皮膚瘡瘍證治思想與生肌類方劑的研究

PROMOTING THE GRANULATION OF SORES

中醫皮膚瘡瘍證治思想的歷代發展演進，可分為三個階段：自馬王堆醫書至隋諸病源候論為萌芽期；自唐《千金翼方》至元《外科精義》為皮膚瘡瘍證治思想的成熟期；自明《外科正宗》至清《醫宗金鑑、外科心法要訣》皮膚瘡瘍證治思想的內容更加豐富，此階段稱之為豐富擴展期。近代醫家在治療皮膚瘡瘍上，遂逐漸展現優越的臨床經驗，即外用劑與內服藥並用。生肌類方劑，臨床上多運用於慢性皮膚潰瘍的外敷，其可加速皮膚瘡瘍癒合。本研究統計歷代典籍的生肌類外治方劑，總共收集63 首方劑，使用中藥達121 種，每則處方平均使用了6 種藥物，出現頻率超過九次以上的藥物分別是：輕粉（Calomelas ）、冰片（Borneolum ）、乳香（Frankincense ）、血竭（Daemonoropis Draconis Resina ）、龍骨（Mastodi Dentis Fossilia ）、兒茶（Catechu ）、沒藥（Myrrha ）、鉛粉（Minium ）、珍珠（Margarita ）、當歸（Angelicae SinensisRadix ）、白芷（Angelicae Dahuricae Radix ）、海螵蛸（Sepiae seu Sepiellae Os ），計十二味藥。這些藥物可提供設計皮膚瘡瘍癒合新處方的參考。The historical evolution of the pattern identification and treatment of sores can be divided into three stages. The initial stage was from the medical book of Ma Wang Dui to the Zhu Bing Yuan Hou Lun in the Sui Dynasty. From the Qian Jin Yi Fang in Tang Dynasty to the Wai Ke Jing Yi published in the Yuan Dynasty, the stage of maturation. The Wai Ke Zheng Zong of the Ming Dynasty to the Wai Ke Xin Fa Yoa Jue of the Qing Dynasty represent the flourishing and expansion of thought concerning the pattern identification and treatment of sores. The modern physicians have developed great clinical skill in the treatment of sores using a combination of external-use formulas and internal oral medicine. Prescriptions promoting the granulation of sores are often topically applied on chronic ulceration of skin to accelerate the wound healing. In this study, we reviewed and calculated the external-use formulas used to promote the healing of sores from classical literature. The total of 63 formulas were selected, comprising 121 Chinese herbs. Each formula consists of 6 Chinese medicinals on average. The frequency rate over nine times in all recipes, there are 12 Chinese medicinals as following: Calomelas, Borneolum, Frankincense, Daemonoropis Draconis Resina, Mastodi Dentis Fossilia, Catechu, Myrrha, Minium, Margarita, Angelicae Sinensis Radix, Angelicae Dahuricae Radix, Sepiae seu Sepiellae Os. These medicinals can reference for designing new formulas to promote the healing of sores.