加味四妙丸治疗痛风的处方筛选研究

Ideas and Methods of Screening Jiaweisimiaowan for Treatment of Acute Gouty Arthritis and Principles of Diagnosis

本文以治疗痛风加味四妙丸为例,介绍经典类方的筛选及组方规律的研究思路和方法。对临床应用的治疗痛风加味四妙丸进行统计分析,根据四妙丸的组方结构,将加味药按功效分类,组成四组加味四妙丸处方；经药效比较,临床验证,筛选出有效处方；对该有效处方各类成分进行药效评价、正交组合筛选,确定各类成分对抗炎、镇痛、降尿酸作用的影响。结果表明,热毒炽盛为急性痛风病机的关键,加清热解毒药组成的四妙丸类方是治疗急性痛风的最佳配伍,加味药中的有机酸类成分在降血尿酸作用上起较重要的作用,增强了四妙丸中黄柏的清热解毒功效；君药苍术中的挥发油部位在抗炎、镇痛、降尿酸方面均起主要作用。

Taking for demonstration the prescription of Jiaweisimiaowan （JSW） for treatment of acute gouty arthritis, this article discusses how to study screening the prescription and its principles of diagnosis. The first the four different kinds of modified JSW was selected by statistical analysis of the construction of clinic JSW; then the assessment of pharmacodynamics of four prescriptions should be done in order to determine the best prescriptions on the anti - inflammatory effect and treating gout disease; finally the assessment the functions of its effectiveness and trace its components of the best prescription on anti - inflammation, analgesia and reduction of the activity of uric acid. These resuhs showed that the Heat and Detoxification plays the major role in mechanism of acute gouty arthritis, Simiaowan with Heat clearing and detoxifying herbs is best combination for the treating of acute gouty arthritis; the organic acids of Jiawei herbs in the prescription plays the more role in reduction of the activity of uric acid to promote effect of Heat clearing and detoxifying of ministerial drug Phellodendron chinense ; Volatile oils of monarch drug Atractylodes chinensis plays the major role in anti - inflammation , analgesia and the reduction of activity of uric acid.