基于方剂数据分析的中药用量历史变迁规律研究

Research on Historical Changes of Dosage of Chinese Medicine Based on Data Analysis

目的:分析不同朝代方剂中药剂量单位及其用量的历史演变规律,为中药临床用量提供参考。方法:对《中医方剂大辞典》中收载的九万余首方剂信息进行结构化和标准化处理,构建方剂数据库,并参考文献,对不同年代的用量单位按照现代单位进行了换算,采用断代史研究方法,分析方剂中药用量的演变规律。结果:筛选有中药组成的方剂8万4千余首,涉及用量单位375个,体积单位包括升、合等149种;数量单位86种;重量单位有两、钱等63种;长度单位包括寸、尺等7种,面积单位3种;历代使用频数最多的用量单位是"两",达一半以上,其次是钱,以清代和民国时期使用频率最高。为了探究中药每日内服用量的规律,我们筛选了13,834首能代表每日服用剂量的内服方剂,有确切用量记载的药物频次81 830次,其中以长度为单位的中药平均长度为10.19 cm;以体积为单位的中药平均体积为753.24 mL;以重量为单位的中药频次是80 135次,平均重量为21.46 g。不同朝代内服方剂单味药一日平均用量唐朝最大,达到82.53 g,其后用量减少,至明以后用量与现代相差不大,多为10 g左右。结论:本研究首次基于大样本量的方剂数据,采用剂量换算和断代史研究方法,分析了不同历史时期中药用量的概貌和演变规律,发现了历代中药用量差异很大,是受诸多因素的影响。现代临床的中药用量,不应局限于古代文献记载,而应根据当前药物的特点,药材性效毒性的变化以及病人的病情、体质等灵活运用,方能达到药到病除,发挥中药的原创优势。

Objective: This paper analyzes the historical evolution law of the dose units and dosage of traditional Chinese medicine in different dynasties, and provides reference for the clinical dosage of traditional Chinese medicine. Methods:The information of more than 90,000 prescriptions collected in the dictionary of traditional Chinese medicine prescription was structured and standardized, a recipe database was constructed, and references were used to convert the dosage units of different dynasties according to modern units. Results: More than 84 000 prescriptions of traditional Chinese medicine were screened, involving 375 dosage units and 149 volume units, including liters and hefei. Quantity unit 86 kinds;There were 63 kinds of weight units, such as two or money. There were 7 types of length units, including inches and feet, and 3 types of area units. The most frequently used unit in the past dynasties was "liang", which was more than half, followed by "qian", which was most frequently used in the qing dynasty and the republic of China. In order to explore the law of daily doses of traditional Chinese medicine, we selected 13,834 internal prescriptions that could represent daily doses.There were 81,830 times of drug frequency recorded in specific dosage, among which the average length of traditional Chinese medicine in length was 10.19 cm. The average volume of traditional Chinese medicine in unit was 753.24 ml.The frequency of traditional Chinese medicine by weight is 80135 times, and the average weight is 21.46 g. In different dynasties, the daily average dosage of single flavor medicine was the largest in tang dynasty, reaching 82.53 g, and then the dosage decreased. After Ming dynasty, the dosage was not much different from modern times, mostly about 10 g.Conclusion: This study, for the first time, based on the prescription data of large sample size, adopted the doseconversion and dating history research methods to analyze the general appearance and evolution rules of the dosage of traditional Chinese medicine in different historical periods. The dosage of traditional Chinese medicine in modern clinical practice should not be limited to ancient documents, but should be flexibly used according to the characteristics of current drugs, changes of the potency toxicity of medicinal materials, as well as patient’s condition and constitution, so as to achieve the cure of drugs and give play to the original advantages of traditional Chinese medicine. This study, for the first time, based on the prescription data of large sample size, adopted the dose-conversion and dating history research methods to analyze the general appearance and evolution rules of the dosage of traditional Chinese medicine in different historical periods. The dosage of traditional Chinese medicine in modern clinical practice should not be limited to ancient documents, but should be flexibly used according to the characteristics of current drugs, changes of the potency toxicity of medicinal materials, as well as patient’s condition and constitution, so as to achieve the cure of drugs and give play to the original advantages of traditional Chinese medicine.