基于方剂组成统计分析的附子减毒配伍规律探讨

Discussion on Reduced Toxicity Rules of Radix Aconiti by Statistical Analysis of Prescription Compatibility

目的基于附子在古今方剂中的组成统计分析,探讨抑减附子毒性的配伍方法,为探索附子等有毒中药配伍减毒的合理性与规律性、揭示其减毒控毒机理、指导临床合理用药提供依据。方法构建附子方药数据库分析平台,应用频数分析观察附子配伍的药物总体分布态势;利用SAS8.1统计软件,运用多元统计方法中的因子分析,探察附子与各药物(组)间的相互配伍关系。结果参与统计分析的3 188首含附子方剂中,涉药524味。频数分析显示,各类药物与附子配伍所占比例由高到低依次为温里药、补气药、理气药、辛温解表药、补血药、活血药、补阳药、收涩药、化痰药、利水药、清热药、风湿药等;单味药与附子配伍所占比例居前者依次为肉桂、干姜、甘草、人参、白术、当归、茯苓等;因子分析共得到81个公因子,以得分大于0.4为标准,提取出80个对附子功效或毒性影响较大的药物(组)。结论通过以寒制热、以甘缓毒、以柔克刚、以守约行、调正制毒等配伍方法,可达控减附子毒性之目的 。

Objective Based on statistical analysis of Radix Aconiti （RA） combined in ancient and modem prescriptions, the compatibility methods of reducing toxicity of RA were discussed, to explore the rationality and regularity of reducing toxicity of RA, reveal the mechanism of reducing toxicity and provide reference to clinical medication. Methods The prescription database analysis platform of RA were constructed to analyze the trend of the overall distribution of drugs combined with RA by frequency analysis with SAS 8.1 statistical software, factor analysis of multivariate statistical methods was used to explore the compatibility relationship of RA and different drug groups. Results Total 3 188 prescriptions combined with RA were studied with statistic analysis, and 524 drugs were included. Frequency analysis showed the proportion of different drugs combined with RA were drugs for dispelling intemal cold, drugs for tonifying Qi, drugs for regulating Qi flow, drugs for relieving exterior syndrome with warm and pungent, drugs for enriching blood, drugs for activating blood circulation, drugs for invigorating Yang, drugs for astringing collape syndrome, drugs for resolving phlegm, drugs for promoting diuresis, drugs for clearing away heat and drugs for expelling wind and dampness respectively. The proportion of single herb composed with RA were Cinnamomum cassina, Rhizoma zingiberis, Ural licorice, Ginseng, Atractylodes macrocephala, Angelica sinensis and Poria cocos. There were 81 common factors obtained by factor analysis. Following the criterion of score must more than 0.4, 80 drugs effected on efficacy or toxicity of RA were extracted. Conclution The toxicity of RA can be regulated and reduced by the following compatibility methods, which were treating hot syndrome with drugs of cold nature, treating pathogenic toxin with drugs of sweet flavour, restraining dryness-heat property with drugs of nourishing Yin, restraining pungent-dispersing property with drugs of inducing astringency, restraining toxicity with drugs of tonifying vital Qi, etc.