| 引用本文:张鼎，蒋鑫，赵日开，苗明三.经典名方栀子大黄汤的文献考证及现代临床应用特点分析[J].世界中医药,2024,(24):. |
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| 经典名方栀子大黄汤的文献考证及现代临床应用特点分析 |
| Literature Verification and Modern Clinical Application of Classic Formula Zhizi Dahuang Decoction |
| 投稿时间：2024-04-08 |
| DOI：10.3969/j.issn.1673-7202.2024.24.013 |
| 中文关键词: 经典名方 文献考证 临床应用 栀子 大黄 枳实 枳壳 伤寒杂病论 |
| English Keywords:Classic formula Literature examination Clinical application Gardeniae Fructus Rhei Radix et Rhizoma Aurantii Fructus Immaturus Aurantii Fructus Treatise on Cold Damage and Miscellaneous Diseases |
| 基金项目:国家中医药管理局联合开放课题项目（GZYKJS-2022-040-1）；豫药全产业链研发河南省协同创新中心项目[豫科技（2023）175号]（221100310400）；河南省国际合作重点项目（231111521200） |
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| 中文摘要: |
| 栀子大黄汤是治疗酒黄疸的经典名方，被纳入国家2023年发布的《古代经典名方目录（第二批）》中。经典名方是中药学中的瑰宝，是中医药文化中璀璨的结晶，因此挖掘整理经典名方，将其古今临床应用实践并标准化是中医药高质量发展和在传承中创新的大势所趋。参考国家药品监督管理局2020年发布的《古代经典名方关键信息考证原则》，对栀子大黄汤的主治病症、药物组成、制法、煎服法及应用范围的拓展与开发等关键信息进行古今文献考证分析，并对其临床研究病症进行分析，结果表明栀子大黄汤在流传过程中大多与《金匮要略》原方相同，组成为栀子、大黄、淡豆豉、枳实，其中大黄栀子比例11:12最为普遍；炮制方面栀子建议采用生栀子仁，大黄采用生大黄，枳实经考证应使用现今的枳壳；剂量考证方面，建议栀子12.6 g、大黄13.8 g、豆豉120 g、枳壳11.5 g，以水1 200 mL，煮取400 mL，每次133 mL，日服3次。张机所创栀子大黄汤，后世医家将其拓展用于谷疸、大病瘥后、伤食劳役等，但总离不开“湿热内蕴”这一核心病机。通过整理现代临床研究，发现栀子大黄汤主要治疗消化系统疾病、心血管系统疾病以及血液系统疾病，为栀子大黄汤的现代临床应用和制剂研发提供一些参考。 |
| English Summary: |
| Zhizi Dahuang Decoction is a classic formula for treating jaundice caused by alcohol，and it has been included in the Catalogue of Ancient Classic Formulas(Second Batch) published by the National Medical Products Administration in 2023.Classic formulas are treasures in the field of science of Chinese Materia Medica，representing the brilliant achievements of traditional Chinese medicine(TCM) culture.Therefore，the exploration and organization of these formulas，along with their ancient and modern clinical applications and standardization，are essential for the high-quality development and innovative inheritance of TCM.Referring to the Principles for the Verification of Key Information in Ancient Classic Formulas released by the National Medical Products Administration in 2020，this study conducts a historical and modern literature verification and analysis on Zhizi Dahuang Decoction，focusing on its indications，medicinal composition，preparation method，decoction method，and the expansion and development of its applications，and analyzes its clinical disease and symptoms.The results show that Zhizi Dahuang Decoction has largely remained the same as the original formula in Synopsis of the Golden Chamber throughout its transmission，consisting of Gardeniae Fructus，Rhei Radix et Rhizoma，Sojae Semen Praeparatum，and Aurantii Fructus Immaturus.The most common ratio of Rhei Radix et Rhizoma to Gardeniae Fructus is 11:12.In terms of processing，it is recommended to use raw Gardenia jasminoides seeds and raw Rhei Radix et Rhizoma，and Aurantii Fructus Immaturus should be substituted with modern Aurantii Fructus.Regarding the dosage，it is suggested to use 12.6 g of Gardeniae Fructus，13.8 g of Rhei Radix et Rhizoma，120 g of Sojae Semen Praeparatum，and 11.5 g of Aurantii Fructus，boiled in 1 200 mL of water to obtain 400 mL of decoction，with each dose being 133 mL，taken three times daily.Originally created by ZHANG Zhongjing，Zhizi Dahuang Decoction has been expanded by later practitioners for dietary jaundice，post-illness recovery，and disorders from overwork and dietary indiscretion，all remaining under the core pathogenesis of “dampness-heat accumulation”.Modern clinical research shows that Zhizi Dahuang Decoction is primarily used for digestive，cardiovascular，and hematologic diseases，providing useful insights for the modern clinical applications and formulation development of this classic prescription. |
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