安宫牛黄丸的古今文献研究

【作者】 高闻蔚；

【导师】 宋乃光；

【作者基本信息】 北京中医药大学 ， 中医临床基础， 2006， 硕士

【摘要】 安宫牛黄丸源于清吴鞠通的《温病条辨》,具有清热解毒、豁痰开窍之功效,主治邪热内陷心包证,由牛黄、犀角、郁金、麝香、珍珠、栀子、黄连、黄芩、朱砂、雄黄、冰片、金箔12味药组成。是中医治疗高热症的“温病三宝”之一,是凉开的代表方剂。制剂主要有丸剂和散剂,属中医急救药。后世医家对此方甚为重视,评价、研究和应用都相当广泛。现代临床上一直将其作为治疗高热惊厥、脑卒中及昏迷的要药。本文首先将近20年来期刊文献中安宫牛黄丸相关的研究报道整理总结。主体部分从《温病条辨》本身的论述入手,追溯源头、重温全部相关原文,分析其组方精义,总结出其适应证及禁忌证等要点。指出安宫牛黄丸的治疗核心为:温病热入心包之神昏。并分析后世注家和现代名家的论述与运用,探讨了现代临床应用中的重点问题。指出临证时应精确分析:如确属适应证,不必因畏惧其中有毒药物而不敢放胆使用;如确属禁忌证,又不可孟浪使用。文末探讨了学习运用古方的方法学问题,强调应追根溯源,重视原文学习。更多还原

【Abstract】 AnGong NiuHuang Wan came from the Treatise on Differentiation and Treatment of Febrile Diseases which was written by Wu Ju-tong in Qing Dynasty. Due to its primary function, such as heat-clearing, detoxicating, phlegm-eliminating and resuscitation, this formula was always used in the syndrome of evil heat defecting pericardium. There are 12 kinds of herbs in the pill, including Niuhuang, Xijiao, Yujin, Shexiang, Zhenzhu, Zhizi, Huanglian, Huangqin, Zhusha, Xionghuang, Bingpian, Jinbo, et al. The formula was also one of the three most effective formulas for warm disease, and a representative formula for resuscitation by drugs with cold or cool property. The widely used dosage form of this formula was pill and powder. And both of them were used for emergency treatment. From the becoming, this formula was put high emphasis on by many doctors or specialists. Thus, there were many papers about the evaluation, research, or application of it. It was applied as a key drug for febrile convulsion, stoke or coma in clinical.In this paper, the relative papers about Angong Niuhuang Wan in the last 20 years’journals were reviewed firstly.The main body of this paper was based on the discussion of the Treatise on Differentiation and Treatment of Febrile Diseases. By tracing back to the source, going over all the correlated original statement, analyzing the consisted principle, a summary about its indicatio and contraindication was obtained. Namely the core cure disease was coma caused by evil heat defecting pericardium. The comment and application of the later annotators and contemporary famous experts were also analyzed, and the focal point of modern clinical use was investigated. Come to a conclusion that precise consideration is needed in clinical, and then reasonably use it in indicatio despite those toxic herbs included and strictly prohibited in contraindication.At last, the method of learning and application of ancient formulas was discussed. It was emphasized to trace something to its source and think highly of original literature.更多还原