从量效关系探讨《伤寒杂病论》厚朴用药规律

Medication Rule of Cortex Magnoliae Officinalis in Treatise on Cold Damage and Miscellaneous Diseases Based on Dose-effect Relationship

目的:分析《伤寒杂病论》中厚朴的量效关系及配伍用药规律,以更好地指导临床。方法:总结归纳《伤寒杂病论》中含有厚朴的条文,采用SPSS 23.0统计软件分析厚朴剂量与相关因素之间的关系。结果:符合筛选条件含厚朴方剂共11首,占全书总方剂数的9.73%。二元相关性分析显示,厚朴单次用量与药味数、用水量、与剩余水量、单次服用水量和服用次数无明显相关性(P>0.05)。单因素逻辑回归分析显示,厚朴是否为主药与厚朴单次用量、用水量有相关性(P<0.05)结论:厚朴以配伍用药为主,未单独使用,多应用在阳明经证,从量效关系发现,厚朴是否为主药与厚朴单次用量、用水量有相关性。厚朴对于虚实类疾病通过配伍均可达到治疗效果,从药物作用气机的升降浮沉角度,厚朴在体内作用以降为主。厚朴小剂量使用,配伍麻黄、杏仁、生姜、桂枝等可治疗呼吸系统疾病,大剂量配伍半夏、人参、生姜、枳实等可治疗消化系统疾病。

Objective:To explore the dose-effect relationship of Cortex Magnoliae Officinalis and the combination rules in Treatise on Cold Damage and Miscellaneous Diseases,to provide reference for clinical application.Methods:The articles containing Cortex Magnoliae Officinalis in Treatise on Cold Damage and Miscellaneous Diseases were systematically summarized,and SPSS 23.0 was used for single factor logistic regression analysis and binary correlation analysis to analyze the relationship between the dose of Cortex Magnoliae Officinalis and related factors.Results:Eleven prescriptions containing Cortex Magnoliae Officinalis met the screening conditions,accounting for 9.73%of the total prescriptions in the book.Binary correlation analysis showed that there was no significant correlation between the single dose of Cortex Magnoliae Officinalis and the number of medicinal materials,water consumption,remaining water volume,single water consumption and frequency of taking medicine(P=0.000,P=0.007,P>0.05).Single factor logistic regression analysis demonstrated that whether Cortex Magnoliae Officinalis was the dominant medicinal material was related to its single dose and water consumption(P<0.05).Conclusion:Cortex Magnoliae Officinalis was mainly used in combination instead of alone.It was mostly applied to the treatment of yang brightness meridian syndrome.According to the dose-effect relationship,a significant correlation was found between Cortex Magnoliae Officinalis being the dominant medicinal material and its single dose and water consumption.Cortex Magnoliae Officinalis could achieve the therapeutic effect on diseases of deficiency and excess through combination with other medicinal materials.From the perspectives of ascending,descending,floating and sinking of qi movement by medicinal materials,Cortex Magnoliae Officinalis mainly played a descending role in the body.It could be used in small doses and in combination with Herba Ephedrae,Semen Armeniacae Amarae,Rhizoma Zingiberis Recens,and Ramulus Cinnamomi to treat respiratory system diseases,and large doses of Cortex Magnoliae Officinalis combined with Rhizoma Pinelliae,Radix Ginseng,Rhizoma Zingiberis Recens,Fructus Aurantii Immaturus,etc.could treat digestive diseases.