備急千金要方婦科學術思想之研究

Study for the Gynecological Thoughts on Qian Jin Yao Fang

中國醫學自東漢張仲景建立臨床辨證論治的體系以來，中醫學的發展可分為四個階段，在這發展過程中，歷來被評價最高的為唐朝孫思邈千金方醫學。千金方其書很雜，兼收各家之學驗，其婦科學術思想深受仲景醫學與巢氏病源論的影響，於調經理論重視「風冷」病因，與「虛、積冷、結氣」病機，故其治病思想主要以溫補祛瘀為主。孫氏婦科用藥以溫補、清熱、活血、固濇四類，為其遣方治病的主要藥物。治婦人不孕、月水不通、月經不調，以溫補化瘀清熱為主；治赤白帶下、崩中漏下，以溫補清熱固濇為主。此為千金婦科治病的特色。千金婦科治病方法，影響後世很大，其溫補用藥開明代溫補學派婦科調經重視溫補思想之先河；其活血用藥如芎藭、桃仁、丹參、澤蘭等，為宋以後醫家活血調經所常用；其清熱用藥如丹皮、地骨皮、黃芩、黃連等，為金元以後醫家涼血清熱調經之典範；其固濇每周藥如烏賊骨、龍骨、牡蠣、赤石脂等，為後世醫家治崩漏不幸色，帶下不止必用之品。此外，後世方約之治崩次第「塞流」、「澄源」、「還舊」亦均師法於千金要方。

The progressing of Chinese medicine has been divided into four stages since Chung Zhong-Jing set up the system of clinical diagnosis and treatment in East-Han Dynasty. During the course of development, the book, Qian Jin Yao Fang written by Sun Si-Miao in Tong Dynasty has gotten the highest appraisal. Sun concluded many ancient medical scholar's experiences and in gynecology， he was deeply influenced by Zhong-Jing and Chao Yuan-Fang's Zhu Bing Yuan hou Lun. The four characters of Sun's gynecological treatment were warm-invigoration, febrifung, invigorating blood circulation and therapy by astrigents. However, the gynecological treatment in Qian Jin Fang has much affected the later generations. The concept of warm-invitoration was the forerunner of warm-invigoration schools in Ming Dynasty. And then, the drugs such as Chuanxiong rhizome, Peach kernel, rood sage root and Bugle weed etc. which were often used for treatment of disorders of menstration in Song Dynasty. The drugs for febrifages such as Mowtan bark, Walfberry bark, Scutellaria root and Coptis root etc. set a good example to the physicians in Jin Dynasty. Meanwhile, the drugs, such as Dragon's bone, Oyster shell, red halloysite and cuttlefish bone etc., were essential ones when the later physicians treated sudden profuse or persistent vaginal bleeding and troublesome leukorrhea.