《太平惠民和剂局方》成药总量大的原因分析

Exploring the reasons for the high dose of prescriptions in the Taiping Huimin Heji Jufang

关键词:  《太平惠民和剂局方》  和剂局  宋代  剂量  非处方药

Key words:  Taiping Huimin Heji Jufang  Heji Ju  Song Dynasty  dose  over-the-counter drugs

摘要:

在宋代药物缺乏的背景下，其药物每服量较前代减少，许多学者对此已进行广泛而深入的研究。然而《太平惠民和剂局方》（以下简称《局方》）作为宋代官药局的成药处方范本，其所载的诸多成药处方的总剂量却十分大，与其较小的每次服用剂量成鲜明对比，其中许多成药可供患者服用百天以上，患者若未服用完毕即病情痊愈则会造成药物浪费，似与宋代缺医少药的情况不符。文章从社会环境、和剂局职能、官药局药物特点3个角度分析了在药材短缺的时代背景下，宋政府如此设定方剂剂量的合理性。文章认为，不能仅从临床角度去理解《局方》的成药剂量设定，因为其不仅要确保临床疗效，还要兼顾交通情况、官药局职能、成药质量、百姓需求等方面，因此临床上使用《局方》所载方剂时应灵活调整其药物剂量。并且宋代作为首个开展全民医保的朝代，其“便民利民”的精神值得学习，其“每服少，全方大”的成药剂量设定也有一定借鉴意义。

Abstract:

Against the backdrop of a shortage of drugs in the Song Dynasty，the amount of drugs taken per dose decreased compared to the previous generation，and many scholars have conducted extensive and in-depth research on this. However，as a model prescription for traditional Chinese medicine in the Song Dynasty，the Taiping Huimin Heji Jufang contains a large total dose of many traditional Chinese medicine prescriptions，which is in stark contrast to the smaller doses taken each time. Many traditional Chinese medicines can be used by patients for more than a hundred days. If patients recover before taking them all，it will result in drug waste，which seems to be inconsistent with the shortage of medicine in the Song Dynasty. This article analyzes the rationality of the Song government’s setting of prescription dosage in the context of a shortage of medicinal materials from three perspectives：social environment，functions of the Chinese herbal medicine bureau，and drug characteristics of the official pharmaceutical bureau. The author believes that the dosage setting of traditional Chinese medicine in the prescription cannot be understood solely from a clinical perspective，as it not only ensures clinical efficacy，but also takes into account factors such as traffic conditions，the functions of the official drug bureau，the quality of traditional Chinese medicine，and the needs of the public. Therefore，when using the prescription in the prescription in clinical practice， the dosage should be flexibly adjusted. Moreover，as the first dynasty to implement universal medical insurance，the Song Dynasty’s spirit of “convenience and benefit the people” is worth learning from，and its dosage setting of traditional Chinese medicine，which is “small for each dose，large for the whole prescription”，also has certain reference significance.