控制人参在复方中功效发挥方向的多因素研究
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摘要
目的:研究影响人参在复方中功效发挥方向的控制因素,阐明人参常用配伍组合的作用机理,揭示人参在复方运用中的配伍规律。
     方法:结合历代本草著作及医家的论述对人参进行功效归纳。以《中医方剂大辞典精选本》为蓝本,收集含人参方剂1977首,用Excel建立数据表,统计分析配伍、剂量、炮制、剂型、用法等诸因素对人参在复方中功效发挥方向的影响。
     结果:与人参配伍使用的前六类药物依次为:补虚药、清热药、利水渗湿药、温里药、解表药、化痰止咳平喘药。人参具有补五脏之气的功效,发挥补气健脾、养胃和中功效时常配伍白术、茯苓、黄芪、陈皮等,多不拘时候服,或食前、空腹服用,并可用米饮送服;发挥补气益肺功效时,常配伍桔梗、半夏、山药、阿胶等,多在食后服用,并可用蜜水送服;发挥补心安神益智功效时,常配伍茯苓、石菖蒲、远志、酸枣仁、柏子仁、龙骨等,汤剂、丸剂入药为主,多在临卧用;发挥补肾纳气功效时常配伍肉桂、蛤蚧等,需用中大剂量,以15-30g较为常用,多在食前、空腹服用,并可用盐汤送服。人参在补气的基础上还有助于血、阴、阳的化生,发挥补气生津功效时,常配伍麦冬、生地黄、知母、石膏、葛根等,汤剂入药为主;发挥补气养血作用时,常配伍当归、白芍、熟地黄等,多在食前、空腹服用,并可用酒送服;发挥补气温阳功效时,常配伍干姜、附子、丁香等,多不拘时候服,或食前、空腹服用,并可用酒、生姜汤、大枣汤送服。人参发挥补气固脱功效时,常配伍附子、五味子、山茱萸等,需用中大剂量,以20-60g较为常用,汤剂入药为主,多不拘时候服用。人参发挥助正祛邪功效时,常配伍防风、柴胡、黄芩、黄连、大黄等,临床用量需用小剂量,以3-10g较为常用,汤剂入药为主。
     结论:配伍是影响人参功效发挥方向的重要因素,而剂量、炮制、剂型、用法等也是影响人参功效发挥方向不可忽视的因素,此外还要考虑人参的产地、品种变迁等因素,并结合病证需要才能正确运用好人参。
Objective: To study the influence factors of oriented efficacy exertion of Ginseng in formula, clarify the mechanisms of usual compatible structures between Ginseng and other herbs and reveal the law of compatibility of prescription.
     Methods:Induction the efficacy Ginseng of by combining with the works of ancient Chinese materia medica and the paper of traditional physicians.1977 pieces of formulae which containing Ginseng were collected from The classic format of Formula Dictionary of Traditional Chinese Medicine, and the data table which containing the information of these formulae established by EXCEL software, then the factors including compatibility, dosage, processing, dosage form and usage which affect efficacy exertion of Ginseng in formulae were statistical analyzed by statistic methods.
     Results:The perceiving six kinds of Chinese medicine which often compatibility with Ginseng is: Tonifying medicinal, Antipyretics, Damp-draining diuretic, Interior-warming medicinal, Diaphoretics and Expectorant Antitussive Antiasthmetics. Ginseng has the efficiency of invigorating qi of five viscera; The compatibilities of Ginseng with Atractylodes, Poria, Astragalus and Tangerine Peel, etc, were usually used to tonify qi and invigorate spleen with taking whenever or before meals or took with the rice soup; The compatibilities of Ginseng with Balloon flower, Pinellia, Chinese yam and Dhg, etc, were usually used to invigorate qi for benefiting lung with took after meals or and took with Honey; The compatibilities of Ginseng with Poria, Sweetflag, Polygala, Spine date seed, Seed of oriental arborvitae and Dragon bone, etc, have the efficacy of mourishing the heart and tranquilization with taking before sleeping in Pills and Decoction; The compatibilities of Ginseng with Cassia, Gecko, etc, with high dose (15-20g) have the efficacy of Invigorating kidney for improving inspiration, and took before meals. Ginseng also has the efficacy of production of blood, yin and yang based on the efficacy of invigorating qi. The compatibilities of Ginseng with Liriope, Radix Rehmanniae, Anemarrhena, Gypsum and Gegen, etc, have the efficacy of invigorating qi and sheng jin; The compatibilities of Ginseng with Angelica, Peony root and Prepared Radix Rehmanniae, etc, have the efficacy of invigorating qi and nourishing blood with taking before meals; The compatibilities of Ginseng with Dried Ginger, Aconite and Clove, etc, have the efficacy of invigorating qi and warming yang with taking whenever, and sometimes taking with wine, decoction of Ginger or Jujube; The compatibilities of Ginseng with Aconite and Cornus officinalis, etc, have the efficacy of invigorating qi and prostration with high dose (20-60g) in decoction; The compatibilities of Ginseng with Saposhnikovia Divaricata, Scutellaria,Coptis and Rhubarb, etc, have the efficacy of strengthening vital qi to eliminate pathogenic factor with low dose(3-10g)in decoction.
     Conclusion:There are many factors influence on the efficacy exertion of Ginseng, such as compatibility, dosage, processing, dosage form usage, and one of the most important factors is compatibility among of them. The producing area and varieties of Ginseng also should to be taken into consideration. Finally, the correct application of Ginseng in treatment of disease must be combination of disease and syndrome.
引文
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