| 摘要: | 六味地黃丸屬於補益類補陰之劑，是治療腎陰虛證的基本方。最早由宋代錢乙依據東漢 張仲景之腎氣丸減去附子、桂枝，易生地黃為熟地黃而得之方，治小兒先天不足、五遲之症。從立方迄今，近900年，是一歷經五代流傳已久的方劑。由熟地、山藥、山茱萸、澤瀉、茯苓及牡丹皮六味中藥所組成，作用為滋腎陰、補腎水。原方治小兒腎陰虛而發育遲緩之證，後來臨床上更擴大使用於腰膝痠軟、頭暈目眩、盜汗、遺精、消渴、口燥咽乾等腎陰虧損之症，範圍遍及內、外、婦、兒等科別。
中醫藥發展的歷史源遠流長，古代醫藥學家將其寶貴知識記載在傳承於後的典籍裡。本論文希望能從浩瀚的典籍中，將六味地黃丸方義的敘述與方中組成藥物之本草典籍所述功能結合，統計分析，對照比較後作一整合性的用藥論述。
本文以六味地黃丸之為關鍵詞，搜尋中華醫典電子資料庫，做為研究資料主要來源。研究顯示，六味地黃丸為錢乙所創，以熟地黃滋腎陰補血衰為君藥；山茱萸補肝腎兼澀精氣、山藥健脾胃，兩者為臣藥；茯苓滲利且補脾、丹皮清瀉肝火，兩者為佐藥；澤瀉去濕熱濁氣，清氣上行為使藥。在錢氏之後醫書則有記載其君臣變化，六味藥在不同情況下，各自能當君藥。雖言六味地黃丸架構為「三補三瀉」，但從本草典籍功效考察得出澤瀉、茯苓、丹皮(三瀉)亦有瀉而補養之功效。由基礎藥物功效去解讀方劑，能學習地更為透徹。
藥與方本為一體，從醫學藥者不能只熟識其一。但歷代典籍浩瀚，終其一生也無法盡讀。幸好TCM-e-Books時代已經來臨，我們利用電子典籍資料庫與電腦程式，輕易地將定義範圍內數位化典籍資料拆解分析，再次統整結論並提出論述。這是一個創新的方法，讓讀者在短時間內快速學習本草用藥論精髓，如同古代醫家熟讀過龐大的本草類典籍，用方上能臻於完善，對於中醫知識的傳承具有重大的價值所在。
‘Liu Wei Di Huang Wan’, a representative formula which is used as a remedy for nourishing kidney overcast and commonly used as a basic formula in Traditional Chinese medicine (TCM). This formula is created from Qian Yi at Song Dynasty based on Zhang Zhongjing’s ” Shenqi Wan (kidney-qi-tonifying pill)” which removed Fu Zi (Aconitum carmichaeli) and Gui Zhi (Cinnamomum cassia) , as well as replaced Shen Di Huang (Rehmannia glutinosa) with Shu Di Huang (Prepared Rehmannia glutinosa). This formula is used for the treatment of infant congenital deficiency and infant developmental retardation. Liu Wei Di Huang Wan is a well knwon formula within 900 years. The formula is composed of Shu Di Huang (Prepared Rehmannia glutinosa), Shan Zhu Yu (Cornus officinal), Shan Yao (Dioscorea opposite), Ze Xie (Alisma orientals), Fu Ling (Poria cocos) and Mu Dan Pi (Paeonia suffruticosa). In the clinical applications, this formula is used to treat the syndrome of the kidney yin deficiency , like as aching lumbus and limp knees, dizzy head and dizzy vision, thief sweating, seminal emission, dispersion-thirst and dry mouth, for internal , surgery, gynecology and pediatrics.
The development of TCM has a long history. Our long-standing historical TCM books have recorded many valuable clinical experiences from several TCM doctors. In order to find out the treasures and succeed the knowledge from the voluminous ancient Chinese Medicine literatures database, we have used the narrative of Fang Yi combined with the ingredients of formula to make an integrated clinical applications exposition through the comparison of the functions, and statistical analysis.
Therefore, " Liu Wei Di Huang Wan, Di Huang Wan " were the keywords for this analysis using the self-created computer program to retrieve and analyze the articles from the Encyclopedia of Traditional Chinese Medicine.
Originally, Qian Yi has indicated the Shu Di Huang as the sovereign , and others ingredients were assistants in Liu Wei Di Huang Wan. However, from the results of study, some books had changed their roles in the later generations. All of ingredients can be serviced as the sovereign in different condotions. The medicinal characteristic of each ingredient in this formula is “The three nourishing and three draining compatibly “. In fact, Ze Xie, Fu Ling, Mu Dan Pi (three draining ) were indicated to have not only draining function but also nourishing function based on survey of the Pents'aological Literatures. Therefore the ratio of dosage for each ingredients in Liu Wei Di Huang Wan is not fixed strictly. The ratio of dosage can be changed according to their clinical applications.
The medicinals and formula are belonged into a whole body, people study Chinese medicine and medicinals are not able to know one of them, and it is impossible to Investigate all of the vast historical books in their lives. Fortunately, the electronic books (TCM-e-Books) database and computer programs can easily help us to study within the definition and analysis of data. This is an innovative method which allows readers to learn TCM quickly in a short time with the essence of herbal medicines, as same as the ancient physicians who had studied TCM with a huge herbal books. It will be helpful to succeed the precious knowledge of Traditional Chinese medicine |
