藏医药与三大传统医药（公元6-10世纪）所用药材异同的定量比较

摘要(中文译文)

藏医学在历史上与三大传统医学有过广泛交流，这些交流在吐蕃王朝时期（公元7—9世纪）达到顶峰。众多学者已认识到藏医学与三大传统医学之间密切的医学与文化往来，但缺乏提供定量、客观比较结果的研究。本研究从药材角度对上述问题进行定量分析，探讨藏医学、三大传统医学体系中药材的总体使用情况以及它们之间共用材的交流情况，并对藏药材的来源构成进行初步分析。首先，数据挖掘：从公元6世纪至10世纪的20部藏医学、中医学、阿育吠陀和阿拉伯医学经典文献中提取数据，系统整理药材的药性信息，即药味、分布、药用部位、功效、治疗用途及用法用量，建立数据集。其次，分析与比较：采用Mann-Whitney检验（一种非参数方法）和直观比较法，分析公元6至10世纪藏医学、中医学、阿育吠陀和阿拉伯医学所用药材之间的异同。藏医学、中医学、阿育吠陀和阿拉伯医学的药材总数分别为1229、2184、760和511种。总体比较显示，藏医学、中医学、阿育吠陀和阿拉伯医学均以植物为主要药材来源，分别占65.09%、59.02%、74.74%和67.32%。它们在药用部位、治疗用途和药味方面存在显著差异（p < 0.05）。在药用部位方面，中医学多使用全草和根茎，而藏医学、阿育吠陀和阿拉伯医学更倾向于使用可再生的果实、种子和叶。在治疗方面，尽管四种传统医学普遍用于治疗消化系统疾病，但中医学更常用于治疗皮肤病，而阿育吠陀和阿拉伯医学更常用于治疗呼吸系统和泌尿生殖系统疾病。共用材比较显示，藏医学与中医学共有药材248种，与阿育吠陀共有140种，与阿拉伯医学共有128种。这些共用材在药用部位、治疗应用和剂量规格方面表现出相似性与差异性。本研究发现四种传统医学在药材使用上存在差异与相似之处，在药用部位、治疗用途和剂型方面存在显著差异，这归因于医学理论和文化习俗等多种因素的综合影响。此外，藏医学所用药材与三大医学体系之间存在部分重叠。这一发现表明，藏医学虽以当地可得资源为基础，但已吸收了中医学（20.18%）、阿育吠陀（11.19%）和阿拉伯医学（10.41%）的药材信息。总体而言，这些发现为理解藏医学与三大医学体系之间的异同提供了实证依据，并为传统医学的比较研究提供了新视角。

Abstract

Tibetan medicine has historically engaged in extensive exchanges with the three traditional medicines. These interactions peaked during the Tubo Dynasty (7th-9th century AD). Numerous scholars have acknowledged the close medical and cultural exchanges between Tibetan medicine and the three traditional medicines, but studies offering quantitative and objective comparative results are lacking. This study quantitatively analyzes the above problems from the perspective of medicinal materials and discusses the general use of medicinal materials in Tibetan medicine, the three traditional medical systems, and the exchange of co-used medicinal materials among them. It provides a preliminary analysis of the source composition of Tibetan medicinal materials. Firstly, Data mining: Data were extracted from 20 classical texts on Tibetan medicine, traditional Chinese medicine, Ayurveda and Arabic medicine dating from the 6th century AD to the 10th century AD. Information on medical properties, namely, medicinal taste, distribution, medicinal parts, efficacy, therapeutic use, and usage and dosage of medicinal materials, were systematically compiled to establish the datasets. Secondly, Analysis and comparison: Similarities and differences among medicinal materials used in Tibetan medicine, traditional Chinese medicine, Ayurveda, and Arabic medicine between the 6th and 10th centuries AD were analyzed using the Mann-Whitney test (a non-parametric method) and an intuitive comparison method. The total numbers of medicinal materials in Tibetan medicine, traditional Chinese medicine, Ayurveda, and Arabic medicine were 1229, 2184, 760, and 511, respectively. The overall comparison showed that Tibetan medicine, traditional Chinese Medicine, Ayurveda, and Arabic medicine all used plants as the main source of medicinal materials, accounting for 65.09%, 59.02%, 74.74%, and 67.32%, respectively. There were significant differences in medicinal parts, therapeutic uses, and medicinal taste among them (p < 0.05). In terms of medicinal parts, traditional Chinese medicine mostly used whole herbs and rhizomes, whereas Tibetan medicine, Ayurveda, and Arabic medicine were more inclined to use renewable fruits, seeds, and leaves. Regarding treatment, although the four traditional medicines were generally used to treat digestive diseases, traditional Chinese medicine was more commonly used to treat skin diseases, whereas Ayurveda and Arabic medicine were more commonly used to treat respiratory and urogenital diseases. The comparison of co-used medicinal materials showed that Tibetan medicine had 248 kinds of co-used medicinal materials with Traditional Chinese Medicine, 140 with Ayurveda, and 128 with Arabic medicine. These co-used medicinal materials exhibited similarities and differences in terms of medicinal parts, therapeutic applications, and dose specifications. This study found differences and similarities in the use of medicinal materials across the four traditional medicines. Significant differences in medicinal parts, therapeutic uses, and dosage forms were found, which were attributed to the combined influence of multiple factors, such as medical theory and cultural customs. In addition, a partial overlap was found between the medicinal materials used in Tibetan medicine and the three medical systems. This finding indicates that although grounded in locally available resources, Tibetan medicine has incorporated medicinal material information from traditional Chinese medicine (20.18%), Ayurveda (11.19%), and Arabic medicine (10.41%). Overall, these findings provide an empirical basis for understanding similarities and differences between Tibetan medicine and the three major medical systems and offer a novel perspective for comparative research in traditional medicine.

如何引用