魏珍珍　方晓艳　白明　苗明三

〔摘要〕 中药外治法与内治法一样，均是以中医的整体观念和辨证论治思想为指导，运用各种不同的方法将药物施于皮肤、孔窍、穴位等部位，达到治病目的。近年来中药外治法普遍用于临床，在局部疗效上与中药内治法相比优势显著，查询《中国药典》收录用于外治的中药材及成方制剂和中国知网近五年中药外治在临床治疗疾病上的研究，笔者从给药途径及其外治机理进行分析，进一步明确不同给药途径在中药外治疗法中的作用机制，以期提高临床疗效。

〔关键词〕 中药外治;给药途径;作用机制

〔中图分类号〕R26       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.09.024

Mechanism Analysis on External Treatment of Chinese Materia Medica Based on

Administration Routes

WEI Zhenzhen， FANG Xiaoyan， BAI Ming， MIAO Mingsan*

（Henan University of Chinese Medicine， Zhengzhou， Henan 450008， China）

〔Abstract〕 External treatment of Chinese materia medica is the same as internal treatment， which is guided by the holistic concept and the theory of syndrome differentiation and treatment of traditional Chinese medicine， and applies various methods to apply medicines to skin， orifices， acupoints and other parts to achieve the purpose of treatment. In recent years， the external treatment of Chinese materia medica has been widely used in clinical practice， which has a significant advantage in local curative effect， compared to the internal treatment of Chinese materia medica. Chinese crude drug and preparations for external treatment included in the Chinese Pharmacopoeia and clinical study on the external treatment of Chinese materia medica in treatment of disease on CNKI in resent 5 years were searched， and they were analyzed by the author from administration routes and mechanism of external treatment， to further define the mechanism of action of different administration routes in the external treatment of Chinese materia medica， hoping to improve the clinical curative effect.

〔Keywords〕 external treatment of Chinese materia medica; administration route; mechanism of action

中醫的特点是辨证论治，重视整体观念，强调人与自然、气血与脏腑、体表与体内相呼应，在疗法上应整体、综合治疗。中药外治是中医学的重要组成部分，中药用于外治疾病已有数千年的历史。早在《黄帝内经》中就记载“桂心渍酒，以熨寒痹”，用白酒和桂心涂治“风中血脉”，后世誉之为膏药之始。《金匮要略》用炮附子为散加盐摩涂痛处治疗头风。《太平圣惠方》中有二节，举方20余首，专讲痹证外治方药。清人吴师机擅长使用膏药等外治法治疗内外疾病，认为内服药有“殊途同归”之妙，并强调外治法也应辨证施治，“外治之理即内治之理，外治之药即内治之药”。其著作《理渝骈文》是历史上外治疗法的专著，记载了许多外治方法，影响深远。外治法与内治法只是在给药途径上不同，外治法使药物直接作用于皮肤和黏膜，通过局部吸收，从而达到治疗目的[1]。……