歸脾湯的方源探討與典籍應用紀錄

The origin tracing and evolution of the Guipi Decoction in ancient traditional Chinese medicine works

莊照宇(Chuang Chao-Yu)；許堯欽(Hsu Yao-Chin)

歸脾湯 ； 氣血兩虛 ； 心脾兩虛 ； 脾不統血 ； MGuipi Decoction ； pattern of dual deficiency of qi and blood ； pattern of dual deficiency of the heart and spleen ； pattern of spleen failing to control the blood

北台灣中醫醫學雜誌

15卷2期（2023 / 09 / 30）

1 - 15

繁體中文;英文

歸脾湯為中醫治療思慮過度，勞傷心脾，氣血兩虛的經典名方，出自南宋．嚴用和《濟生方．健忘論治》，立方時原為十味藥，值至明．薛立齋《校注婦人良方》為增強養血寧神之效，又增入當歸、遠志，而成大家熟悉的十二味藥。透過蒐集整理宋元明清重要典籍，結果發現歸脾湯在內、外、婦、兒、男各科都有普遍被運用的紀錄，舉凡失眠、便祕、消化道出血（吐血、下血）、婦人調經、崩漏、男子夢遺滑精、小兒夜啼、乳癰／乳巖、癭瘤等，只要符合心脾兩虛的主要病機，均見本方之證治紀錄。

Guipi Decoction is a classic prescription of Chinese medicine for treating overthinking, pattern of overstrain injuring heart and spleen, pattern of dual deficiency of qi and blood. It originated from the prescriptions《Jisheng Fang Volume 4》writtern by Yan Yonghe in the Southern Song Dynasty. Guipi Decoction originally consisted of ten herbs, but in order to enhance the effect of nourishing blood and calming heart, Xue Lizhai added angelica and polygala to form the twelve herbs in his book《Annotated Complete Collection of Prescriptions for Women》. By collecting and sorting important classics of the Song, Yuan, Ming and Qing Dynasty, it was found that Guipi Decoction has been widely used in subjects of internal medicine, surgery, gynecology, pediatrics, and andrology, dealing with symptoms such as insomnia, constipation, gastrointestinal bleeding (vomiting blood, bleeding in stool), menstrual disorders, spermatorrhea, nocturnal fretfulness in children, breast abscess/cancer, goiter, etc., as long as they meet the pattern of dual deficiency of the heart and spleen.