中药剂型

吴宇琛

SUM WU

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Director of Hurstville Chinese Herbs Centre

Vice Dean of College of Traditional Chinese Medicine Orthopedics Australia

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吴宇琛，澳大利亚政府注册中医师、针灸师，五龙岗大学心理学学士、悉尼科技大学中医系学士，澳大利亚松轩中医药中心主任医师，澳大利亚中医骨伤专科学院副院长。

擅长用传统针灸理伤手法和中药治疗各种新旧损伤痛症，特别采用中医中药和现代心理学、营养学相结合调理治疗各种慢性病和亚健康。

中药剂型

Traditional Chinese Medicine (TCM) employs a wide range of herbal preparations, known as dosage forms, each carefully designed to influence how herbs act within the body. These forms are not merely about convenience, they reflect deeper therapeutic strategies aligned with pattern differentiation, disease stage, and individual constitution. Understanding the advantages and disadvantages of each preparation helps clarify why a practitioner may choose one form over another.

中医（TCM）采用多种中药剂型以发挥药物在体内的不同作用，每种形式皆经过精心设计。这些剂型不仅仅是为了便利，更体现了基于辨证论治、疾病阶段以及个体体质的深层治疗策略。理解不同剂型的优缺点，有助于说明为何临床医师会选择某一种形式。

Decoction remains the cornerstone of traditional TCM practice. It involves boiling raw herbs in water to extract their active constituents, producing a medicinal liquid taken daily. Decoctions are highly valued for their flexibility and potency. Practitioners can modify formulas frequently, adjusting dosages or adding and removing herbs as a patient’s condition evolves. This makes decoctions particularly effective for acute illnesses, complex syndromes, or rapidly changing conditions. However, they come with notable drawbacks. Preparation is time-consuming, often requiring 30–60 minutes of boiling, and the taste can be strong or unpleasant, which may affect patient compliance. Additionally, consistency can vary depending on preparation technique.

汤剂仍是传统中医临床的核心形式。其制作方法是将中药饮片加水煎煮，提取有效成分，制成每日服用的药液。汤剂以其灵活度高、药效显著而受到高度重视。医师可根据病情变化随时调整方药组成与剂量，进行加减化裁，因此特别适用于急性疾病、复杂证候或变化较快的病情。然而其缺点也较明显：煎煮过程较为耗时，通常需30–60分钟，且味道较苦重，可能影响患者的依从性。此外，不同的煎煮方法也可能导致药效存在一定差异。

Powders represent one of the oldest forms of herbal medicine. Herbs are dried and finely ground, then taken directly or mixed with warm water. Their main advantage lies in rapid absorption, as the increased surface area allows quicker interaction with the digestive system. Powders are also relatively convenient compared to decoctions and can be used both internally and externally. However, they are generally less potent than decoctions for severe conditions and may irritate the throat or stomach if not prepared or dosed properly. Stability and preservation can also be an issue in humid environments.

散剂是最古老的中药剂型之一。其制法是将药材干燥后研磨成细粉，直接服用或用温水冲服。其主要优点在于吸收较快，因粉末状增加了与消化系统的接触面积。同时，相较汤剂更为方便，且既可内服也可外用。然而，对于较为严重的疾病，散剂的疗效通常不及汤剂；若制备或用量不当，还可能刺激咽喉或胃部。在潮湿环境中，其稳定性与保存性也较差。

Pills often made by combining powdered herbs with honey or water into small balls, are designed for slow, sustained release. This makes them ideal for chronic diseases, deficiency patterns, and long-term regulation, such as digestive weakness or fatigue. Their convenience and mild taste improve patient adherence. However, the trade-off is a slower onset of action, making them less suitable for acute or urgent conditions. Additionally, fixed formulations limit flexibility, and the concentration of active ingredients may be lower compared to freshly prepared decoctions.

丸剂通常是将药粉与蜂蜜或水混合，制成小丸，以实现缓慢而持久的药效释放。这使其非常适用于慢性疾病、虚证调理以及长期调养，如脾胃虚弱或慢性疲劳等。丸剂服用方便、味道较温和，有助于提高患者依从性。但其起效较慢，不适用于急性或紧急情况。同时，由于配方固定，灵活性较低，其有效成分的浓度通常也低于新鲜煎制的汤剂。

In modern practice, granules have become increasingly popular. These are concentrated extracts of herbs that are dried into powder-like granules and dissolved in hot water. Granules offer a balance between tradition and convenience: they are quick to prepare, portable, and standardized in dosage, making them widely used in busy clinical settings, especially in places like Australia. Their main advantage is compliance. Patients are far more likely to take them consistently. However, granules may be less individualized, as they often rely on pre-manufactured extracts, and some practitioners argue that they are slightly less potent or lack the “depth” of traditional decoctions.

在现代临床中，颗粒剂越来越普及。这类剂型是将中药提取浓缩后制成颗粒状，使用时用热水冲服。颗粒剂在传统与便利之间取得了平衡：冲泡快捷、携带方便、剂量标准化，因此在如澳大利亚等节奏较快的临床环境中广泛应用。其最大优势在于提高患者依从性，患者更容易坚持服用。然而，其缺点在于个体化程度较低，通常依赖预先生产的提取物，部分医师认为其药效略逊于传统汤剂，缺乏一定的“层次感”。

Alcohol-based preparations, including tinctures and medicinal wines, involve soaking herbs in alcohol to extract their active compounds. Alcohol enhances the circulatory and warming properties of herbs, making these preparations particularly effective for blood stasis, cold conditions, and musculoskeletal pain. They also have a long shelf life. On the downside, they are not suitable for all patients, especially those with heat patterns, liver conditions, or sensitivity to alcohol. Dosage must be carefully controlled, and cultural or personal preferences may limit their use.

酒剂包括药酒和酊剂，是通过将药材浸泡于酒精中选取有效成分而制成。酒精能够增强药物的活血通络与温通作用，因此特别适用于血瘀、寒证以及筋骨疼痛等情况，同时具有较长的保存期限。但其不足之处在于并不适用于所有人群，尤其是有热证、肝脏疾病或对酒精敏感者。使用时需严格控制剂量，且文化或个人习惯也可能限制其应用。

Topical preparations, such as plasters, ointments, and liniments, are widely used for localized conditions. These include muscle pain, joint inflammation, and traumatic injuries. Their key advantage is that they act directly on the affected area, minimizing systemic side effects. For example, herbal liniments like “Die Da Jiu” are commonly used in martial arts medicine to promote circulation and reduce swelling. However, their effects are generally limited to the surface or local tissues, and they may not address deeper systemic imbalances. Skin irritation or allergic reactions can also occur in some individuals.

外用制剂如膏药、软膏和搽剂，广泛用于局部病症，包括肌肉疼痛、关节炎症及跌打损伤等。其主要优势在于可直接作用于患处，从而减少全身性副作用。例如，“跌打酒”常用于活血化瘀、消肿止痛。然而，其作用多局限于体表或局部组织，难以调节深层或全身性失衡，且部分人群可能出现皮肤刺激或过敏反应。

Herbal pastes and syrups are highly concentrated extracts often mixed with honey into a thick, palatable form. These are traditionally used as tonic formulas, especially during recovery or for chronic deficiency conditions such as Qi, Blood, Yin, or Yang deficiency. Their advantages include high concentration, ease of consumption, and nourishing properties, making them suitable for long-term use. However, they are typically expensive and time-intensive to produce, and their richness may be too heavy for patients with weak digestion or dampness accumulation.

膏方是将中药高度浓缩后与蜂蜜等制成稠厚、口感较佳的制剂，常用于滋补调养，尤其适用于恢复期或慢性虚证，如气、血、阴或阳虚。其优点在于浓度高、易于服用且具有良好的滋补作用，适合长期调理。然而，其制作过程耗时且成本较高，且滋腻之性较重，对于脾胃虚弱或湿气较重者可能不太适合。

Medicinal teas are a gentler form of herbal preparation, involving mild herbs brewed like everyday tea. They are commonly used for preventive care, lifestyle support, and mild imbalances. Their main strengths are simplicity, safety, and suitability for daily use, often incorporating food-grade herbs such as goji berries or chrysanthemum. However, their therapeutic strength is relatively weak, making them unsuitable for treating serious or complex conditions.

茶剂是一种较为温和的中药形式，通常将性质平和的药材如日常饮茶般冲泡饮用。其多用于预防保健、日常调养及轻度失衡状态。其优点在于简单、安全，适合长期日常使用，常选用如枸杞、菊花等食疗性质的药材。然而，其药力相对较弱，不适用于治疗严重或复杂的疾病。

Finally, fumigation and wash therapies involve boiling herbs and applying them externally as steam, soaks, or washes. These methods combine the effects of heat and herbal action, making them effective for skin conditions, joint pain, and gynaecological disorders. They allow for direct local treatment while also promoting circulation through warmth. Their limitation lies in their localized scope, and they often need to be combined with internal treatments for comprehensive results.

最后，熏洗剂是通过煎煮药物后以蒸汽、浸泡或外洗的方式进行外治。这种方法结合了热力与药效，适用于皮肤疾病、关节疼痛及妇科问题等。其优势在于可直接作用于局部，同时借助温热促进气血运行。但其局限在于作用范围较为局部，通常需要配合内服治疗，才能达到更全面的疗效。

In TCM, the choice of herbal preparation is a deliberate and strategic decision. It reflects not only the nature of the disease but also the patient’s constitution, lifestyle, and treatment goals. A skilled practitioner selects the appropriate form to maximize therapeutic effect while balancing convenience and compliance. This integration of form and function is one of the defining features of TCM’s holistic approach to healing.

总体而言，中药剂型的选择是一项有意识且具有策略性的临床决策。它不仅取决于疾病的性质，还与患者的体质、生活方式以及治疗目标密切相关。经验丰富的医师会在疗效、便利性与依从性之间取得平衡，从而选择最合适的剂型。这种形与效相结合的理念，正是中医整体观的重要体现。

如有疑问想咨询吴宇琛中医师，可以在微信或whatsapp搜索61 404836368，加吴宇琛中医师微信或whatsapp，也可以发短信或致电0404836368作语音留言，吴宇琛中医师有空就会回复。