“十九畏”本质的文献研究

【作者】 彭惠珍；

【导师】 钟赣生；

【作者基本信息】 北京中医药大学 ， 临床中药学， 2007， 硕士

【摘要】 “十九畏”属中药药性理论范畴,也是众所周知的配伍禁忌,但历代医药学者对它的研究甚少,相关研究也没有统一定论,因而,“十九畏”的实质不甚明了。本文从以下几个方面进行研究,探讨“十九畏”的实质:1.“十九畏”的源流通过收集、查阅“十九畏”源流的相关资料,系统整理了“十九畏”的最早文献记载、“十九畏”药物的最早本草文献记载、“十九畏”歌诀的最早文献记载、“十九畏”的发展、“十九畏”与“十九畏”歌诀的关系等方面的内容。研究认为“十九畏”歌诀的出现应该不早于宋代,“十九畏”的最早文献记载为明代刘纯的《医经小学》,“十九畏”应是“十九畏”歌诀的简称,“十九畏”形成之初即以歌诀的形式存在。2.“十九畏”的内涵通过对“相畏”、“相恶”、“相反”的分析,总结了“十九畏”与“相畏”、“相恶”、“相反”的关系,“十九畏”不能简单的概括为“相畏”或者“相恶”,亦或“相反”。其他研究显示,“十九畏”似乎应包含药物七情中的“相恶”、“相反”、“相使”,具体情况依据不同药组而定。并认为“十九畏”不是由“相畏”药物编的歌诀,另外,对“十九畏”的研究应包括对“十九畏”中的药物种类讨论。3.“十九畏”与炮制的关系将“十九畏”中各个药物的炮制方法进行分析,总结出“十九畏”包括药物配伍内容并涉及药物炮制内容。“十九畏”强调炮制的重要性,意义在于说明降毒的必要,而不是药物不可混合炮制。4.“十九畏”实验研究“十九畏”的实验研究在近二十年中才取得一定进展,通过对相关资料的分析,总结了“十九畏”实验研究的现状和存在问题。研究显示,大部分药组的配伍关系归属于“相恶”、“相反”范畴。人参配伍五灵脂似属药物七情“相使”范畴;丁香配伍郁金、肉桂配伍赤石脂属于“相使”或“相恶”与其不同的药理作用有关;硫黄配伍朴硝、川乌草乌配伍水牛角、三棱配伍芒硝似属“相恶”范畴;狼毒配伍密陀僧属“相反”或“相恶”范畴;水银配伍砒霜、巴豆配伍牵牛子似属“相反”范畴。5.“十九畏”的临床应用分别整理、分析古代“十九畏”应用记载和现代“十九畏”临床应用资料,总结“十九畏”药物配伍应用的规律。研究显示,“十九畏”不是绝对的配伍禁忌,临床仍可配伍应用治疗某些特殊疾病。其中,以官桂配伍赤石脂、川草乌配伍犀角、人参配伍五灵脂、巴豆配伍牵牛子四个药组多见。6.“十九畏”药组不宜配伍应用的文献记载通过对历代具有代表性医药书籍的查阅,分析了“十九畏”药组不宜配伍应用的记载,探讨了“十九畏”药组不宜配伍的实质。“十九畏”虽以配伍禁忌的形式出现,但没有配伍应用后出现不良后果的记载;不同书籍对“十九畏”的记载不尽一致;相关记载多数是对单个药组的说明。因而,将“十九畏”作为绝对的配伍禁忌没有一定的文献依据。上述研究,分别从文献、临床、实验等角度对“十九畏”的相关资料进行了系统的总结、分析,研究结果认为,最早文献记载“十九畏”的医籍为明代刘纯的《医经小学》,“十九畏”似乎应包含药物七情中的“相恶”、“相反”、“相使”,具体情况依据不同药组而定。“十九畏”虽以配伍禁忌的形式出现,但“十九畏”不是绝对的配伍禁忌。更多还原

【Abstract】 Nineteen mutual inhibitions is a famous prohibited combination and belongs to the theory of medicinal property. The study about nineteen mutual inhibitions is limited and no conclusion has been given. As a result, the natural of nineteen mutual inhibitions is not clear.This paper is focus on the natural of nineteen mutual inhibitions:1. The headstream of nineteen mutual inhibitionsThrough collecting and looking up the records concerning Nineteen mutual inhibitions, we get the conclusion that Nineteen mutual inhibitions appeared after song dynasty. Nineteen mutual inhibitions was firstly recorded in Yijingxiaoxue in ming dynasty. Nineteen mutual inhibitions resisted in the form of verse.2. The connotation of nineteen mutual inhibitionsThrough analyzing mutual restraint, mutual inhibition and mutual antagonism, we find that the combinations of nineteen mutual inhibitions are none of mutual restraint, mutual inhibition, mutual antagonism. The combinations of nineteen mutual inhibitions include mutual assistance, mutual inhibition, mutual antagonism. We should do the research on herbal species.3. The connection between nineteen mutual inhibitions and herb processingThrough analyzing the herbs in Nineteen mutual inhibitions, we get Nineteen mutual inhibitions contain parts of herb processing. Herb processing can alleviate the toxin of herbs in nineteen mutual inhibitions.4. The experimental research on nineteen mutual inhibitionsThere are more the experimental researches on nineteen mutual inhibitions enlarged during recent twenty years than ever. The combinations of herbs in nineteen mutual inhibitions mostly belong to mutual inhibition and mutual antagonism.5. The clinical applications of nineteen mutual inhibitionsSeveral applications of Nineteen mutual inhibitions aren’t absolute prohibited combination and can be used to cure some special diseases as the combinations of guangui and Halloysitum Rubrum, Radix Aconiti and Cornu Rhinocerotis, Radix Aconiti Kusnezoffii and Cornu Rhinocerotis, Radix Ginseng and Faeces Trogopterori, Fructus Crotonis and Semen Pharbitidis .6. The records of nineteen mutual inhibitions which are forbidden to combineThis part demonstrates that no kickback can be found in the records of Nineteen mutual inhibitions which are forbidden to combine. The records of Nineteen mutual inhibitions which are forbidden to combine are differential in many medical books. There isn’t enough evidence to support that nineteen mutual inhibitions must be avoided in combinations.In summary, this paper shows nineteen mutual inhibitions was firstly recorded in Yijingxiaoxue in ming dynasty and the combinations of Nineteen mutual inhibitions includes mutual assistance, mutual inhibition, and mutual antagonism. Nineteen mutual inhibitions doesn’t belong to prohibited combination absolutely.更多还原