白芥子涂法的研究进展

Research Progress on White Mustard Seed Coating Method

由于疗效广泛、靶点多样、不良反应发生率低,白芥子涂法越来越受到国内外学者的关注。本文就白芥子涂法的临床应用现状（基本组方的配伍比例、给药方式、贴敷穴位、给药方案等）及研究动态进行总结,并指出了研究中存在的问题,如临床应用多凭经验而定、缺乏合理依据、中医药理论的指导作用淡化;给药制剂多为传统剂型,新剂型产品尚未上市;贴敷药物皮肤刺激性大,患者难以接受甚至中断治疗;经穴给药机制分析缺乏深度,尚未揭示药物对腧穴作用的科学内涵;对药代动力学、生物药剂学、量效关系等研究较少。同时,提出必须严格按照循证医学的原则,规范临床应用;在注重临床验方的基础上,积极引进中药缓控释、智能化、靶向制剂等新剂型;全面考察皮肤刺激性影响因素,从药用物质基础角度对皮肤刺激性进行药效学评价,建立临床合理用药方案;采用中药谱效学的研究方法,借鉴现代皮肤免疫学、针灸学的最新研究成果,从系统论、整体论的角度综合分析各指标变化的相关性,阐明药物对腧穴作用的科学内涵。

Due to the effect of extensive,diverse targets and low incidence of adverse reactions,white mustard seed coating method has attracted more and more attention of scholars both at home and abroad.In this paper,the current clinical application of white mustard seed coating method（compatibility proportion of basic prescription medications,sticking point,dosing regimen,etc.） and their research trends were reviewed.The problems existing in this area were pointed out,such as administration by experience and clinical application,lack of reasonable basis,the guiding role of theory of traditional Chinese medicine was weakened;the dosage forms are mostly traditional dosage forms,and the new dosage form is not available yet;because thrill of the sticking drugs,patients are difficult to accept or even interrupt treatment;the mechanism of acupoint administration is lack of breakthrough;studies on the pharmacokinetics,biopharmaceutics,dose-response relationship were very few.At the same time,proper measures and suggestions are put forward.We should strictly follow principles of evidencebased medicine and standardize clinical practice;on the basis of paying attention to clinical preparations,we should actively introduce controlled-release,intelligent,targeting and other new dosage forms;study on the influencing factors of skin irritation should be comprehensive,reasonable clinical medication plan should be established;experiment should be carried out by adopting the latest research results of modern skin immunity,acupuncture and moxibustion,then elucidating the scientific connotation of the action of drugs on acupoints.