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抵当乌头桂枝汤考

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"抵当乌头桂枝汤"出自《金匮要略》腹满寒疝篇,为治疗表里俱寒之寒疝经典方剂,历来对"抵当"二字的阐释争议颇多,方中乌头剂量亦有阙如.文章综合运用版本学、训诂学等研究方法,通过对比《金匮要略》现存5个主要版本和中医古籍中与此方相关文献,认为"抵当"二字当为衍文,北宋校正医书局根据《外台秘要》中讹误的记载,在条文中增补了"抵当"二字,但并未出注;乌头剂量为五枚;附方乌头汤与乌头桂枝汤药物剂量、煎服法各异,因宋代煮散风尚,将汤剂改为散剂时,二者药物组成相同,北宋校正医书局故而将其列为一方,这种较大的改动使得宋代及其之后的不少医家将两方相混淆,两方也逐渐淡化了各自的主治特点.
Probe into Didang Wutou Guizhi Decoction
'Didang Wutou Guizhi Decoction'is from the chapter of Abdominal Fullness and Cold Hernia in the Synopsis of the Golden Chamber,as a classic prescription for the treatment of cold colic in abdomen and vulva that cold in both superficies and interior,there is always a lot of controversy over the interpretation of the word'Didang',and the dose of aconitum in the prescription is also missing.This paper comprehensively uses the literature research methods such as edition study and exegetics,and compares the five major extant versions of the Synopsis of the Golden Chamber and the records of the Didang Wutou Guizhi Decoction in the ancient medical literatures,and believes that the word'Didang'should be a unwanted words,and the Northern Song Dynasty Bureau for Revising Medical Books added the word'Didang'to the Synopsis of the Golden Chamber article according to the errors in the Waitai Miyao,but did not make a note;The dose of aconite in Didang Wutou Guizhi Decoction is five pieces;The drug dose and decoct method between Fufang Wutou Decoction and Wutou Guizhi Decoction is different.Because it is popular for people to boil the powder in Song dynasty,the decoction is changed to powder,the main drug needs to be cut into powder,the two drug composition is the same,so listed as one prescription.However,this large change made many doctors in the Song dynasty and later confuse the two prescriptions,and the two prescriptions gradually diluted their respective main characteristics.

Synopsis of the Golden ChamberDidang Wutou Guizhi DecoctionDidangAconiteFufang Wutou Decoction

李志鸣、周冉冉、官庆烨、侯鉴宸、杨凤、张艺、邱月华、陶晓华

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北京中医药大学中医学院,北京 100029

北京中医药大学中医文献研究院,北京 100029

《金匮要略》 抵当乌头桂枝汤 抵当 乌头 附方乌头汤

北京中医药大学"揭榜挂帅"项目国家重点研发计划国家重点研发计划

2022-JYB-JBZR-0102019YFC17092002019YFC1709204

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子:1.135
ISSN:1673-1727
年,卷(期):2024.39(8)