从量效关系探讨《伤寒杂病论》半夏用药规律

Discussion on Medication Rules of Pinelliae Rhizoma in Shang Han Za Bing

目的:辨析半夏在《伤寒杂病论》中的量效关系和配伍用药逻辑。方法:系统整理《伤寒论》《金匮要略》中含有半夏的条文,采用SPSS 20.0统计软件单因素逻辑回归分析及二元相关性分析半夏剂量与相关因素之间的关系。结果:经筛选共纳入含半夏方剂42首占《伤寒杂病论》全部方剂比例的16.28%,对其中可统计的33首方剂分析发现,半夏单次用量与药味数、用水量有相关性;单因素逻辑回归分析表明,半夏的单次用量、阴阳类方、药味数量、用水量、剩余水量、单次服用水量、服用次数和半夏在组方中是否作为主药尚无相关性;与其作为非主药比较,半夏与黄芩、厚朴配伍时作为主药的单次用量差异明显。结论:通过对其量效关系的研究可以发现,半夏在临床上的使用及其疗效主要通过与其他药物配伍实现,且仅在与黄芩、厚朴相伍使用时与剂量有关。遵守半夏的药物配伍规律和量效关系,并"依证组方用药"才能发挥其最大临床疗效。

Objective This study aims to provide references for clinical medication through the analysis on the dose-response relationship and compatibility medication rules of Pinelliae Rhizoma.Methods It systematically arranged the provisions containing Pinelliae Rhizoma.Relationship between the dose of Pinelliae Rhizoma and the related factors were analyzed by single factor logistic regression analysis and binary correlation analysis by SPSS 20.0 statistical software.Results:After screening,42 prescriptions including Pinelliae Rhizoma are selected,accounting for 16.28%in the total prescriptions of Shang Han Za Bing Lun.33 prescriptions which can be analyzed,the taken dose of every time of Pinelliae Rhizoma has a close relationship with the number of medicine and water consumption,with statistical significance.Single factor logistic regression analysis shows whether Pinelliae Rhizoma as a main medicine has not the close relationship with other factors.Compared with Pinelliae Rhizoma as not the main medicine,when Pinelliae Rhizoma there is a statistical significance difference in the taken dose of every time of Pinelliae Rhizoma as the main medicine,if that used as a composite prescription with Huangqin or Houpo.Conclusion:From the dose-response relationship,we can see that the clinical application and efficacy of Pinelliae Rhizoma mainly lies in drug compatibility.It has a dose-dependent manner when composed with Huangqin or Houpo.It should be strictly abide by the rule of its drug compatibility;and also using the prescription and the drug according to the syndrome,for grasping its using method flexibly.