中药汤剂煎药方法

       中药汤剂是中医自古以来应用最广泛的剂型。因其适汤剂能够充分适应中医辨证施治的需要随症加减,又具有制备简便、疗效快,易吸收,作用强,取材天然、毒副作用小等几大特点。临床上特别适用于各种内外疑难眼科疾病,清代著名医学家徐灵胎就曾讲:"病之愈不愈。不但方必中病,方虽中病而服之不得其法,则非特无功,反而有害……"就指出了正确的服用汤剂可以加速病情的好转,而错误的服用方法会使病情恶化。由此可见汤剂服用方法是否正确,直接影响着药物在人体中的吸收和治疗效果,为此向您介绍煎中药的方法供您参考(具体需遵医嘱为准)。

       

第一步煎药前的浸泡:药物在煎煮前一定要浸泡,这是因为来源于植物类的中药多是干燥品,通过加水浸泡可使药材变软,组织细胞膨胀后恢复其天然状态,煎药时易于有效成分浸出。一般以花,叶,茎类为主的药物,浸泡时间为一个小时左右。以根,种子,根茎,果实类为主的药物浸泡时间为2小时。

第二步、将药放在火上,用武火(即大火)熬开,沸腾后改用文火(小火)保持微沸状态,减慢水分蒸发,有利于有效成分的溶出。改用文火后开始计时,一般煎40~50分钟。

第三步、将第一次煎出的药液倒出,加入适量的热水(水不要太多,以刚淹没药材2-3cm为宜)进行第二次煎煮,煎煮的时间约20-30分钟左右即可。

       其他注意事项:煎药的加水量也很重要,加水量的多少直接影响到汤剂的质量。加水少了,会造成药物煎煮不透,有效成分浸出的不完全。加水多了,煎煮出的药液多,病人服药时很不方便。中药材因其质地不同,它的吸水量差别也较大,一般加水量控制在5-10倍。重量相同的药物,质地疏松其体积就大,吸水量自然就多。质地坚实其体积就小,吸水量就少。因此,煎煮花,叶,全草类药物,加水量就要多一些。煎煮矿物类,贝壳类药物,加水量就少一些。按照传统的加水方法,是将药物放入锅内,第一次煎煮的加水量以水超过药物表面3-5厘米,第二次煎煮的加水量以超过药物表面3厘米为准。这种加水方法,简便易行,又很容易掌握。如果加水加少,熬干了,那就不能再服用了,因为熬干的中药药性已经变了,不但起不到治病的作用,反而会适得其反。并且会产生毒素。所以要记住药万一不小心敖干,就千万不能再服用!

       煎煮次数:以多次煎煮比一次长时间煎煮的效果好。实践证明,汤剂煎煮两次能够煎出所含成分的90%左右,第三次药物的有效成分已经非常有限,所以煎药的次数以两次为宜

       留取药液量:一般指一剂药经两次煎煮合并后的药液量。成人剂量一般取400-600毫升,每日分两次服用。因年龄、体质、体重等原因具体用药剂量和时间以遵医嘱为准。儿童服用剂量根据年龄和体重及其他情况具体遵医嘱服用为准。

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