复方简药的临床应用经验
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摘要
复方药物的组成复杂、配伍关系复杂、功效复杂,适应复杂病证。复方配伍方法:理法方药一贯,方证对应;病-证-症的药物对应;脉证症状的取舍,增减对应药物。复方的遣药方法:复方大方理论指导,配伍用药;药证类从,重复用药;主从有序,重点用药;合方为一,重叠用方。复方的药物精简方法:寻找治病主药;精选小方组方;应用组方结构;应用药物的固定结构;活用药物的多重配伍关系;借鉴中药药理研究成果。医者需要有丰富的理论知识和临床经验,才能做到复方的合理用药。
The compound decoction is complex, the compatibility and function is complex, to fit complex disease syndrome. The compatibility methods of the compound decoction are as followed: principle-method-recipe-medicines is conformable and prescription is corresponding to the syndrome; disease-syndrome-manifestation is conformable in drug use; according to choice of pulse, syndrome and manifestation to increase or decrease the corresponding drug. The compound decoction dispensing methods are as followed: medicine according to the compound generous theory guidance; the medicine corresponding to the syndrome and repeating drug use; focused drug use; combining the decoctions to one and overlapping the decoctions. Compound drug simplification methods are as followed: finding the main medicine for treatment; selecting small decoctions to form new prescription; application of decoction structure; application of fixed structure of drugs; flexible use of multiple compatibility; in reference of pharmacological research results of traditional Chinese medicine. The doctor needs wealthy theoretical knowledge and clinical experience so that can achieve a rational use of the compound decoction.
The compound decoction is complex, the compatibility and function is complex, to fit complex disease syndrome. The compatibility methods of the compound decoction are as followed: principle-method-recipe-medicines is conformable and prescription is corresponding to the syndrome; disease-syndrome-manifestation is conformable in drug use; according to choice of pulse, syndrome and manifestation to increase or decrease the corresponding drug. The compound decoction dispensing methods are as followed: medicine according to the compound generous theory guidance; the medicine corresponding to the syndrome and repeating drug use; focused drug use; combining the decoctions to one and overlapping the decoctions. Compound drug simplification methods are as followed: finding the main medicine for treatment; selecting small decoctions to form new prescription; application of decoction structure; application of fixed structure of drugs; flexible use of multiple compatibility; in reference of pharmacological research results of traditional Chinese medicine. The doctor needs wealthy theoretical knowledge and clinical experience so that can achieve a rational use of the compound decoction.
引文
[1]谢鸣.方剂与复方的名实辨析[J].中国实验方剂学杂志,2015,21(22):140-144.
[2]王淑玲,孙云廷.中医系统论与中药复方研究[J].时珍国医国药,2008,19(1):212-213.
[3]王庆国,李宇航,赵琰,等.半夏泻心汤及其拆方对正常大鼠胃肠运动功能的影响[J].北京中医药大学学报,2001,24(6):19-21.
[4]胡少伟,姜艳艳,高尧春,等.四妙勇安汤中甘草苷、金丝桃苷和木犀草苷提取率的拆方分析[J].北京中医药大学学报,2016,39(7):590-594.
[5]谢鸣,周然.方剂学[M].2版.北京:人民卫生出版社,2012:21,439.
[6]林萃才,王仙伟,李煦昀,等.周德生教授辨治焦虑症的用药规律及学术见解[J].中医研究,2012,25(1):53-55.
[7]王佳君,胡华,陈莎,等.周德生教授辨治失眠症配伍用药规律[J].中医研究,2011,24(3):57-60.
[8]曾荣,王燕,胡华,等.周德生教授辨治多发性硬化的学术见解及临床经验[J].世界中医药,2014,9(1):61-63.
[9]蒋成婷,周德生,陈大舜,等.复方配伍与药物精简应用[J].中医杂志,2017,58(9):796-799.
[10]丁瑞丛,胡华,袁雅洁,等.周德生教授治疗帕金森病开关现象的临床经验总结[J].环球中医药,2013,6(S1):152-153.
[11]邓龙,周德生,廖端芳,等.姜黄及其配伍复方在脑病治疗中的应用规律[J].湖南中医药大学学报,2017,37(7):753-756.
[12]胡华,刘利娟,林萃才,等.周德生教授辨治后循环短暂性脑缺血发作的学术思想和临床经验[J].中国中医急症,2012,21(8):1237.
[13]刘枭,刘涛.吴鞠通配伍应用金银花、连翘的经验[J].中医药导报,2016,22(3):24-25.
[14]李中,吴兵兵,周颖灿,等.周德生教授脑病专科药对举隅[J].环球中医药,2015,8(12):1498-1500.
[15]张昱,陈云慧,王燕,等.布尔关联规则挖掘四君子汤类方药物配伍规律研究[J].江苏中医药,2008,40(7):67-68.
[16]王一战,范吉平,徐志男,等.基于数据挖掘孟河医派治疗温病中医用药规律研究[J].辽宁中医药大学学报,2017,19(5):76-78.
[17] Huang X,Wang F,Chen W,et al. Dao-Tan decoction inhibits tumor necrosis factor-alpha-induced intercellular adhesion molecule-1 expression by blocking JNK and p38 signaling pathways in human umbilical vein endothelial cells[J]. Pharm Biol,2012,50(9):1111-1117.
[18]高家荣,徐双枝,韩燕全,等.补骨脂-肉豆蔻药对配伍前后主要成分的UPLC-MS/MS测定及药代动力学研究[J].中国中药杂志,2017,42(9):1782-1786.
[19]李晓,杨金龙,马度芳,等.桂枝汤桂芍不同比例配伍对糖尿病模型大鼠心脏自主神经病变的影响[J].中国中西医结合杂志,2015,35(6):741-745.
[20]陈金星,王硕仁,赵明镜,等.活血益气药不同剂量配伍对心梗后心衰大鼠心脏系数及功能的影响[J].中国中药杂志,2003,28(5):66-69.
[2]王淑玲,孙云廷.中医系统论与中药复方研究[J].时珍国医国药,2008,19(1):212-213.
[3]王庆国,李宇航,赵琰,等.半夏泻心汤及其拆方对正常大鼠胃肠运动功能的影响[J].北京中医药大学学报,2001,24(6):19-21.
[4]胡少伟,姜艳艳,高尧春,等.四妙勇安汤中甘草苷、金丝桃苷和木犀草苷提取率的拆方分析[J].北京中医药大学学报,2016,39(7):590-594.
[5]谢鸣,周然.方剂学[M].2版.北京:人民卫生出版社,2012:21,439.
[6]林萃才,王仙伟,李煦昀,等.周德生教授辨治焦虑症的用药规律及学术见解[J].中医研究,2012,25(1):53-55.
[7]王佳君,胡华,陈莎,等.周德生教授辨治失眠症配伍用药规律[J].中医研究,2011,24(3):57-60.
[8]曾荣,王燕,胡华,等.周德生教授辨治多发性硬化的学术见解及临床经验[J].世界中医药,2014,9(1):61-63.
[9]蒋成婷,周德生,陈大舜,等.复方配伍与药物精简应用[J].中医杂志,2017,58(9):796-799.
[10]丁瑞丛,胡华,袁雅洁,等.周德生教授治疗帕金森病开关现象的临床经验总结[J].环球中医药,2013,6(S1):152-153.
[11]邓龙,周德生,廖端芳,等.姜黄及其配伍复方在脑病治疗中的应用规律[J].湖南中医药大学学报,2017,37(7):753-756.
[12]胡华,刘利娟,林萃才,等.周德生教授辨治后循环短暂性脑缺血发作的学术思想和临床经验[J].中国中医急症,2012,21(8):1237.
[13]刘枭,刘涛.吴鞠通配伍应用金银花、连翘的经验[J].中医药导报,2016,22(3):24-25.
[14]李中,吴兵兵,周颖灿,等.周德生教授脑病专科药对举隅[J].环球中医药,2015,8(12):1498-1500.
[15]张昱,陈云慧,王燕,等.布尔关联规则挖掘四君子汤类方药物配伍规律研究[J].江苏中医药,2008,40(7):67-68.
[16]王一战,范吉平,徐志男,等.基于数据挖掘孟河医派治疗温病中医用药规律研究[J].辽宁中医药大学学报,2017,19(5):76-78.
[17] Huang X,Wang F,Chen W,et al. Dao-Tan decoction inhibits tumor necrosis factor-alpha-induced intercellular adhesion molecule-1 expression by blocking JNK and p38 signaling pathways in human umbilical vein endothelial cells[J]. Pharm Biol,2012,50(9):1111-1117.
[18]高家荣,徐双枝,韩燕全,等.补骨脂-肉豆蔻药对配伍前后主要成分的UPLC-MS/MS测定及药代动力学研究[J].中国中药杂志,2017,42(9):1782-1786.
[19]李晓,杨金龙,马度芳,等.桂枝汤桂芍不同比例配伍对糖尿病模型大鼠心脏自主神经病变的影响[J].中国中西医结合杂志,2015,35(6):741-745.
[20]陈金星,王硕仁,赵明镜,等.活血益气药不同剂量配伍对心梗后心衰大鼠心脏系数及功能的影响[J].中国中药杂志,2003,28(5):66-69.