| 摘要: | 四物湯是補血的基本方，也是婦科調經的重要方劑，在婦科臨床上被廣泛使用。此方由熟地、當歸、川芎及芍藥組成，其作用為補血，滋養氣血，調益榮衛，活血調經，治療一切失血體弱，營血虛滯，婦人月經不調，血虛或血行不暢之病。
中醫藥典籍源遠流長，記載了很多古代醫藥專家寶貴的臨床經驗。本論文希望能從浩瀚的中醫典籍中，找出四物湯的傳承沿流，瞭解其歷史發展過程，並進一步研究四物湯的衍生方，考證方劑之出處及出典書籍在典籍分類樹狀圖的定位，書卷部集名、章節項目名之歸納統計、比較及收載內容文字量之評比。除了上述發展史的研究關係，我們也要找出四物湯的組方變化、治療病症的種類與其使用，再與現代臨床研究及台灣中醫健保使用狀況做交叉比對，以探討此方目前在兩岸的使用趨勢及研究進展是否超越古代醫家的範疇，為臨床醫師提供寶貴的資料。
本文以四物湯為關鍵詞，搜尋中華醫典電子資料庫(一千多本)，目錄區共156筆，全文區共5041筆。研究發現四物湯最早記載於唐朝的《仙授理傷續斷方》中作為傷科用藥，而非宋朝的《太平惠民和劑局方》之婦科要藥。經統計得知有531本中醫藥典籍記載四物湯，將各典籍按《全國中醫圖書聯合目錄》分類後，發現記載四物湯之典籍以臨證各科類為最多，佔38.98%；臨證各科中又以婦產科最多，其次為兒科及內科。現代中國大陸期刊對四物湯的研究也是以臨床報告為主，主要治療痛經。
四物湯在古籍中的使用以血液及造血器官之疾病妊娠、生產及產褥期之併發症及女性生殖系統疾病為主。根據現代中國大陸期刊及台灣健保的統計，四物湯治療的疾病分類則是以女性生殖系統疾病為主。
Si-Wu Tang (四物湯), a main blood-supplementing formula which is used as a remedy for nourishing the blood and commonly used as a basic formula in Traditional Chinese medicine (TCM) for treating women’s illness especially dysmenorrhea. This formula is composed of Di Huang (Radix Rehmanniae), Dang Gui (Radix Angelicae Sinensis), Chuan Xiong (Rhizoma Chuanxiong) and Bai Shao (Radix Paeoniae Albae).
Our long-standing historical TCM books have recorded many valuable clinical experiences of TCM doctors. In order to find out the source and historical inheritance from the voluminous ancient Chinese Medicine literatures database, we use the relevant keywords to link and retrieve articles focus on the study of Si-Wu Tang. Furthermore, we can also find out the development of variable combination and treatment of Si-Wu Tang. Such variable treatment of TCM formula shows the necessity of historical development and the ways to explore the theory of formula organization and medicine using from the ancients. Besides the study of the historical development, we also have to find out the variable combination, treatment, present clinical research and the application of National Health Insurance in Taiwan. Such results can explore the development and use tendency of Si-Wu Tang between Taiwan & Mainland China, and provide valuable information to clinical doctors.
We use a self-created computer program to retrieve and analyze the articles from the Encyclopedia of Traditional Chinese Medicine (中華醫典). From the results, we know that Si-Wu Tang comes from “Secret Formulary for Traumatology and Fracture Taught by Immortal” (《仙授理傷續斷方》) since Tang Dynasty, but not from Song Dynasty’s “Tai Ping Imperial Grace Formulary” (《太平惠民和劑局方》). This shows that Si-Wu Tang was used to treat Traumatology in ancient, but not gynecology. According to the classification of “Library Union Catalogue of Mainland China”, the result shows that the different clinical department of TCM ancient books recorded the most abundant details of Si-Wu Tang, accounts for 38.98%. For the different clinical department of TCM ancient books, Si-Wu Tang is commonly recorded in gynecology. The result of the TCM journals in Mainland China show that the clinical reports which treat dysmenorhea are the main research of Si-Wu Tang.
The evidences from the literature show that the original Si-Wu Tang is a well accepted remedy from the past to the present. The Si-Wu Tang is prescribed for disease of blood and blood-forming organs, pregnancy, childbirth, puerperium and genito-urinary disorder in ancient time. Meanwhile, the main application of Si-Wu Tang in Mainland China and Taiwan is the gynecology system. |
