新冠疫情爆发以后,国家中医药管理局推荐使用“清肺排毒汤”,其有效率高达94%,“清肺排毒汤”配方中使用黄芩治疫的相关研究目前并不完善。本文通过查阅历代记载过黄芩的本草专著,发现黄芩来源较为一致,古今差别不大。纵观历代黄芩治疫的记录,黄芩最早用于疫病的治疗可追溯至汉代,从晋代至清代的治疫文献中也均有记载,直到近现代仍被今人沿用。由此可见,黄芩在历代治疗疫病的过程中都发挥着重要的作用。然而关于历代黄芩如何治疫,目前尚不明确。本文通过对历代黄芩的性味,功效,含黄芩的治疫方剂加以整理,研究和归纳,使得黄芩治疫功效更加明确,更好地为临床用药提供文献依据。 After the outbreak of the COVID-19 epidemic, the Administration of Traditional Chinese Medicine 2recommended the use of “Qingfei Paidu Decoction”, which has an effective rate of up to 94%. Scutellariae appeared in the formula of “Qingfei Paidu Decoction”. However, the research on the treatment of Scutellaria baicalensis Georgi is not perfect at present, so the research on Scutellaria baicalensis Georgi has certain significance. Browsing the herbal monographs of Scutellaria in the past dynasties, it is found that the sources of Scutellaria are more consistent, and there is little difference between ancient and modern. Looking at the records of Scutellaria baicalensis for treating epidemics in the past dynasties, the earliest use of Scutellaria baicalensis for the treatment of epidemics can be traced back to the Han Dynasty. Since then, there have been records in the epidemic control literature from the Jin Dynasty to the Qing Dynasty, and it is still used by modern people until modern times. It can be seen that Scutellaria baicalensis has played an important role in the treatment of epidemic diseases in the past dynasties. However, it is not clear how Scutellaria baicalensis has treated the epidemic in the past. This article sorts out, researches and summarizes the nature and flavor of Scutellaria baicalensis Georgi, its efficacy, and the anti-epidemic prescriptions containing Scutellaria baicalensis Georgi. It makes the efficacy of Scutellaria baicalensis Georgi more clear and provides a better literature basis for clinical medication.
新冠疫情爆发以后,国家中医药管理局推荐使用“清肺排毒汤”,其有效率高达94%,“清肺排毒汤”配方中使用黄芩治疫的相关研究目前并不完善。本文通过查阅历代记载过黄芩的本草专著,发现黄芩来源较为一致,古今差别不大。纵观历代黄芩治疫的记录,黄芩最早用于疫病的治疗可追溯至汉代,从晋代至清代的治疫文献中也均有记载,直到近现代仍被今人沿用。由此可见,黄芩在历代治疗疫病的过程中都发挥着重要的作用。然而关于历代黄芩如何治疫,目前尚不明确。本文通过对历代黄芩的性味,功效,含黄芩的治疫方剂加以整理,研究和归纳,使得黄芩治疫功效更加明确,更好地为临床用药提供文献依据。
黄芩,疫病,本草考证,基源,性味,功效
Wenli Wang, Yingwei Wu, Hanqing Zhao*
College of Traditional Chinese Medicine, Hebei University, Baoding Hebei
Received: Aug. 3rd, 2021; accepted: Sep. 7th, 2021; published: Sep. 14th, 2021
After the outbreak of the COVID-19 epidemic, the Administration of Traditional Chinese Medicine 2recommended the use of “Qingfei Paidu Decoction”, which has an effective rate of up to 94%. Scutellariae appeared in the formula of “Qingfei Paidu Decoction”. However, the research on the treatment of Scutellaria baicalensis Georgi is not perfect at present, so the research on Scutellaria baicalensis Georgi has certain significance. Browsing the herbal monographs of Scutellaria in the past dynasties, it is found that the sources of Scutellaria are more consistent, and there is little difference between ancient and modern. Looking at the records of Scutellaria baicalensis for treating epidemics in the past dynasties, the earliest use of Scutellaria baicalensis for the treatment of epidemics can be traced back to the Han Dynasty. Since then, there have been records in the epidemic control literature from the Jin Dynasty to the Qing Dynasty, and it is still used by modern people until modern times. It can be seen that Scutellaria baicalensis has played an important role in the treatment of epidemic diseases in the past dynasties. However, it is not clear how Scutellaria baicalensis has treated the epidemic in the past. This article sorts out, researches and summarizes the nature and flavor of Scutellaria baicalensis Georgi, its efficacy, and the anti-epidemic prescriptions containing Scutellaria baicalensis Georgi. It makes the efficacy of Scutellaria baicalensis Georgi more clear and provides a better literature basis for clinical medication.
Keywords:Baikal Skullcap, Epidemic Disease, Textual Research of Materia Medica, Base Source, Sexual Taste, Effect
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《本草经集注》中记录黄芩:“圆者名子芩为胜。破者名宿芩,其腹中皆烂,故名腐肠” [
从历代记载来看,黄芩古今用名统一。也有人根据黄芩的新旧将其分为枯芩和子芩。
《神农本草经》中记载黄芩“生川谷” [
从历代本草记载来看,黄芩产于河北、陕西、山西、四川、湖北、甘肃等地。其中以山东和河北记载最多,其为黄芩的道地产区的可能性也最大。
《吴普本草》中描述黄芩为“二月生,赤黄叶,两两四四相值,茎空中,或方圆,高三、四尺,四月华紫红赤,五月实黑,根黄,二月至九月采” [
历代本草记载中,药用黄芩大多属于黄芩属。黄芩来源较为统一,并无争议。
黄芩的名称,产地,来源,从古至今变化不大,大致可认为,药用黄芩多来源于黄芩属,以河北,山东两地所产质量为佳。
汉代的《神农本草经》中记载黄芩“味苦平”。“主治诸热黄疸,肠澼泄利,逐水,下血闭,恶疮疽蚀,火疡。”张仲景的《金匮要略方论》中的治劳疟的“柴胡去半夏加栝蒌汤”具有“和解少阳,生津止渴”的功效,其中用“黄芩三两”来清泄邪热。《金匮要略方论》中的另一方——治霍乱的“泻心汤方”具有“泻火燥湿”的功效,其中用“黄芩一两”,以黄芩苦寒泻心火,清邪热,除邪以安正。张仲景的另一书《伤寒论》中用于“伤寒时疫”的“小柴胡汤”具有“和解少阳”的功效,其中用黄芩三分来清泄邪热。
晋代的《吴普本草》中记载黄芩“神农、桐君、黄帝、雷公、扁鹊:苦,无毒。李氏:小温。”葛洪的《肘后备急方》卷二治伤寒时气温病方第十三“葛根解肌汤”具有“解肌清热,发表散邪”的功效,方中用“黄芩一两”来清泻肺热。
唐代的《新修本草》中记载黄芩“味苦,平、大寒,无毒。”“主诸热黄胆,肠泄痢,逐水,下血闭,恶疮,疽蚀,火伤。疗痰热,胃中热,小腹绞痛,消谷,利小肠,女子血闭、淋露、下血,小儿腹痛”,孙思邈在《备急千金要方》卷九伤寒方上发汗汤第五——用于治伤寒温病的“解肌汤”具有“发表,解肌,退热”的作用。
宋代的《证类本草》中记载黄芩“味苦,平、大寒,无毒。”“主诸热黄胆,肠泄痢,逐水下血闭,恶疮疽蚀火疡,疗痰热,胃中热,小腹绞痛,消谷,利小肠,女子血闭,淋露下血,小儿腹痛” [
元代王好古的《汤液本草》中记载黄芩“气寒,味微苦,苦而甘。微寒,味薄气浓,阳中阴也。阴中微阳,大寒。无毒” [
陈嘉谟的《本草蒙筌》中记载“味苦,气平、大寒。”“宿芩泻肺火,消痰利气,更除湿热,不留积于肌表间;子芩泻大肠火,养阴退阳,又滋化源,常充溢于膀胱内。赤痢频并可止,赤眼胀痛能消” [
叶桂的《本草经解》中记载黄芩“气平。味苦。无毒。”“主诸热。黄胆。肠泄痢。逐水。下血闭。恶疮疽蚀。火疡” [
《中华本草》中记载黄芩具有抗菌作用和抗病毒作用,可以用于治疗急性菌痢和传染性肝炎。《中药大辞典》中记载黄芩具有抗微生物作用,可用于治疗急性菌痢,治疗传染性肝炎。赵锡武的《赵锡武医疗经验》中用于脊髓灰质炎(小儿麻痹症)的急性期的“加味葛根芩连汤”,具有清热透表,芳香逐秽,调肝熄风,宣痹通络的功效。
大量现代研究表明,清热解毒药能杀死病毒或抑制病毒复制等发挥直接抗病毒作用,或双向调节人体免疫机能发挥抗间接病毒作用。黄芩是临床常用的清热解毒类药,具有清热燥湿,泻火解毒的功效,其有效成分主要是黄酮类化合物,如黄芩素、黄芩苷、汉黄芩素和汉黄芩苷。有大量研究表明,黄芩素和黄芩苷具有抗菌,抗炎,抗病毒的作用。
在抗菌方面,黄芩对常见致病菌具有广谱抗菌作用。体外实验证明,黄芩煎剂对肺炎球菌、白喉杆菌、炭疽杆菌、痢疾杆菌、霍乱弧菌等均有一定的抑制作用。已有研究表明,黄芩苷可能通过破坏细胞膜和细胞壁的完整性,抑制菌体的DNA、RNA或蛋白质的合成,从而达到抑菌或杀菌的目的 [
在抗病毒方面,黄芩对流感病毒、肝炎病毒、艾滋病病毒均有一定的抑制作用。黄芩煎剂体外对甲型流感病毒有抑制作用,对体内感染流感病毒的小鼠可减轻小鼠肺部病变和延长存活时间。黄芩苷对乙型肝炎的三种抗原均有抑制作用。黄芩素对登革热病毒具有直接杀灭作用。黄芩及其主要活性成分黄芩苷可通过直接杀灭病毒、抑制病毒复制、调控宿主细胞功能蛋白表达、抗炎等作用机制来有效防治病毒 [
黄芩自汉代开始用于治疗疫病,主要是通过其清泻邪热的功效来发挥作用。黄芩用于治疫的记录在汉,晋,唐,宋,金元时期不太多,以明清为多,直到今日,诸多医家仍在使用黄芩来治疗疫病。经过整理和考证,可见黄芩在治疗疫病的过程中发挥着重要的作用,本研究可为临床医生合理使用黄芩治疫提供理论基础。
本研究得到河北省高等学校科学研究项目(QN2020272),河北大学大学生创新创业训练计划(2021262)立项资助。
王文丽,吴迎微,赵汉青. 历代治疫处方中黄芩的本草考证Textual Research on Radix scutellariae in Epidemic Treatment Prescriptions of Past Dynasties[J]. 中医学, 2021, 10(05): 650-655. https://doi.org/10.12677/TCM.2021.105088