Zhang Xiao-Meng, Lin Zhi-Jian, Zhang Bing, Li Ang
Beijing University of Chinese Medicine, Beijing 100029, China.
Zhongguo Zhong Yao Za Zhi. 2018 Jan;43(2):211-215. doi: 10.19540/j.cnki.cjcmm.20171106.008.
The application of Aconitum herbs in the treatment of Bi syndrome has a long history and exact effects.By taking Aconiti Radix(Chuanwu), Aconiti Kusnezoffii Radix(Caowu) and Aconiti Lateralis Radix Preparata(Fuzi) as example, this study was aimed to mine the prescription rules of Aconitum herbs in the treatment of Bi syndrome, and provide thoughts and bases for modern clinical medication. 1 106 prescriptions were obtained in more than 20 classic books including medical, pharmacy, and synthesized books from Eastern Han dynasty to Qing dynasty. Based on the methods of frequency statistics, percentile statistics and Apriori algorithm of association rules, the characteristics of syndrome classification, dosage and compatibility of Aconitum herbs in the treatment of Bi syndrome were analyzed. The data-mining results indicated that 60.76% prescriptions contained Fuzi, which was obviously higher than Chuanwu or Caowu, and 17.63% contained two or more kinds of Aconitum herbs. 70.34% prescriptions were used mainly to treat Bi syndrome with wind-cold-wetness, others were for the syndrome with the deficiency of liver and kidney, blockage of phlegm and blood stasis, and wind-heat-wetness Bi. In the prescriptions with definite dose, 80% dosage of Fuzi was in the range from 0.29-2.14 g·d⁻¹, while the dosage of Chuanwu and Caowu was from 0.14-1.01g·d⁻¹, which was also affected by patterns, formulations and processing. The dose of Aconitum herbs was highest in the Bi syndrome with wind-cold-wetness, and its dose in the decoction and vinum was significantly higher than that in the pills and powders. The processed products were used in 93.11% prescriptions, and their dosage was higher than the raw ones. In the clinical treatment of Bi syndrome, Chuanwu and Caowu were often used with Saposhnikoviae Radix(Fangfeng), Liquiritiae Radix et Rhizoma(Gancao), Myrrha(Moyao) and Ephedrae Herba(Mahuang), while Fuzi was often used with Cinnamomi Cortex(Rougui), Achyranthis Bidentatae Radix(Niuxi), Fangfeng and Chuanxiong Rhizoma(Chuanxiong), which can both expel wind-dampness and relieve pain. All in all, Aconitum herbs are widely used in the treatment of Bi syndrome, which can relieve arthralgia and pain.
乌头类药物在痹证治疗中的应用历史悠久且疗效确切。本研究以川乌、草乌、附子为例,旨在挖掘乌头类药物治疗痹证的用药规律,为现代临床用药提供思路和依据。从东汉至清代的医学、药学及综合性书籍等20余部经典著作中获取1106首方剂。基于频次统计、百分位数统计及关联规则的Apriori算法,分析乌头类药物治疗痹证的证候分类、用量及配伍特点。数据挖掘结果显示,60.76%的方剂中含有附子,明显高于川乌或草乌,17.63%的方剂含有两种或两种以上乌头类药物。70.34%的方剂主要用于治疗风寒湿痹证,其他用于肝肾亏虚、痰瘀阻滞、风湿热痹证。在有明确用量的方剂中,80%的附子用量在0.29 - 2.14 g·d⁻¹范围内,而川乌和草乌的用量为0.14 - 1.01g·d⁻¹,其用量还受证型、剂型及炮制影响。风寒湿痹证中乌头类药物用量最高,其在汤剂和酒剂中的用量显著高于丸剂和散剂。93.11%的方剂使用炮制品,其用量高于生品。临床治疗痹证时,川乌、草乌常与防风、甘草、乳香、麻黄配伍,附子常与肉桂、牛膝、防风、川芎配伍,均能祛风除湿、通络止痛。总之,乌头类药物在痹证治疗中应用广泛,能缓解关节疼痛。