基于古籍文献和现代研究成果，从历史沿革、方药组成、剂量、主治病症、煎煮方法、服用方法、药物炮制及现代 应用等方面对经典名方四神煎进行了系统考证和梳理。关于方剂来源，已知四神煎最早可见于清代谢汉的 《宝树堂舟车经 验方》，方名为“张真人传治鹤膝风神方”，已知最早将本方命名为“四神煎”的古籍为《仙拈集》。关于药物组成、炮制与 剂量，根据 《宝树堂舟车经验方》 所载的四神煎，将其换算成现代剂量如下：生黄芪 596.8 g，铁皮石斛 149.2 g，制远志 111.9 g，怀牛膝 111.9 g，金银花 37.3 g。煎服法方面，煎煮时以 350 mL为一碗对古代文本进行换算，服药后的汗出程度以 “汗出至涌泉”为宜。总结该方的功效为“益气养阴，透邪除痹”。在古代文献中，四神煎是治疗鹤膝风的专方；现代文献 中，可见四神煎用于类风湿关节炎、骨关节炎、膝关节滑膜炎等30余种疾病的治疗经验或临床研究。该文通过充分的文献 考证，总结了四神煎的古今应用，确定了其关键信息，可为其临床运用的拓展、制剂开发等提供依据。

Based on records in ancient literature and achievements of modern research， this study conducts a systematic literature investigation and analysis of the classic famous formula Sishen Decoction， covering its historical evolution， formula composition， dosage of herbs， indications， decocting methods， administration methods，drug processing，and modern applications. Regarding the origin of Sishen Decoction，the earliest record of Sishen Decoction appears in Bao Shu Tang Zhou Che Jing Yan Fang（Baoshutang’s Effective Prescriptions for the Journey） by Xie Han in the Qing Dynasty， where it was named after Zhang Zhenren’s Immortal Formula for Treating Crane-Knee Syndrome. The earliest known ancient text to name this formula Sishen Decoction is Xian Nian Ji（Collective of Immortal’s Prescriptions）. Regarding drug composition and the processing and dosage of the herbs from Sishen Decoction recorded in Bao Shu Tang Zhou Che Jing Yan Fang，the modern equivalent dosages of the herbs are calculated as follows： Astragali Radix （raw）596.8 g， Dendrobii Officinalis Caulis 149.2 g， Polygalae Radix （processed）111.9 g，Achyranthis Bidentatae Radix 111.9 g，and Lonicerae Japonicae Flos 37.3 g.For the decocting method and administration method，350 mL was equivalent to one bowl recorded in the ancient literature during decocting，and sweat reaching to Yongquan points at the sole （a metaphor for profuse sweating） is required after administration. The efficacy of this formula is summarized as “supplementing qi and nourishing yin， expelling pathogens and relieving arthralgia”. In ancient literature， Sishen Decoction was a specific formula for treating crane-knee syndrome （arthroncus of knee）. In modern literature， Sishen Decoction has been used for treating over 30 kinds of disorders in the reports of clinical experience or studies，including rheumatoid arthritis， osteoarthritis，and knee joint synovitis. After systematic textual research，this article summarizes the ancient and modern applications of Sishen Decoction，clarifies its key information，and will provide a foundation for expanding its clinical use and facilitating pharmaceutical development.

R289.5

首都卫生发展基金项目（编号：首发 2024-1-4162）；国家重点研发计划项目（编号：2022YFC3501201）；国家自然科学基金 项目（编号：82074408)；中国中医科学院望京医院高水平中医医院建设项目（编号：WJCC-202317，WJCC-202321）