傅青主生化湯之適應症與藥物劑量及加減的關係

《傅青主女科》是一部極具代表性且廣為後世醫家推崇的中醫婦產科經典專著，生化湯為傅青主的產後常用方，其根據不同病機、症狀、病程等以生化湯原方為基礎做用藥加減來治療產後諸疾，而延伸出許多生化湯相關處方。各個生化湯相關處方的生化湯原方劑量、外加藥物組成以及適應症不盡相同，本研究收集《傅青主女科》中名稱包含「生化湯」的處方共二十八帖，並將其適應症歸類為七個生理系統的疾病，分析各系統處方的當歸、川芎、桃仁、黑薑、甘草五味生化湯原方基本用藥的每日劑量差異以及常見的外加藥物等。此外，血塊痛的有無是傅青主調整用藥的辨證重點，因此研究中亦分析五味基本用藥運用於有、無血塊間的差異。研究結果發現當歸、川芎、桃仁、黑薑、甘草的每日劑量在各生理系統間無顯著差異，但是桃仁的每日劑量在有、無血塊間則達顯著差異。各系統的外加藥物共四十三味，以補虛類藥物最多，所有外加藥物以人參出現的頻率最高、與生化湯原方的關聯度最高。

關鍵字

傅青主女科；生化湯；產後；加減藥物

並列摘要

＂Fu Qing-Zhu's Gynecology＂ is an ancient book onobstetrics and gynecologyin Traditional Chinese Medicine (TCM) which serves as a good learning model for many TCMphysicians.Qing-ZhuFu usually used Sheng-Hua-Tangfor the treatment of postpartum diseases. Moreover,he modified the compositions and dosage of Chinese herbs inSheng-Hua-Tangbased ondifferent etiologies, pathogenesis, symptoms, and stages of postpartum diseases. The five basic Chinese herbal compositions of Sheng-Hua-Tang are Danggui, Chuanxiong, Taoren, black Ginger, and honey-fried Gancao.In ＂Fu Qing-Zhu's Gynecology＂, modified ShengHuaTang formulas were recorded with different dosages of the five basic Chinese herbal compositions, additional Chinese herbal medicines, and indications. In this study, a full text search of ＂Fu Qing-Zhu's Gynecology＂ showed twenty-eight formulas names containing＂ShengHuaTang＂. We classified the indications of these formulas into seven body systems. The daily dosage of the five basic herbs and additionalChinese herbs were systematically summarized.Formulas were also divided intothose treating symptoms ＂with blood clot＂ and those treating symptoms ＂without blood clot＂,since whether there are blood clotsplays an important role in medication adjustment in ＂Fu Qing-Zhu's Gynecology＂. The results showed that there were no significant differences in the daily dosage of Danggui, Chuanxiong, Taoren, black Ginger, and honey-fried Gancaoamong formulastreating symptoms of the seven body systems. However, the daily dosage of Taorenin formulas treating symptoms＂with blood clot＂was significantly higher thanin those treating symptoms＂without blood clot＂.As for additional Chinese herbs, we found that tonifying Chineseherbs were frequently used, and Ginsengwas the most frequently usedherb among the forty-three additionalChinese herbs in modified ShengHuaTang formulas.