大黄不同功效的古今用药规律分析

Multifunctional regularity of Rhei Radix et Rhizoma in ancient and modern medicine

基于文本数据挖掘研究,分析归纳大黄不同功效的古今用药规律。将中医方剂数据库中含有大黄的7 226首古方与《中国药典》2015年版和药智网中含有大黄的736条现代中成药处方信息分别进行筛选归纳,统计大黄在方剂中占比、制法、配伍药、功效及所治疾病科属,探究大黄制法用法与功效、疾病科属间的联系。通过数据挖掘发现,除生用内服、最常用于治疗内科疾病外,大黄发挥"泻下攻积、清热泻火"作用时古代常水煎液内服,现多酒炙内服,还用于儿科;"凉血解毒"时古代常贴膏外用或水煎液内服,现多醇提内服,还用于外科;"逐瘀通经"时古方中以酒煎液或酒送服为主,现今以水煎液内服为主,较多用于妇科;"利湿退黄"时古代常水煎液内服,而现代以酒煎液或水酒共煎液居多,还用于儿科。古方中大黄多与甘草配伍而现代与黄芩配伍较多,在"逐瘀通经"中配伍药古方以当归、肉桂、木香为主,现代以芍药和干漆为主。这些研究结果为大黄的临床精准使用与相关药物创制提供了参考。

This paper analyzes and summarizes the multifunctional regularity of Rhei Radix et Rhizoma(rhubarb) in ancient and modern medicine based on text data mining approach. The 7 226 ancient prescriptions containing rhubarb in traditional Chinese medicine prescription database and 736 formulas of modern Chinese medicine prescriptions containing rhubarb in Chinese Pharmacopoeia(2015 edition) and Yaozhi network were screened and summarized respectively. The proportion of rhubarb in prescriptions, preparation methods, compatibility drugs, efficacy and disease attributions were determined, and the relationships between rhubarb preparation methods and efficacy, disease attributions were also explored. Through data mining, in addition to direct oral administration and mostly being used for the treatment of internal medicine diseases, rhubarb was orally taken with water decoction in ancient times while wine-treated rhubarb now commonly used in pediatrics as well to remove accumulation with purgation and clear heat and purge fire. When rhubarb plays a role in cooling blood and detoxifying, it was often used externally or taken in the form of water decoction in the past. In modern times, rhubarb is usually taken in by alcohol extraction method, and is also applied in surgery. To eliminate blood stasis and remove obstruction in the channels, wine decoction or taken with wine was used primarily in ancient times while taken orally with water decoction is focused on today, mainly for gynecology. For eliminating dampness and removing jaundice, rhubarb was mostly used orally with water decoction in the past instead of wine decoction or wine and water co-decoction nowadays, and mainly used for treating pediatric diseases. In ancient prescriptions, rhubarb was often combined with Glycyrrhizae Radix et Rhizoma and now used with Scutellariae Radix. In the efficacy of eliminating blood stasis, compatibility drugs were focused on Angelicae Sinensis Radix, Cinnamomi Cortex, and Aucklandiae Radix in the past and used mostly with Paeoniae Radix and Toxicodendri Resina today. These findings provide reference for the accurate clinical use of rhubarb and the creation of related drugs.