基于经典名方的山茱萸本草考证

Herbal Textual Research on Corni Fructus Based on Classical Famous Prescriptions

关键词:  经典名方  山茱萸  本草考证  名称  基原  药用部位  炮制

Key words:  famous classical formulas  Corni Fructus  herbal textual research  name  origin  medicinal parts  processing

摘要:

山茱萸作为临床常用中药，具有补益肝肾，收涩固脱之效。鉴于历代医药学家对山茱萸药用部位颇有争议，笔者通过查阅历代本草、医学典籍，结合现代相关文献、标准等资料，对山茱萸名称、基原、产地变迁及品质、药用部位、采收加工及炮制、性味功效、用法用量等内容进行本草学考证，为确保含有山茱萸的经典名方能够精准用药以及为进一步开发利用提供参考。经考证可知，山茱萸从古至今来源为山茱萸科植物山茱萸Cornus officinalis Sieb.et Zucc.，最早产于山东、陕西一带，后延伸至河南、浙江等地大量栽培，现商品多以浙江所产品质为佳。山茱萸最初应是以全果实入药，但由于“核能滑精”说的影响致使山萸肉(去核之果肉)成了历代主流品规，但在临床实际应用中，2种规格均存在，应根据患者类型辨证使用。山茱萸在历代本草、医学典籍中记载的炮制方法也较多，但主流品种为山茱萸生品和酒萸肉。此外，山茱萸性味也从最初“味酸，平、微温无毒”演变为“味酸、涩，性微温”，历代用药剂量更是与药典规定的剂量范围出入较大，建议临床医师在条件允许的情况下，应根据患者及病证类型，选择合适的经方剂量，以最大限度保证山茱萸应有的临床疗效。

Abstract:

Corni Fructus, as a commonly used Chinese materia medica in clinical practice, has the efficacy of tonifying and replenishing the liver and kidney as well as stopping collapse with astringent therapy. Given the controversy among medical experts through the ages over its medicinal parts, the author conducted a textual research on the name, origin, changes in producing areas and quality, medicinal parts, collecting, harvesting and processing, natures, tastes, efficacy, usage and dosage of Corni Fructus by consulting materia medica and medical classics of past ages, and combining relevant modern literature and standards, to ensure the precision medication of classic formulas containing it and provide a reference for further development and utilization. According to the textual research, it can be concluded that Corni Fructus has originated from Cornus officinalis Sieb.et Zucc. since ancient times. It was first produced in Shandong and Shaanxi, and later extended to Henan, Zhejiang, and other places for large-scale cultivation. Currently, the quality of products produced in Zhejiang is recommended. Initially, the whole fruit of Corni Fructus was used for medicine, but due to the influence of “the core causes spontaneous seminal emission” theory, the flesh of Corni Fructus(flesh with removing the core from the fruit) has become the mainstream product standard throughout the ages. However, in clinical practice, both specifications exist and should be used in accordance with syndrome differentiation and patient types. There are also many processing methods for Corni Fructus recorded in materia medica and medical classics of past ages, but the mainstream processing varieties are raw medicinal materials of Corni Fructus and flesh of Corni Fructus processed by wine. In terms of the properties and flavors of Corni Fructus, initially priority have been given to “taste sour, mild, lukewarm without toxicity in nature”, now have been switched to “taste sour, astringent, lukewarm in nature”. Moreover, its dosage range of medication of past ages varies greatly from that specified in the pharmacopoeia. It is recommended that clinical doctors choose the appropriate dosage recorded in classic prescriptions according to the patient and disease type, as conditions permit, to maximize the clinical efficacy of Corni Fructus.