| 摘要: | 咳嗽哮喘是小兒科臨床常見疾病，本研究藉由分析中醫歷代重要兒科咳嗽哮喘處方文獻，探討重要醫家用藥特色，並追溯該醫家之學術特點、傳承背景，及所處年代的氣候特點等；再依時間先後分析重要醫家治療小兒咳嗽哮喘處方之藥物，瞭解其用藥在「藥氣」、「藥味」及「藥數」的變化趨勢。同時配合中國歷史上氣候變遷的因素，探討其對成人與小兒用藥的影響。
經分析21本載述小兒咳嗽哮喘之兒科專書或醫學全書，藥氣、藥味及藥數的變化趨勢為：（一）藥氣方面：隨著時代的變遷，無論兒科專書與醫學全書之方劑其藥氣應用的趨勢呈現「溫藥」漸減、「平藥」及「涼藥」漸增，「溫藥/涼藥」的比值呈現下降趨勢。（二）藥味方面：在兒科專書或醫學全書中：「酸味藥」、「鹹味藥」所佔的比例都最少。隨時代變遷，「苦味藥」之應用有漸增的趨勢，「酸味藥」之使用微幅上升，「辛味藥」有漸減的趨勢，「鹹味藥」與「甘味藥」的變化則不明顯。（三）藥數方面：在小兒專書中，每個方劑的平均藥物數目變化，依年代遷移有增加的趨勢；在醫學全書中，藥物數目則稍減。但將兩者合併分析，則藥物數目有增加的趨勢。（四）以中醫小兒咳嗽哮喘之治療發展而言，除歷史上氣候變遷因素影響各學派的形成發展，「小兒體質特點」也是影響用藥趨勢的重要因素。
結論：影響小兒咳嗽哮喘用藥的因素，除了地理位置、時代氣候環境，小兒體質亦同時扮演著重要角色。
Cough and panting are common pediatric clinical diseases, this study aimed to explore the characteristics of the ancient physicians about their medication, academic thoughts, inherited background, and the climate features of their times. Then, the trends in the frequency of the medicinal properties “Qi” (warmth, neutral, coolness), “flavors” (sourness, bitterness, sweetness, pungency, saltiness) and numbers were compared chronologically. Simultaneously, “the transition of the climate in the China history” was taken into account to investigate its effects on the medication for adults and children.
Literatures about cough and panting medicinals in 21 pediatric-specific books or general medical books were analyzed, and the trends in the frequency of the qi, flavors and numbers are: (1) Qi: the “warmth” decreased while “the neutral” and “coolness” increased, and the ratio of “warmth/coolness” lowered with time were found in both kind of analyzed books.(2) Flavors: the proportion of the “sourness” and “bitterness” were both the lowest. With time change, the application of the “bitterness” increased, the “sourness” only increased slightly, the “pungency” decreased, while there was no obvious change in the “saltiness” and “sweetness”.(3) Numbers: in pediatric-specific books, the number of medicinals increased with time while it decreased in the general medical books. When these 2 kinds of books were analyzed together, the medicinal numbers showed an elevated trend. (4) in the treatment of pediatric cough and panting, not only the transition of climate in China history had certain degree impact on the sect formation, but "the constitution of children" also played an important role in the trend of medication.
Conclusions: Besides geographic location and environmental climate with time, the constitution of the children also affects the medication for pediatric cough and panting obviously. |
