基于量效关系的《伤寒杂病论》麻黄用药规律研究
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摘要
目的分析《伤寒杂病论》中麻黄的量效关系及用药配伍规律,为临床提供参考。方法整理《伤寒杂病论》收载的含麻黄方剂,采用SPSS20.0统计软件单因素逻辑回归分析及二元相关性分析研究麻黄剂量与相关因素之间关系。结果《伤寒杂病论》含麻黄方剂32首,占全部方剂的12.40%,其中30首可进行剂量转换。麻黄单次用量与药味数(P=0.016)、用水量(P=0.032)、单次服用水量(P=0.000)及服用次数(P=0.030)密切相关,而与剩余水量无显著相关性(P>0.05)。单因素逻辑回归分析显示,麻黄是否为主药与麻黄单次用量、阴阳类方、药味数、用水量、剩余水量、单次服用水量及服用次数均无显著相关性(P>0.05)。《伤寒杂病论》中麻黄不单独使用,将其作为基础药对使用的有麻黄甘草汤、半夏麻黄丸、麻黄醇酒汤,并多与杏仁、桂枝和芍药、附子、石膏、半夏等配伍使用。麻黄作为主药与其作为非主药的单次用量差异无统计学意义(P>0.05)。结论从量效关系可发现《伤寒杂病论》麻黄的临床应用及疗效发挥主要在于药物配伍。临证应严格遵守麻黄配伍规律并灵活应用。
Objective To analyze dose-response relationship and medication compatibility rules of Ephedrae Herba; To provide references for clinical medication. Methods It systematically arranged prescriptions containing Ephedrae Herba in Shang Han Za Bing Lun. Relationship between the dose of Ephedrae Herba and the related factors were analyzed through univariate logistic regression analysis and binary correlation analysis by SPSS20.0 statistical software. Results After screening, 32 prescriptions including Ephedrae Herba were selected, accounting for 12.40% in the total prescriptions of Shang Han Za Bing Lun, and 30 of them could be dose converted. The single dose of Ephedrae Herba was closely related to taste(P=0.016), water consumption(P=0.032), single dose(P=0.000) and number of doses(P=0.030), but had no correlation with the remaining water(P>0.05). Univariate logistic regression analysis showed that there was no correlation between Ephedrae Herba as primary medicine and the single dose of Ephedrae Herba, yin or yang prescription, number of medicine, water consumption, remaining water, single dose, and number of dose(P>0.05). In Shang Han Za Bing Lun, Ephedrae Herba was not used alone, and was used as basic medicine in Mahuang Gancao Decoction, Mahuang Banxia Pills, and Mahuang Chunjiu Decoction. Ephedrae Herba was used with Semen Armeniacae Amarum, Cinnamomi Ramulus, Paeonia lactiflora Pall., Aconiti Lateralis Radix Praeparata, Gypsum Fibrosum, and Pinelliae Rhizoma. There was no statistical significance in the single dose of Ephedrae Herba as the main medicine and as non-main medicine(P>0.05). Conclusion From the dose-response relationship, it can be found that the clinical application and efficacy of Ephedrae Herba mainly lie in medicine compatibility. It should be strictly abide by the rule of its medicine compatibility and should be applied flexibly.
Objective To analyze dose-response relationship and medication compatibility rules of Ephedrae Herba; To provide references for clinical medication. Methods It systematically arranged prescriptions containing Ephedrae Herba in Shang Han Za Bing Lun. Relationship between the dose of Ephedrae Herba and the related factors were analyzed through univariate logistic regression analysis and binary correlation analysis by SPSS20.0 statistical software. Results After screening, 32 prescriptions including Ephedrae Herba were selected, accounting for 12.40% in the total prescriptions of Shang Han Za Bing Lun, and 30 of them could be dose converted. The single dose of Ephedrae Herba was closely related to taste(P=0.016), water consumption(P=0.032), single dose(P=0.000) and number of doses(P=0.030), but had no correlation with the remaining water(P>0.05). Univariate logistic regression analysis showed that there was no correlation between Ephedrae Herba as primary medicine and the single dose of Ephedrae Herba, yin or yang prescription, number of medicine, water consumption, remaining water, single dose, and number of dose(P>0.05). In Shang Han Za Bing Lun, Ephedrae Herba was not used alone, and was used as basic medicine in Mahuang Gancao Decoction, Mahuang Banxia Pills, and Mahuang Chunjiu Decoction. Ephedrae Herba was used with Semen Armeniacae Amarum, Cinnamomi Ramulus, Paeonia lactiflora Pall., Aconiti Lateralis Radix Praeparata, Gypsum Fibrosum, and Pinelliae Rhizoma. There was no statistical significance in the single dose of Ephedrae Herba as the main medicine and as non-main medicine(P>0.05). Conclusion From the dose-response relationship, it can be found that the clinical application and efficacy of Ephedrae Herba mainly lie in medicine compatibility. It should be strictly abide by the rule of its medicine compatibility and should be applied flexibly.
引文
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[8]余秋平,韩佳瑞,焦拥政.从张仲景对麻黄的运用看经方的用药策略[J].中医杂志,2011,52(21):1824-1827.
[2]张伟.从量效关系探讨《伤寒论》桂枝用药规律[J].中国中医药信息杂志,2017,24(7):98-101.
[3]张伟.从量效关系探讨《伤寒论》甘草用药规律[J].中国中医药信息杂志,2016,23(9):52-55.
[4]上海中医学院伤寒论教研室.宋本《伤寒论》[M].上海:上海中医药大学,1991.
[5]汉·张仲景述,晋·王叔和集.金匮要略方论[M].北京:人民卫生出版社,1981.
[6]冯世纶,张长恩.解读张仲景医学经方六经类方证[M].2版.北京:人民军医出版社,2016.
[7]傅延龄,宋佳,张林.论张仲景对方药的计量只能用东汉官制[J].北京中医药大学学报,2013,36(6):365-370.
[8]余秋平,韩佳瑞,焦拥政.从张仲景对麻黄的运用看经方的用药策略[J].中医杂志,2011,52(21):1824-1827.