本院常用中药饮片剂量分析
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摘要
目的分析单味中药饮片的使用剂量的特点和规律,为确定其合理的剂量范围提供参考依据。方法调查2018年1～6月使用频次占总处方数10%以上的单味药的剂量分布,并与2015年版《中华人民共和国药典》(以下称"《中国药典》")等法定标准的推荐剂量进行比较分析。结果单味中药饮片使用频次占总处方数≥10%32种,剂量分布前5位分别为10 g、15 g、9 g、30 g、6 g,占比接近90%。32个品种在本院门诊处方中,无超大剂量应用,有个别超小剂量应用;剂量90%以上在《中国药典》范围内的品种有21个。中药饮片在临床使用中存在超药典剂量使用的情况,但是并不突出。结论常用中药合理的剂量范围有待更深入的研究;临床使用中药饮片既要考虑安全性,也要考虑量效关系。
Objective To analyze the characteristics and regularity of the dosage of single-flavored traditional Chinese medicine decoction pieces, and to provide reference for determining the reasonable dosage range. Methods The dose distribution of single-flavored drugs with a frequency of more than 10% of the total prescriptions from January to June2018 was investigated, and compare with the 2015 edition of the Pharmacopoeia of the People's Republic of China(hereinafter referred to as "Chinese Pharmacopoeia") and other recommended doses. Results There were 32 kinds of single-flavored traditional Chinese medicine decoction pieces, which accounted for more than 10% of the total prescription. The top 5 dose distributions were 10 g, 15 g, 9 g, 30 g and 6 g, respectively, accounting for nearly 90%.These 32 pieces were not used in large-dose applications in our outpatient prescriptions, and there were some ultralow-dose applications; there were 21 pieces with more than 90% of the doses in the scope of the Chinese Pharmacopoeia. In the clinical use of traditional Chinese medicine decoction pieces, there were cases of out of the scope of the Chinese Pharmacopoeia, but were not prominent. Conclusion The reasonable dosage ranges of commonly used traditional Chinese medicines needs further study; the clinical use of traditional Chinese medicine decoction pieces should consider both safety and dose-effect relationship.
Objective To analyze the characteristics and regularity of the dosage of single-flavored traditional Chinese medicine decoction pieces, and to provide reference for determining the reasonable dosage range. Methods The dose distribution of single-flavored drugs with a frequency of more than 10% of the total prescriptions from January to June2018 was investigated, and compare with the 2015 edition of the Pharmacopoeia of the People's Republic of China(hereinafter referred to as "Chinese Pharmacopoeia") and other recommended doses. Results There were 32 kinds of single-flavored traditional Chinese medicine decoction pieces, which accounted for more than 10% of the total prescription. The top 5 dose distributions were 10 g, 15 g, 9 g, 30 g and 6 g, respectively, accounting for nearly 90%.These 32 pieces were not used in large-dose applications in our outpatient prescriptions, and there were some ultralow-dose applications; there were 21 pieces with more than 90% of the doses in the scope of the Chinese Pharmacopoeia. In the clinical use of traditional Chinese medicine decoction pieces, there were cases of out of the scope of the Chinese Pharmacopoeia, but were not prominent. Conclusion The reasonable dosage ranges of commonly used traditional Chinese medicines needs further study; the clinical use of traditional Chinese medicine decoction pieces should consider both safety and dose-effect relationship.
引文
[1]国家药典委员会.中华人民共和国药典[M].北京:中国医药科技出版社,2015:一部,凡例ⅩⅢ.
[2]邱凤邹,张斯汉,陆燕萍.超药典中药处方剂量分析[J].中外医疗,2010,29(23):9.
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[4]段红福,马文建,崔瑛,等.基于Wilcoxon符号秩检验的临床常用中药饮片剂量调查分析[J].时珍国医国药,2015,26(9):2296-2298.
[5]张志国,杨磊,张志国,等.中医药历代度量衡的研究[J].辽宁中医杂志,2018,45(3):499-502.
[6]何鹏彬,张宁,曹海山,等.95363张中药饮片处方剂量分析[J].中国药业,2008,17(6):56-57.
[7]唐仕欢,黄璐明,黄璐琦,等.常用中药饮片用量问卷调查报告[J].中国中药杂志,2010,35(4):543.
[8]张玉国,杨建英.如何掌握柴胡解郁的适应症及用量?[J].中医杂志,2002,43(10):793.
[9]陈敏时.柴胡用量小议[J].江苏中医,1996,17(2):37.
[10]杨付明.张锡纯控制黄芪功效发挥方向的基本构架[J].中医杂志,2011,52(24):2081-2083.
[11]兰雄飞.剂量与疗效变化举隅[J].中医药研究,1989,5(1):30-31.
[12]王永炎,张启明,于东林.“重剂起沉疴”与“轻量释顽疾”辨析[J].中医杂志,2011,52(19):1645.
[13]张玉辉,赵凯维,刘理想,等.周超凡谈无毒中药的潜在不良反应[J].中国中医基础医学杂志,2017,23(4):544-545,560.
[14]国家食品药品监督管理总局.国家食品药品监管总局提示关注口服何首乌肝损伤风险[EB/OL].(2014-07-16).http://www.sda.gov.cn/WS01/CL0051/102902.html.
[15]黄璐琦,唐仕欢,杨洪军.论中药用量的特点及研究的关键点[J].中医杂志,2009,50(3):203-205.
[16]韦胤寰.中药处方用量增大原因探析[J].广西中医药大学学报,2017,20(3):115-119.
[17]傅延龄,王倩,王振宇.论中药临床处方用量控制[J].中医杂志,2015,56(16):1315-1354.
[18]肖小河,鄢丹,金城,等.突破中药传统用量局限,提高中医药临床疗效[J].中国中药杂志,2008,33(3):229-232.
[19]刘理想,赵凯维,张玉辉,等.周超凡对中药常用量与超大剂量应用的认识[J].中国中医基础医学杂志,2018,24(7):993-995.
[20]胡昌江,陈志敏,吴珊珊,等.中医精准医疗的智慧[J].中华中医药学刊,2018,36(1):7-10.
[2]邱凤邹,张斯汉,陆燕萍.超药典中药处方剂量分析[J].中外医疗,2010,29(23):9.
[3]牛凯云.3774张中药处方剂量调查[J].中医药管理杂志,2008,16(7):510.
[4]段红福,马文建,崔瑛,等.基于Wilcoxon符号秩检验的临床常用中药饮片剂量调查分析[J].时珍国医国药,2015,26(9):2296-2298.
[5]张志国,杨磊,张志国,等.中医药历代度量衡的研究[J].辽宁中医杂志,2018,45(3):499-502.
[6]何鹏彬,张宁,曹海山,等.95363张中药饮片处方剂量分析[J].中国药业,2008,17(6):56-57.
[7]唐仕欢,黄璐明,黄璐琦,等.常用中药饮片用量问卷调查报告[J].中国中药杂志,2010,35(4):543.
[8]张玉国,杨建英.如何掌握柴胡解郁的适应症及用量?[J].中医杂志,2002,43(10):793.
[9]陈敏时.柴胡用量小议[J].江苏中医,1996,17(2):37.
[10]杨付明.张锡纯控制黄芪功效发挥方向的基本构架[J].中医杂志,2011,52(24):2081-2083.
[11]兰雄飞.剂量与疗效变化举隅[J].中医药研究,1989,5(1):30-31.
[12]王永炎,张启明,于东林.“重剂起沉疴”与“轻量释顽疾”辨析[J].中医杂志,2011,52(19):1645.
[13]张玉辉,赵凯维,刘理想,等.周超凡谈无毒中药的潜在不良反应[J].中国中医基础医学杂志,2017,23(4):544-545,560.
[14]国家食品药品监督管理总局.国家食品药品监管总局提示关注口服何首乌肝损伤风险[EB/OL].(2014-07-16).http://www.sda.gov.cn/WS01/CL0051/102902.html.
[15]黄璐琦,唐仕欢,杨洪军.论中药用量的特点及研究的关键点[J].中医杂志,2009,50(3):203-205.
[16]韦胤寰.中药处方用量增大原因探析[J].广西中医药大学学报,2017,20(3):115-119.
[17]傅延龄,王倩,王振宇.论中药临床处方用量控制[J].中医杂志,2015,56(16):1315-1354.
[18]肖小河,鄢丹,金城,等.突破中药传统用量局限,提高中医药临床疗效[J].中国中药杂志,2008,33(3):229-232.
[19]刘理想,赵凯维,张玉辉,等.周超凡对中药常用量与超大剂量应用的认识[J].中国中医基础医学杂志,2018,24(7):993-995.
[20]胡昌江,陈志敏,吴珊珊,等.中医精准医疗的智慧[J].中华中医药学刊,2018,36(1):7-10.