摘要
大黄硝石汤是张仲景治疗湿热黄疸的重要方剂。目前涉及本方的研究,存在“芒硝”“硝石”错用、混用的现象。本文全面梳理《金匮要略》不同传本有关记载,旁参注家注释,结果发现,古籍文献中“芒硝”“硝石”混乱,源于《脉经》和《备急千金要方》引《金匮要略》相关条文时以“芒硝”代“硝石”所致;元明以后,伴随硝石、芒硝基原辨识逐渐清晰,诸版本均作“硝石”而非“芒硝”。从病机来看,硝石燥湿、活血作用均强于芒硝,更加符合大黄硝石汤“湿热”“血瘀”的病机特点。方中所用应为硝石。现阶段在大黄硝石汤中用芒硝的原因和硝石被列为危险化学品有一定关系。明析大黄硝石汤的药物组成,对以黄疸为主要表现的肝胆疾病治疗具有重要意义。
Dahuang Xiaoshi Decoction is an important prescription for treating damp-heat jaundice by Zhang Zhongjing.However,there is a phenomenon of misuse and confusion between“mirabilite”and“nitrate”in research.This paper comprehensively combs the relevant records in different biographies of Synopsis of Golden Chamber,and makes textual research on this issue with the help of annotations.It is found that in ancient literature,the confusion between“mirabilite”and“nitrate”originates from the substitution of“nitrate”with“mirabilite”when citing relevant texts from Synopsis of Golden Chamber in the Pulse Classic and the Essential Recipes for Emergent Use Worth A Thousand Gold.After the Yuan and Ming dynasties,as the distinction between the origins of nitrate and mirabilite became clearer,all versions have been corrected to use“nitrate”instead of“mirabilite”.From the perspective of pathogenesis,nitrate has stronger effects in drying dampness and promoting blood circulation than mirabilite,which more closely aligns with the pathogenic characteristics of the Dahuang Xiaoshi Decoction,which treats conditions with“damp-heat”and“blood stasis”.Therefore,nitrate should be used in the formula.The reason for using mirabilite in Dahuang Xiaoshi Decoction at present is also related to the fact that nitrate is classified as a hazardous chemical.The composition of Dahuang Xiaoshi Decoction is of great significance for the treatment of hepatobiliary disease.
作者
孙超
陈婷
张秋霞
王伽伯
迟莉
SUN Chao;CHEN Ting;ZHANG Qiuxia;WANG Jiabo;CHI Li(School of Traditional Chinese Medicine,Capital Medical University,Beijing100069,China)
出处
《中国医药导报》
CAS
2024年第31期132-135,共4页
China Medical Herald
基金
国家社会科学基金项目(23BTQ039)
北京市社会科学基金一般项目(22LSB005)
北京市自然科学基金面上项目(7242212)
北京市教育委员会科技计划一般项目(KM202110025021)。
关键词
大黄硝石汤
硝石
芒硝
黄疸
Dahuang Xiaoshi Decoction
Nitrate
Mirabilite
Jaundice
