,3.73 g Angelicae Pubescentis Radix,3.73 g Gentianae Macrophyllae Radix,11.19 g Angelicae Sinensis Radix,11.19 g Mori Ramulus,2.61 g Chuanxiong Rhizoma,1.87 g Cinnamomi Cortex,1.87 g stir-fried Glycyrrhizae Radix et Rhizoma,7.46 g Piperis Kadsurae Caulis,2.98 g Olibanum,and 2.98 g Aucklandiae Radix,which should be decocted with 600 mL water to reach a volume of 300 mL.The decoction should be taken 3 times a day before meals.Juanbitang,a classical formula specialized for treating impediment diseases,has the effects of dispelling wind,removing dryness,and alleviating impediment to relieve pain.It can be used for treating vexing pain in body,spasm of nape and back,and heaviness in waists and legs.Modern studies have shown that Juanbitang can be used for treating rheumatoid arthritis,knee osteoarthritis,and periarthritis of shoulder.The above results served as a reference for the future development of Juanbitang.