先煎是中药汤剂特殊煎法的一大特色，而一些人对需先煎的中药、先煎的原因以及如何先煎缺乏基本的认识或存在一定的误解，从而出现因中药煎煮不当导致的临床疗效不佳或不良反应等一系列问题。结合古今文献，从减毒增效的角度剖析中药先煎的原因，从先煎时间、粉碎度等对先煎的影响来探讨中药先煎的注意事项，并对如何先煎提出探索性的思考，为中药先煎提供科学依据，以促进临床合理用药。

Decoction first is one of the characteristics of the special decoction of Chinese materia medica (CMM). However, some people have misunderstanding or lack of basic knowledge about the CMM for decoction first leading to the poor cruative effect or even toxic effects because of improper decoction. This study attempts to analyze the causes of CMM for decocting first from the perspective of reducing toxicity and increasing efficacy, discuss its matters needing attention from the point of view of the effect of decoction time and crushing degree on the decoction first based on ancient and modern literature, and put forward exploratory thinking on methods for decocting first in order to provide scientific evidence for promoting clinical rational decoction for CMM.

国家自然科学基金资助项目（81673618，81403152）；教育部高等学校博士学科点专项科研基金项目（20120013130002，20130013120001）