| 引用本文: |
孟庆鸿,王雪茜,李楠,曾凤.千里流水汤主治病机衍化的文献考证[J].湖南中医药大学学报,2023,43(1):176-180[点击复制] |
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| 千里流水汤主治病机衍化的文献考证 |
| 孟庆鸿,王雪茜,李楠,曾凤 |
| (北京中医药大学, 北京 100029;中国中医科学院研究生院, 北京 100700) |
| 摘要: |
| 通过相关文献溯源发现，千里流水汤创方之初主治“虚烦不得眠”。北宋校正医书局整理医书，使该方出现了两条不同的病机衍化脉络：其一，宋校本《千金要方》将本方与“胆”的病位相结合，提出“胆虚寒”病机；陈无择进一步补充证候完善理论，并易名为“温胆汤”；《千金方衍义》围绕方剂组成，在“胆虚寒”基础上加入新的病机。其二，宋校本《外台秘要方》将本方与“虚劳”病诊疗理论相结合；《圣济总录》提出其病机是“营卫俱伤”；《奇效良方》将本方收录于《痨病门》，极大扩展了其应用范围。文献考证提示：宋臣对中医古籍文本的调整改动、宋以后医家的不断补充，使千里流水汤主治病机逐渐衍化，呈现出理论化与多元化的倾向，在一定程度上对后世中医临床产生影响。 |
| 关键词: 千里流水汤 温胆汤 主治 病机 不寐 溯源 |
| DOI：10.3969/j.issn.1674-070X.2023.01.030 |
| 投稿时间：2022-11-01 |
| 基金项目:国家社会科学基金项目（21BTQ026）；北京中医药大学孙思邈研究院科研项目（SSMYJY-1-2020-01，SSMYJY-2-2021-17）。 |
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| The pathogenesis derivation of Qianli Liushui Decoction indications by source tracking |
| MENG Qinghong,WANG Xueqian,LI Nan,ZENG Feng |
| (Beijing University of Chinese Medicine, Beijing 100029, China;Graduate School of China Academy of Chinese Medical Sciences, Beijing 100700, China) |
| Abstract: |
| The indications of Qianli Liushui Decoction was "deficiency vexation and insomnia" at the beginning of its creation by source tracking of relevant literature. The medical books, after being allocated by the Bureau for Revising Medical Books in the Northern Song Dynasty, demonstrated two different derivation routes of pathogenesis: Firstly, the Song's edition of Qian Jin Yao Fang (Important Formulas Worth a Thousand Gold Pieces) combined this formula with the disease location of "gallbladder" and put forward the pathogenesis of "gallbladder deficiency cold"; CHEN Wuze further replenished the patterns and theory, and changed its name to "Wendan Decoction"; Qian Jin Fang Yan Yi (Extension of the 'Important Formulas Worth a Thousand Gold Pieces') focused on the composition of formulas and add new pathogenesis on the basis of "gallbladder deficiency cold". Secondly, the Song's edition of Wai Tai Mi Yao Fang (Formulas of Arcane Essentials from the Imperial Library) combined this formula with the diagnosis and treatment theory of "deficiency"; Sheng Ji Zong Lu (Comprehensive Recording of Divine Assistance) put forward that the pathogenesis was "damage to both Ying-nutrients and Wei-defense"; Qi Xiao Liang Fang (Fine Formulas of Wonderful Efficacy) included this formula in Lao Bing Men (Tuberculosis), greatly expanding its scope of application. Textual research suggests that the changes by Song’s ministers and the replenishment by doctors after the Song Dynasty to the ancient books of Chinese medicine had continuously derived the indications of Qianli Liushui Decoction, showing a theorized and diversification tendency, which may affect the later clinical practice of Chinese medicine. |
| Key words: Qianli Liushui Decoction Wendan Decoction indication pathogenesis insomnia source tracking |
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