经典名方桂枝麻黄各半汤的古代文献分析及关键信息考证

Ancient Literature Analysis and Key Information Textual Research of Classic Formula Guizhi Mahuang Geban Tang

摘要:

桂枝麻黄各半汤出自张仲景《伤寒论》，被收录于国家中医药管理局发布的《古代经典名方目录（第二批）》中。通过搜集桂枝麻黄各半汤的相关古代文献，分析和考证方剂源流与组成、药物基原与炮制、剂量与煎服法、方义功效与主治等，共获取桂枝麻黄各半汤古代文献数据186条，涉及中医古籍108部。桂枝麻黄各半汤共6种异名方。其由桂枝、芍药、生姜、甘草、麻黄、大枣、杏仁7味药物组成；其药物基原与炮制基本清晰；结合现代临床常用剂量，每次服用剂量：桂枝7.67 g、白芍4.60 g、生姜4.60 g、甘草4.60 g、麻黄4.60 g、大枣4.00 g、苦杏仁2.60 g。煎服法：以水1 000 mL，先煮麻黄15 min，去上沫。纳诸药，煮取360 mL，温服120 mL；该方由桂枝汤与麻黄汤合方而成，其功效为发散风寒、调和营卫；其历代主治病证在《伤寒论》原书主治上有延伸拓展，传统主治涉及太阳、厥阴、阳明、少阴病证。除风寒感冒外有头痛、口苦、咽干、腹满、喘、妇人热入血室、身痒如虫行皮中、痘疹、厥证、无脉等病证。现代临床用于治疗上呼吸道感染等肺系疾病；荨麻疹、湿疹、银屑病、神经性皮炎等各种皮肤病；肾衰竭、糖尿病并发瘙痒等。

Abstract:

Guizhi Mahuang Geban Tang derived from ZHANG Zhongjing's Treatise on Cold Damage is included in the Catalogue of Ancient Classic formulas （the second batch） issued by the National Administration of Traditional Chinese Medicine. By reviewing the ancient literature related to Guizhi Mahuang Geban Tang， this study analyzed the origin， medicinal composition， original plants and processing， dosage， decocting method， compatibility， effects， and indications of this formula. A total of 186 records of Guizhi Mahuang Geban Tang were obtained， involving 108 ancient books of traditional Chinese medicine. There are 6 synonyms of Guizhi Mahuang Geban Tang. This formula consists of Cinnamomi Ramulus， Paeoniae Radix Alba， Zingiberis Rhizoma Recens， Glycyrrhizae Radix et Rhizoma， Ephedrae Herba， Jujubae Fructus， and Armeniacae Semen Amarum， the original plants and processing of which are clear. With consideration to the dosage in modern clinical practice， it is recommended that the formula should be composed of 7.67 g Cinnamomi Ramulus， 4.60 g Paeoniae Radix Alba， 4.60 g Zingiberis Rhizoma Recens， 4.60 g Glycyrrhizae Radix et Rhizoma， 4.60 g Ephedrae Herba， 4.00 g Jujubae Fructus， and 2.60 g Armeniacae Semen Amarum. The decoction should be prepared by boiling Ephedrae Herba with 1 000 mL water for 15 min before the addition of other medicines， and the mixture was decocted to reach a volume of 360 mL， and 120 mL of the decoction should be taken warm once. Guizhi Mahuang Geban Tang is a combination of Guizhi Tang and Mahuang Tang， with the effects of dispersing wind cold and harmonizing nutrient-defense. The main diseases treated by this formula in the past dynasties have expanded compared with those in Treatise on Cold Damage. The traditional indications of this formula involve the diseases of greater Yang， reverting Yin， Yang brightness， and lesser Yin. In addition to common cold due to wind-cold， this formula can be used to treat headache， bitter mouth， dry throat， full abdomen， panting， heat invading blood chamber in women， skin itching， exanthema variolosum， syncope， and hardly perceivable pulse. In modern clinical practice， Guizhi Mahuang Geban Tang is used for treating pulmonary diseases such as upper respiratory tract infection， skin diseases （e.g.， urticaria， eczema， psoriasis， and neurodermatitis）， kidney failure， and diabetes complicated with pruritus.