《伤寒论》中药药嘱初步分析(1)
[摘要]为了系统整理和分析《伤寒论》中有关中药药嘱的文献资料，归纳概括中药药嘱的主要内涵。对《伤寒论》中有关药嘱的内容，按照中药剂型的制法、中药的服法、服药禁忌、服药后护理等4个方面进行收集、筛选、比较、归纳和分析。查阅相关研究《伤寒论》中方剂用药的文献，归纳其论点，并做比较。规范的发药交代有利于指导临床合理使用中药。规范如下，中药的煎煮用水常选择自来水和井水。对于具有活血通络作用组成的汤剂，可以加入酒共煮;含有毒性药组成的汤剂，可以加入蜂蜜共煎。特殊煎煮的中药，如麻黄可先煎，并去除药汤上的浮沫。煎煮火候的衡量可在汤剂中加入粳米，米熟即汤成;不同剂型的服用剂量(合或升，梧桐子或弹丸，方寸匙);汤剂的服药时间、温度及次数变化，要考虑汤剂的作用部位，功效主治及患者的病情轻重缓急等因素;服药饮食宜忌(宜食糜粥调养，忌食与药物功效相反的食物);服药后护理(服热粥以利解表剂发汗，服稠粥以利服泻下剂后调养，药物不同用药途径及方法不同);用药护理的核心，保证患者服药后身体正常机能调节;药物疗效观察二便，血的形态，疗效观察要“以知为度”。总之，《伤寒论》是最早论述药嘱的著作，详细记述了中药药嘱的各项内容，该文归纳出中药药嘱的新规范，是开展中医临床药学服务的重要依据，也是中药临床调剂技术的主要支撑内容之一。
, http://www.100md.com
[关键词]中药药嘱;《伤寒论》;临床药学
Preliminarily analysis on traditional Chinese medicine advices
in Treatise on Febrile Diseases
LIU Tong1，3， ZHAI Hua-qiang1*， ZHANG Tian1， JIN Shi-yuan2
(1. College of Traditional Chinese Medicine， Beijing University of Chinese Medicine， Beijing 100102， China;
2. Beijing Health School， Beijing 100875， China; 3.Beijing Hepingli Hospital， Beijing 100013， China)
, 百拇医药
[Abstract]To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases， and summarize the main connotations of traditional Chinese medicine advices， relevant TCM advices in Treatise on Febrile Diseases were collected， screened， compared， summarized and analyzed according to TCM dosage form preparation methods， TCM administration methods， medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted， summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods， e.g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre， pill， medicine spoon). Administration times， temperature and frequency shall be adjusted according to target positions， functions and stage of illness. As for dietary contraindications during medication， thick porridges are recommended， where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions， particularly warm porridges can go with diaphoretic recipes， while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements， and blood form. In conclusion， Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study， new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology., http://www.100md.com(刘童 翟华强 张田 金世元)
, http://www.100md.com
[关键词]中药药嘱;《伤寒论》;临床药学
Preliminarily analysis on traditional Chinese medicine advices
in Treatise on Febrile Diseases
LIU Tong1，3， ZHAI Hua-qiang1*， ZHANG Tian1， JIN Shi-yuan2
(1. College of Traditional Chinese Medicine， Beijing University of Chinese Medicine， Beijing 100102， China;
2. Beijing Health School， Beijing 100875， China; 3.Beijing Hepingli Hospital， Beijing 100013， China)
, 百拇医药
[Abstract]To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases， and summarize the main connotations of traditional Chinese medicine advices， relevant TCM advices in Treatise on Febrile Diseases were collected， screened， compared， summarized and analyzed according to TCM dosage form preparation methods， TCM administration methods， medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted， summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods， e.g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre， pill， medicine spoon). Administration times， temperature and frequency shall be adjusted according to target positions， functions and stage of illness. As for dietary contraindications during medication， thick porridges are recommended， where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions， particularly warm porridges can go with diaphoretic recipes， while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements， and blood form. In conclusion， Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study， new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology., http://www.100md.com(刘童 翟华强 张田 金世元)