《中国药典》收录补肾中成药的组方规律分析

Composition Principles of Kidney-tonifying Chinese Medicine Prescriptions in Chinese Pharmacopoeia

分析补肾中成药的用药特点及组方配伍规律。方法:收集2015年版《中国药典》收录补肾中成药,利用"中医传承辅助系统(V2.5)"软件进行组方规律分析。结果:腰膝酸软、头晕、耳鸣是肾虚常见症状;补肾中成药主要涉及52种证候,其中肝肾不足证、脾肾两虚证及肝肾阴虚证是常见证候;142首补肾中成药中,包含290味中药,使用频率前3味的是熟地黄、茯苓、当归,而熟地黄、茯苓、山药、当归是主要核心组合;针对肝肾同病,药物组合可视为六味地黄丸合四物汤加减,并配以专入肝肾二经的何首乌、枸杞子;针对脾肾同病,药物组合以四君汤为基础方的补气药物为主,并配以具有脾肾双补的菟丝子、山药,可视为源自于《景岳全书》主治脾肾虚损的苓术菟丝丸。结论:肾虚为本,重视"肾为五脏之本",立足肾与他脏及气血之间的关系,兼顾虚实;补为核心,把握肾虚的病理变化,重视肾的阴阳特点,补泻结合。

Objective： To analyze composition principles of kidney-tonifying Chinese medicine prescriptions（ KTCMP） in Chinese Pharmacopoeia. Method： Traditional Chinese medicine（ TCM） prescriptions for tonifying kidney were collected from the 2015 edition of Chinese Pharmacopoeia. We used TCM inheritance auxiliary system V2. 5 to analyze the principles of prescription composition. Result： Soreness and weakness of waist and knees, dizziness andtinnitus are common symptoms of kidney deficiency. KTCMP mainly involes 52 syndromes,with liver and kidney deficiency,spleen and kidney deficiency and deficiency of liver-Yin and kidneyYin as common syndromes. The 142 KTCMPs contain 290 herbs,and Rehmanniae Radix Praeparata,Poria and Angelicae Sinensis Radix were frequently used. Rehmanniae Radix Praeparata-Poria-Dioscoreae Rhizoma-Angelicae Sinensis Radix is the main core combination. As forliver and kidney deficiency syndrome,the drug combination of Liuwei Dihuangwan and Siwutang could be used and combined with Polygoni Multiflori Radix and Lycii Fructus. As for spleen and kidney deficiency,Sijuntang could be used and combined with Lycii Fructus and Dioscoreae Rhizoma,which was derived from Lingzhu Tusi Wan. Conclusion： Based on the relationship between kidney and other viscera,considerations are given to both deficiency and excess. With kidney tonifying as the core,emphasis was given to pathological changes in kidney deficiency,characteristics of Yin and Yang of kidney and combination of reinforcing and reducing methods.