大承气汤治疗肠梗阻临床用量研究

Dose of Dachengqi Decoction for Bowel Obstruction in Clinical Practice

目的了解大承气汤治疗肠梗阻的临床用量情况。方法检索中国知网数据库（CNKI）1994年至2012年大承气汤治疗肠梗阻的相关文献,对其中明确研究方法、处方用量及疗效判定的文献进行归纳,总结大承气汤治疗肠梗阻的所治疾病种类及组成药物临床实际用量。结果共纳入文献42篇。腹部手术后粘连性肠梗阻文献17篇,大承气汤原方药物用量范围为大黄9-40g,芒硝5-30g,枳实8-20g,厚朴8-30g;术后早期炎性肠梗阻文献8篇,大承气汤原方药物用量范围为大黄15-30g,芒硝9-20g,枳实9-15g,厚朴10-20g;小儿肠梗阻文献4篇,大承气汤原方药物用量范围为大黄5-10g,芒硝5-7g,枳实10-15g,厚朴10-15g;急性肠梗阻文献8篇,大承气汤原方药物用量范围为大黄10-30g,芒硝6-30g,枳实10-30g,厚朴10-30g;老年性肠梗阻文献2篇,大承气汤原方药物用量范围为大黄10g,芒硝10g,枳实10g,厚朴10g;麻痹性肠梗阻文献1篇,大承气汤原方药物用量范围为大黄12g,芒硝9g,枳实12g,厚朴12g;机械性肠梗阻文献2篇,大承气汤原方药物用量范围为大黄10g,芒硝10-12g,枳实12-30g,厚朴10-30g。结论大承气汤原方治疗肠梗阻的剂量范围为大黄5-40g,芒硝5-30g,枳实8-30g,厚朴8-30g,此结果提示了大承气汤治疗肠梗阻临床用量的有效及安全范围。

Objective To explore the dosage of Dachengqi Decoction（Major Qi-Coordinating Decoction）for bowel obstruction in clinical practice.Methods The articles related to Dachengqi Decoction for bowel obstruction from 1994to 2012were searched in China National Knowledge Infrastructure（CNKI）.The articles with clear research method,dosage and efficacy determination were summarized.The dosage,indications and efficacy of Dachengqi Decoction were analyzed.Results Totally 42articles were included.The dosage of Dachengqi Decoction in 17articles related to adhesive bowel obstruction after abdominal surgery was Dahuang（Radix et Rhizoma Rhei）9-40g,Mangxiao（Natrii Sulfas）5-30g,Zhishi（Fructus Aurantii Immaturus）8-20g and Houpu（Cortex Magnoliae Officinalis）8-30g.The dosage of Dachengqi Decoction in 8articles related to early postoperative inflammatory ileus was Dahuang 15-30g,Mangxiao 9-20g,Zhishi 9-15g and Houpu 10-20g.The dosage of Dachengqi Decoction in 4articles related to pediatric bowel obstruction was Dahuang 5-10g,Mangxiao 5-7g,Zhishi 10-15g and Houpu 10-15g.The dosage of Dachengqi Decoction in 8articles related to acute bowel obstruction was Dahuang 10-30g,Mangxiao 6-30g,Zhishi 10-30g and Houpu 10-30g.The dosage of Dachengqi Decoction in 2articles related to senile ileus was Dahuang 10g,Mangxiao 10g,Zhishi 10g and Houpu 10g.The dosage of Dachengqi Decoction in one article related to paralytic ileus was Dahuang 12g,Mangxiao 9g,Zhishi 12g and Houpu 12g.The dosage of Dachengqi Decoction in 2articles related to mechanical obstruction was Dahuang 10g,Mangxiao 10-12g,Zhishi 12-30g and Houpu10-30g.Conclusion The dosage of Dachengqi Decoction for bowel obstruction is Dahuang 5-40g,Mangxiao 5-30g,Zhishi8-30g and Houpu 8-30g.The result indicates the effective and safe dose range of Dachengqi Decoction for bowel obstruction.