Pharmacy Information
Vol. 08  No. 04 ( 2019 ), Article ID: 31396 , 7 pages
10.12677/PI.2019.84022

Exploring the Rule of Indications for the Residual Volume of “Hui Hui Prescription” Containing Croton Formula

Xusheng Jia1, Menghui Jia2,3*, Nalin Wang1, Yuwei Ma1, Jiating Feng1, Peipei Wang2, Li Liu2, Yanli Zuo2

1College of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan Ningxia

2The Second Affiliated Hospital of Ningxia Medical University, Yinchuan Ningxia

3Key Laboratory of Ningxia Hui Medicine Modernization, Ministry of Education, Yinchuan Ningxia

Received: Jun. 27th, 2019; accepted: Jul. 17th, 2019; published: Jul. 24th, 2019

ABSTRACT

Objective: To investigate the rule of indication of the croton formula in the “Hui Hui Prescription”. Methods: The 73 prescriptions containing Croton in the Chapter “Zhongfeng Category” and “Incurable Diseases Category” of residual “Hui Hui Prescription” were classified, summarized, compared and analyzed by list one by one according to the original text of the main symptoms. Results: There were 460 prescriptions in the Chapter “Zhongfeng Category” and “Incurable Diseases Category” of residual “Hui Hui Prescription”, including 73 croton-contained prescriptions, accounting for 15.87%. Among them, there are 255 prescriptions of “Zhongfeng Category” Chapter, including 39 croton-contained ones, accounting for 15.29%; 205 prescriptions of “Incurable Diseases Category” Chapter, including 34 croton-contained ones, accounting for 16.59%. Among the 8 types of symptoms in “Zhongfeng Category” Chapter, there are 74 prescriptions in “Left-related Paralysis, mouth- and Eye-related Disorder” type, including 19 croton-contained ones, accounting for 25.68%; 19 in “Sparing Wind and Smooth” type, in which 4 croton-contained ones account for 21.05%; 22 in “Rheum Gluten” type, including 0 prescriptions of Croton; 8 in “Chests” type, including 1 croton-contained one, 12.50%; 12 in “Dark Winds” type, including 1 croton-contained one, accounting for 8.33%; 10 in “Wind and Magic” type, including 0 croton-contained one; 69 in “Purpura and Vitiligo” type, including 11 croton-contained ones, accounting for 15.94%; 41 in “the wind and miscellaneous treatments” type, including three croton-contained ones, accounting for 7.32%. The first rule of 73 prescriptions containing croton is good at treating "Left Paralysis, Right Paralysis, Mouth- and Eyes-Disorders" in "encephalopathy" the second is to “diffusion, open chest, pass through qi” to cure “the disease in the chest” and “bone joint pain”; the third is good at pulling the skin “stubborn disease”, “sparing the wind and poisoning” to cure “Purpura and Vitiligo”. Conclusion: The residual “Hui Hui Prescription” is used to overcome difficulties and cure stubborn disease with croton.

Keywords:Hui Hui Prescription, Croton, Indications

《回回药方》残卷含巴豆方剂主治规律探要

贾戌生1,贾孟辉2,3,王娜琳1,马玉炜1,冯佳婷1,王佩佩2,刘丽2,左艳丽2

1宁夏医科大学中医学院,宁夏 银川

2宁夏医科大学第二附属医院,宁夏 银川

3宁夏回医药现代化省部共建教育部重点实验室,宁夏 银川

收稿日期:2019年6月27日;录用日期:2019年7月17日;发布日期:2019年7月24日

摘 要

目的:探讨《回回药方》残卷含巴豆方剂的主治规律。方法:将《回回药方》残卷“众风门”篇和“杂证门”篇中含巴豆的73首方剂,按照主治病证原文逐一列表分类、归纳、比较和分析。结果:《回回药方》残卷“众风门”、“杂证门”现存460首方剂,含巴豆方73首,占比15.87%。其中,“众风门”篇255首,含巴豆39首,占“众风门”15.29%;“杂证门”篇205首,含巴豆34首,占16.59%;“众风门”篇8病证类中,“左瘫右痪口眼呙斜类”74首,含巴豆19首,占25.68%;“疏风顺气类”19首,含巴豆4首,占21.05%;“风湿筋搐类”22首,含巴豆的方剂0首;“胸膈风类”8首,含巴豆1首,12.50%;“暗风类”12首,含巴豆1首,占8.33%;“风魔胡想类”10首,含巴豆0首;“风癞紫白癜类”69首,含巴豆11首,占15.94%;“众风杂治类”41首,含巴豆3首,占7.32%。73首含巴豆方剂的主治规律一是善治“脑病”之“左瘫右痪、口眼歪斜”;二是最能“散痰、开胸、通经、顺气”以治“胸中之病”和“骨节疼痛”;三则擅拔皮肤“顽疾”,“疏风剔毒”以治“癞风、紫白癜风”。结论:《回回药方》残卷方剂喜用巴豆攻难克艰、善治顽恶之疾。

关键词 :回回药方,巴豆,主治

Copyright © 2019 by author(s) and Hans Publishers Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY).

http://creativecommons.org/licenses/by/4.0/

1. 引言

元末明初的《回回药方》残卷(以下简称为《残卷》)是一部现存最早的回医药经典方书 [1] ,该书论治病种齐全、载方数千、用药独特、剂型多样,具有鲜明的回医药论治理论体系特征,是当今挖掘、整理和总结回医药病症论治理论、遣方用药规律的重要文献之一。回族医药以“四元”“三子”为哲学基础,以“四性”“四体”“四液”为理论指导,“香药”的广泛应用也成为其主要的治疗特点,因香药具有醒脾开胃、透骨入络、开窍辟秽、温养脏腑、宣通气机、增进饮食等功效,临床上广泛应用于疫病急救、心脑血管病、外科、骨伤等领域 [2] [3] 。巴豆作为香药之一,多次出现在《回回药方》中,巴豆为大戟科植物巴豆树的成熟干燥果实,是一种极为常用的传统草药,传统中医认为巴豆性热、味辛,功能破积、逐水、涌吐痰涎,主治寒结便秘、喉风喉痹、痈疽、恶疮疥癣等 [4] 。强调有大毒,须慎用。本文仅将《残卷》所载含巴豆方剂的主治病证进行梳理和总结,以期探讨回医药运用巴豆主治病证的规律和经验,以启迪临床。

2. 《残卷》中巴豆之别名

通过对《残卷》“众风门”及“杂证门”篇所载方剂中巴豆的别名进行梳理,共计有撒黑木尼牙、撤黑木尼牙、撒吉木你牙、撒吉尔你牙、马哈木答、撒吉母你牙、数吉木你牙等7种别名称谓。

3. 《残卷》含巴豆方剂的分类和占比分析

《残卷》含巴豆的方剂主要分布在《残卷》卷之十二、卷之三十的“众风门”篇和“杂证门”篇。统计可知(见表1),“众风门”篇又分为8病证类,共计255首方剂,含巴豆的方剂共39首,占“众风门”方剂总数的15.29%。其中,“左瘫右痪口眼呙斜类”共74首,占“众风门”方剂总数29.02%,含巴豆的方剂19首,占“左瘫右痪口眼呙斜类”方剂数的25.68%,占“众风门”总方剂数的7.45%;“疏风顺气类”共19首,占“众风门”方剂总数的7.45%,含巴豆的方剂4首,占“疏风顺气类”方剂数的21.05%,占“众风门”方剂总数的1.57%;“风湿筋搐类”共22首方剂,占“众风门”总方剂数的8.63%,含巴豆的方剂0首;“胸膈风类”共计8首,占“众风门”总方剂数的3.14%,含巴豆的方剂1首,占“胸膈风类”方剂数的12.50%,占“众风门”总方剂数的0.39%;“暗风类”共计12首,占“众风门”总方剂数的4.71%,含巴豆的方剂1首,占“暗风类”方剂数的8.33%,占“众风门”总方剂数的0.39%;“风魔胡想类”共计10首,占“众风门”总方剂数的3.92%,含巴豆的方剂0首;“风癞紫白癜类”共计69首,占“众风门”总方剂数的27.06%,含巴豆的方剂11首,占“风癞紫白癜类”方剂数的15.94%,占“众风门”总方剂数的4.31%;“众风杂治类”共计41首,占“众风门”总方剂数的16.08%,含巴豆的方剂3首,占“众风杂治类”7.32%,占“众风门”总方剂数的1.18%。“杂证门”篇共计205首方剂,其中含巴豆的方剂为34首,占“杂证门”方剂总数的16.59%。可见现存《残卷》460首方剂中,含巴豆方剂为73首,占15.87%。

Table 1. Statistics on the proportion of total croton prescriptions in the Hui Hui Prescription

表1. 《残卷》各门、类病证中含巴豆方剂总数占比情况统计

表1可知,《残卷》卷之十二“众风门”篇中,“左瘫右痪口眼呙斜类”、“疏风顺气类”和“风癞紫白癜类”中使用含巴豆的方剂数排位前三,分别占其方剂总数的25.68%、21.05%和15.94%。其次《残卷》卷之三十“杂证门”篇中使用含巴豆的方剂也多达16.59%,可见,《残卷》在治疗“左瘫右痪口眼呙斜类”、“疏风顺气类”和“风癞紫白癜类”病证,以及“杂证门”病证过程中使用巴豆的普遍性。

“风湿筋搐类”、“风魔胡想类”2大类病证中没有含巴豆方剂的使用,以及“胸膈风类”、“暗风类”2大类病证各仅有1首含巴豆的方剂,说明《残卷》使用巴豆对病证之适应证是有一定选择性的。

4. 《残卷》含巴豆方剂的主治规律

4.1. “左瘫右痪口眼呙斜类”19首含巴豆方剂主治规律

《残卷》“众风门”篇之“左瘫右痪口眼呙斜类”含巴豆的19首方剂,其主治原文汇总见表2。其中,19首方剂均主治“左瘫右痪、口眼歪斜”证,10首方剂名言主治“脑病”。原文所述的含巴豆19首方剂均可主治“左瘫右痪、口眼歪斜”病证,有涉“脑病”而致“左瘫右痪、口眼歪斜”病证的方剂竟多达10首,占52.63%。可见《残卷》含巴豆方剂主治以脑病为主的规律性是明确的。

Table 2. 19 original texts containing croton prescription of “Left Paralysis, Right Paralysis, Mouth- and Eyes-Disorders”

表2. “左瘫右痪口眼呙斜类”19首含巴豆方剂之主治原文

4.2.“疏风顺气类”4首含巴豆方剂主治规律

《残卷》“众风门”篇之“疏风顺气类”含巴豆的4首方剂,其主治原文汇总见表3。其中,4首方剂功效均能“疏风、顺气”。所谓“疏风顺气类”证,是指具有“疏风顺气”、“化痰散结”和“宽胸除满”之效,主要用于治疗胸膈不利、情志郁闷等病症,相当于中医郁证之范畴。可见,《残卷》含巴豆方剂主治郁证的规律性也是无疑的。

Table 3. 4 original texts containing croton prescription of “Sparing Wind and Smooth”

表3. “疏风顺气类”4首含巴豆方剂之主治原文

4.3.“风癞紫白癜类”11首含巴豆方剂主治规律

《残卷》“众风门”篇之“风癞紫白癜类”含巴豆的11首方剂,其主治原文汇总见表4。其中,9首方剂均主治“紫白癜风”证,占81.82%;2首方剂言及主治“风癞”,占18.18%。“紫白癜风”实际包括“紫白癜风”和“白癜风”2类,分别相当于中医的“汗斑”和“白驳风”,或西医的“花斑癣”和“白癜风”,均属于难治性皮肤疾患 [5] 。所谓的“风癞”,即西医的“麻风病”,更是一种皮肤顽恶之疾,如明代戴元礼的《秘传证治要诀·中风》所云:“其有害大风者,古谓之癞风,俗呼为麻风,病之至恶无出于此。”由此,《残卷》含巴豆方剂主治皮肤顽恶疾患之规律性可见一斑。

Table 4. 11 original texts containing croton prescription of “Purpura and Vitiligo”

表4. “风癞紫白癜类”11首含巴豆方剂之主治原文

另外,在“众风门”篇中,除“风湿筋搐类”和“风魔胡想类”没有含巴豆方剂外,“胸膈风类”和“暗风类”均各仅有1首含巴豆的方剂,没有统计学意义,故暂存不论。

4.4.“杂证门”篇34首含巴豆方剂主治规律

《残卷》“杂证门”篇含巴豆的方剂共34首,其主治原文汇总见表5。其中,以主治“脑病,通经脉;左瘫右痪、口眼歪斜;顺气开胸;白癜风”等多病症者19首方剂,占55.88%;以主治“头痛眼疼、骨节疼痛”病证者为10首方剂,占29.41%;以“将身内浊白痰、黑血恶根源去净”为主治和以“开闭塞”“开经脉”为主治的各5首方剂,各占14.70%。可见,《残卷》“杂证门”篇含巴豆方剂的主治病证较为复杂,基本综合了“众风门”篇的主治病症类。如“左瘫右痪口眼歪斜类”、“疏风顺气类”、“风癞紫白癜风类”和“众风杂治类”等主要病症,悉数包括。即《残卷》“杂证门”篇含巴豆方剂的主治规律与“众风门”篇的规律是一致的,主要体现在治疗脑病疾患、善开胸散结和治疗皮肤顽恶之疾三方面。

Table 5. 34 original texts containing croton prescription of “Incurable Diseases” category

表5. “杂证门”34首含巴豆方剂之主治原文

综上所述,《残卷》“众风门”及“杂证门”篇所载460首方剂中,含有巴豆的方剂就有73首之多,占比高达15.87%。足见回医方剂喜用巴豆攻难克艰、治之以奇的治则大法;73首含巴豆方剂的主治规律不外三个方面:一则善治“脑病”所致之“左瘫右痪、口眼歪斜”;二是最能“散痰、开胸,通经、顺气、”以治“胸中之病”和“骨节疼痛”;三则擅拔皮肤“顽疾”,“疏风剔毒”以治“癞风、紫白癜风”。

基金项目

国家自然科学基金(81260568);国家自然科学基金(81560816);国家自然科学基金(81760906)。

文章引用

贾戌生,贾孟辉,王娜琳,马玉炜,冯佳婷,王佩佩,刘 丽,左艳丽. 《回回药方》残卷含巴豆方剂主治规律探要
Exploring the Rule of Indications for the Residual Volume of “Hui Hui Prescription” Containing Croton Formula[J]. 药物资讯, 2019, 08(04): 165-171. https://doi.org/10.12677/PI.2019.84022

参考文献

  1. 1. 贺晓慧, 贾孟辉, 左艳丽, 等. 略论《回回药方》残卷中的“经”、“经脉”和“经络”[J]. 宁夏医科大学学报, 2016, 38(11): 1225-1227.

  2. 2. 牛阳, 南一, 王荣, 郑海生, 马英峰. 基于回医“四性学说”的“回回体质假说”内涵初探[J]. 宁夏医科大学学报, 2010, 32(1): 9-11.

  3. 3. 康菊英. 论回医香药的特点及临床应用[J]. 中国中医基础医学杂志, 2014, 20(9): 1283-1284.

  4. 4. 陈彦琳, 金峰, 杜杰, 等. 不同制霜方法制备巴豆霜饮片质量比较[J]. 中国现代中药, 2015(11): 1201-1203, 1232.

  5. 5. 贾孟辉. 《回回药方》残本注评[M]. 银川: 阳光出版社, 2015: 2.

期刊菜单