《醫部全錄》小兒與成人嗽喘用藥性味之比較

Comparison of Properties and Flavors of Herbs Adopted in the Formulas Recorded in “Yi-Bu-Quan-Lu”for the Treatment of Cough and Dyspnea in Children and Adults

小兒體質屬寒或屬溫的兩派學術之爭，從宋朝至今，將近千年。對於小兒體質屬寒或溫的認知，也影響臨床治病選藥之「藥性」、「藥味」的趨勢。為了探討小兒用藥的特點，我們以《醫部全錄》（成人）「哮喘門」與「咳嗽門」與小兒「嗽喘門」之方劑，作為研究物件，分析成人與小兒嗽喘方劑中的「藥性」（溫、平、寒）、「藥味」（酸、苦、甘、辛、鹹）在每個方劑中出現的頻率（比率），並進行統計分析。同時，以統計檢定挑選出成人或小兒用藥頻率有明顯差異的單一藥物，進一步分析成人或小兒用藥的異同。成人平均每方用藥的數目，明顯高於小兒（p<0.01）。藥性方面，成人每一方中用「溫性藥」比率，成人皆明顯高於小兒（p<0.05）；藥味方面，成人用酸味藥比率，亦明顯高於小兒（p<0.01），達統計上之差異。此外，各個單一藥在成人（340方）或小兒（204方）方劑中出現比率，經由統計檢定發現，成人方劑中使用酸收類、養陰血類藥物等用藥明顯多於小兒；而小兒之用藥則以鎮靜安神類藥物、芳香與健脾藥、寒瀉藥（大黃）、香竄藥物、涼血藥等用藥頻率明顯高於成人。就《醫部全錄》咳嗽哮喘的成人與小兒用藥之異同而言，可初步說明小兒疾病的變化趨勢用藥與特點與成人有所不同。 In order to realize the characteristics of the Chinese medical medication for children, we tried to analyze the frequency (percentage) of the properties (warmth, neutral, cold) and the flavors (sourness, bitterness, sweetness, pungency, saltiness) of the Chinese herbs from 204 formulas in children’s “Sou-Chuan-MerT, 340 formulas in adults, “Xiao-Chuan-Men” and “Ke-Sou-Men” recorded in “Yi_Bu_Quan-Lu”. Our results showed the average number of herbs adopted in one formula in adults was significantly higher than that in children (p < 0.01). Furthermore, the percentage of herbs with warmth (p < 0.05), and sourness property (p < 0.01) in each formula were also significantly higher in adults than in children. When further examining the functional categories of the above herbs, we found the percentage of “sourness astringent” and “yin-blood tonifying” herbs were higher in adults than in children. On the contrary, in children, the frequencies of using “settling tranquillizing”, “aromatic spleen-fortifying' “cold purgative medicines (Rheum officinale)”, and “aromatic orifice-opening' and “blood-cooling” herbs were higher than adults. All the above results revealed that the characteristics of the Chinese medical medication in children are different from those in adults for the treatment of cough, wheezing and dyspnea.