经典名方人参五味子汤的历史沿革与现代临床应用*
作者：康 婷1，李玉丽2，欧阳聪1，杨 雪1，胡 杨1，蒋 屏1
单位：1.湖南中医药大学第一中医临床学院，湖南 长沙 410007； 2.湖南省中医药研究院，湖南 长沙 410300
引用：引用：康婷，李玉丽，欧阳聪，杨雪，胡杨，蒋屏.经典名方人参五味子汤的历史沿革与现代临床应用[J].中医药导报,2025,31(7):114-120.
DOI：10.13862/j.cn43-1446/r.20250527.003
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摘要：人参五味子汤被收录于《古代经典名方目录（第二批儿科部分）》。通过查阅古今文献，考证分析其历史源流、主治病证及病机、方义、药物基原与炮制方法、剂量及现代临床应用病种等。涉及古籍文献共19部，共获取有效数据36条。结果显示，人参五味子汤的同名同方首见于清代陈复正的《幼幼集成》，但在《幼幼集成》前其异名同方早已应用，首载于《保婴撮要·卷十二》。其功效为健脾益气，补肺养阴，主治肺脾两虚之咳嗽、汗证、喘证、脱证、小儿流注、眩晕等。本方药物基原及炮制方法明确，但白术的使用剂量存在争议，从现代临床实际出发，推荐全方药味及使用剂量为人参（生品）4 g，白术（米泔水漂制）6 g，茯苓（生品）4 g，五味子（生品）2 g，麦冬（生品）4 g，甘草（炒制）3 g，大枣9 g，生姜3 g。现代临床主要应用于小儿肺系疾病，具体病症涉及百日咳、小儿肺炎、小儿哮喘、小儿反复呼吸道感染、小儿咳嗽等。
关键词：人参五味子汤；经典名方；《幼幼集成》；《保婴撮要》；白术；小儿肺系疾病；文献考证
Abstract：Renshen Wuweizi Decoction is included in the Catalogue
of Ancient Classical Masterpieces (Second Part of Pediatrics). By reviewing
ancient and modern literature, this paper aims to investigate and analyze the
historical origin, main treatments and disease mechanisms,formulae, drug bases
and concoctions, dosages and modern clinical applications. A total of 19
ancient medical texts were consulted, yielding 36 valid data entries. The
results showed that the homonymous formula of Renshen Wuweizi Decoction was
firstly found in CHEN Fuzheng's the Juvenile Integration in the Qing Dynasty,
but its homonymous formula had been applied long before the Juvenile
Integration and was firstly published in the Infant Protection Summary- Volume
12. Its efficacy is to invigorate the spleen and Qi, supplement the lungs and
nourish Yin, and is mainly used for treating cough, sweating, wheezing,
dehydration, paediatric rheumatism, and vertigo caused by deficiency of both
the lung and the spleen. This formula has a clear base and processing method,
but the dosage of Baizhu (Atractylodis Macrocephalae Rhizoma) used in the
formula is controversial. From modern clinical practice, the recommended dosage
of the whole formula is 4 g of Renshen (Ginseng Radix) (raw), 6 g of Baizhu
(Atractylodis Macrocephalae Rhizoma) (bleached in rice swill), 4 g of Fuling
(Poria) (raw), 2 g of Wuweizi (Schisandrae Fructus) (raw), 4 g of Maidong
(Ophiopogonis Radix) (raw), 3 g of Gancao (Glycyrrhizae Radix) (fried), 9 g of
Dazao (Jujubae Fructus), and 3 g of Shengjiang (Zingiberis Rhizoma Recens). In
modern clinical practice, it is primarily used for pediatric lung diseases,
including whooping cough, pediatric pneumonia, pediatric asthma, recurrent
respiratory infections in children, and pediatric cough.
Key words：Renshen Wuweizi Decoction; classical prescriptions; Juvenile Integration; Infant Protection Summary; Baizhu (Atractylodis Macrocephalae Rhizoma); pediatric lung diseases; textual research
发布时间：2026-01-06
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