突破中药传统用量局限,提高中医药临床疗效

Increasing dosage:a momentous proposition to improve therapeutic efficacy of traditional Chinese medicine

从增加中药用量角度,寻求提高中医药临床疗效的重大举措。通过对中医药疗效的现状、中药用量与疗效的关系、传统中药用量规定的合理性等进行回顾性和前瞻性分析,阐释了从增加中药用量角度提高中医药临床疗效的科学性、必要性和可行性。中医药之所以屡屡受到诟病,关键还是中医药的疗效问题;中药疗效平平或者不够确切,剂量偏低是其重要原因,中药大剂量应用在中医临床上往往有上佳表现;从西药的临床剂量和中药有效成分的有效剂量看,一些中药传统用量设定是欠严谨和科学的;"中庸思想局限论"、"沙锅容积局限论"、"肚皮容积局限论"、"超大剂量风险论"等是中药用量难以突破的制约瓶颈;阐明中药量-效(毒)关系,突破中药传统用量局限,增加中药用量,可能将是提高中医药临床疗效的重大乃至根本性举措。"治疗窗"摸查法、生物效价比测法等可作为寻找和科学制定中药临床最佳用量范围的重要参考方法。

To explore a key approach for improving therapeutic efficacy of traditional Chinese medicine by means of increasing its dosage. The rationality, necessity and feasibility of this proposition were explained and verified by the retrospective and prospective analysis about the current situation of therapeutic efficacy of traditional Chinese medicine, the relationship between dosage and therapeutic efficacy of traditional Chinese medicine, the rationality of conventional dosage specification. The unremarkable therapeutic efficacy was the main reason of traditional Chinese medicine to be denounced frequently, which was heavily due to its low dosage. However, many cases showed excellent therapeutic efficacy if a big dosage was used. Compared with the clinical dosage of western medicine and curative dose of active substance from traditional Chinese medicine or crude drugs, the specification of the conventional dosage of traditional Chinese medicine failed to be rigorous and objective. The viewpoint of ＂Cooking pot size limitation＂ and ＂Human stomach size limitation＂ may be the bottleneck which restricted the increase of traditional dosage. In conclusion, to increase the dosage of traditional Chinese medicine and elucidate the relationship between dosage and therapeutic efficacy would be a momentous and essential method to improve the therapeutic efficacy of traditional Chinese medicine.