Qin Zi-Nan, Wang Meng-Xin, Shi Nan-Nan, Wang Yan-Ping, Zhai Hua-Qiang
Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine Beijing 102488, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2020 Apr;45(7):1515-1520. doi: 10.19540/j.cnki.cjcmm.20200305.501.
Qingfei Paidu Decoction is a traditional Chinese medicine compound recommended by National Health Commission of the People's Republic of China and National Administration of Traditional Chinese Medicine for clinical therapies of coronavirus disease 2019(COVID-19). Qingfei Paidu Decoction consists of 21 traditional Chinese medicines, such as Asari Radix et Rhizoma. However, the dosage of Asari Radix et Rhizoma has been questioned by some people, because of one ancient proverb. To explore the rationality of the dosage of Asari Radix et Rhizoma in Qingfei Paidu Decoction, this study systematically examined the ancient and modern physicians' understanding of the toxicity of Asari Radix et Rhizoma, and collated the application and dosage of Asari Radix et Rhizoma in ancient prescriptions and modern clinics based on literature analysis. As a result, we found that ancient and modern physicians have different understanding on the toxicity of Asari Radix et Rhizoma and that the theory about the dosage of Asari Radix et Rhizoma is flawed. We also found that the dose of Asari Radix et Rhizoma in ancient and modern clinical applications was not constrained by ancient experience. Physicians usually increase the dosage of Asari Radix et Rhizoma in clinical therapy according to the actual conditions, and there were no adverse reactions. Additionally, according to laws and regulations concerning medical affairs, physician could increase or decrease the dosage of the drug under special circumstances. Based on the analysis of safety and effectiveness of Asari Radix et Rhizoma in Qingfei Paidu Decoction, we conclude that the dose of Asari Radix et Rhizoma in Qingfei Paidu Decoction is safe, effective and reasonable.
清肺排毒汤是中华人民共和国国家卫生健康委员会和国家中医药管理局推荐用于新型冠状病毒肺炎（COVID-19）临床治疗的中药复方。清肺排毒汤由21味中药组成，如细辛。然而，由于一句古谚，细辛的用量受到了一些人的质疑。为探讨清肺排毒汤中细辛用量的合理性，本研究系统考察了古今医家对细辛毒性的认识，并通过文献分析整理了细辛在古代方剂和现代临床中的应用及用量。结果发现，古今医家对细辛毒性的认识存在差异，细辛用量理论存在缺陷。还发现古今临床应用中细辛的用量并未受古代经验的限制。医生在临床治疗中通常会根据实际情况增加细辛用量，且未出现不良反应。此外，根据医疗相关法律法规，医生在特殊情况下可增减药物用量。基于对清肺排毒汤中细辛安全性和有效性的分析，我们得出结论：清肺排毒汤中细辛的用量安全、有效且合理。
