“十九畏”同方配伍应用分析

Analysis of Compatibility and Application of Prescriptions Containing Drugs of “Nineteen Incompatibilities”

整理古今"十九畏"同方配伍应用文献并进行分析,探讨"十九畏"古今同方应用情况及配伍特点。收集"十九畏"同方应用方剂共1600首(古代方剂602首、现代方剂998首),其中以肉桂-赤石脂最为常见(35. 00%),其次为人参-五灵脂(31. 56%)、丁香-郁金(17. 00%);乌头类-犀角(8. 88%)及巴豆-牵牛(7. 00%)应用较少,水银-砒霜、三棱-牙硝、硫黄-朴硝、狼毒-密陀僧古今均极少同方配伍应用。肉桂-赤石脂多配伍补气药、温里药和清热药,常用于腹泻、腹痛等脾胃疾病及痛经等妇科疾病;人参-五灵脂多配伍补气健脾药、活血化瘀药,用于妇女经产诸疾、小儿惊风、恶性肿瘤及心血管疾病等;丁香-郁金多配伍健脾药、理气药、化痰止咳药,常用于呃逆、胃痛等脾胃疾病。提示配伍禁忌"十九畏"中肉桂-赤石脂、人参-五灵脂、丁香-郁金古今均有应用,但具有一定病证特点和配伍环境特点,其安全性及组方规律值得进一步研究。

In order to discuss the features of compatibility and application of prescriptions containing drugs of"nineteen incompatibilities" in ancient and modern times,literatures including "nineteen incompatibilities"from ancient and modern times were collected and analyzed.A total of 1,600 prescriptions were collected including 602 ancient prescriptions and 998 modern prescriptions,among which the frequency of use of Rougui(Cortex Cinnamomi)with Chishizhi(Halloysitum Rubrum) was the highest(35.00%),followed by Renshen(Radix Ginseng) with Wulingzhi(Faeces Togopteri)(31.56%),Dingxiang(Flos Caryophylli) with Yujin(Radix Curcumae)(17.00%),Wutou(Radix Aconiti/Radix Aconiti Kusnezoffii) with Xijiao(Cornu Bubali)(8.88%),and Badou(Fructus Crotonis) with Qianniu(Semen Pharbitidis)(7.00%).Besides,the combinations of mecury with arsenic,Sanleng(Rhizoma Sparganii) with Yaxiao(Natrii Sulfas),Sulfur with Puxiao(Natrii Sulfas),Langdu(Stellera chamaejasme Linn) with litharge are rarely used either ancient or modern.The combination of Cortex Cinnamomi with Halloysitum Rubrum is commonly used with medicines of tonifying qi,warmimg the interior and clearing heat to treat diseases of spleen and stomach including diarrhea and abdominal pain,as well as gynecologic diseases like dysmenorrhea.The combination of Radix Ginseng with Faeces Togopteri is used with medicines of invigorating qi and strengthening the spleen,activating blood to remove stasis to treat obstetrical and gynecological diseases,malignant tumors,infantile convulsion,cardiovascular diseases,etc.The combination of Flos Caryophylli with Radix Curcumae is used with medicines of strengthening the spleen,regulating the flow of qi,resolving phlegm,and stopping coughing to treat diseases of spleen and stomach,such as hiccups and stomachaches.The results showed that under such circumstances as special symptoms and synergies,the prescription containing drugs of"nineteen incompatibilities"were used in both ancient and modern times.Therefore,the safety and compatible principles of the "nineteen incompatibilities"need further study.