基于方剂计量学的敦煌《辅行诀》方剂君药识别研究

Study on Identification of Principal Medicines in Prescriptions in Fu Xing Jue in Dunhuang Based on Prescription Metrology

目的采用方剂计量学方法分析敦煌《辅行诀》方剂君药,以明确组方配伍思路,为敦煌《辅行诀》方剂临床运用提供参考。方法选取《敦煌石窟秘方与针灸图》所载敦煌《辅行诀》方剂,运用方剂计量学方法计算有效相对药量,识别各方剂君药,计算君药指数,分析药物性味归经特点,及所判定君药与古代医家认定君药的符合程度。结果纳入方剂61首,涉及药物64味,其中1味君药者57首、2味君药者4首。去重后得到作为君药的药物26味。君药指数最大的药物为附子,其次为栀子、黄连、石膏、半夏等。研究判定君药与文献既定君药符合率为83.87%。君药与非君药特性比较,君药中寒性,苦味,归胆、膀胱、肾经者多于非君药,而君药中温性,甘味,归肺、肾、脾、肝经者少于非君药。结论君臣药配伍分析表明,敦煌《辅行诀》方剂主要治疗寒热天行病。本研究判定君药准确率较高,可为敦煌《辅行诀》方剂研究提供参考。

Objective To analyze the principal medicines in prescriptions in Fu Xing Jue in Dunhuang based on prescription metrology;To clarify the compatibility ideas of prescriptions;To provide references for the clinical application. Methods Prescriptions in Fu Xing Jue recorded in Dun Huang Shi Ku Mi Fang Yu Zhen Jiu Tu were selected. Prescription metrology was used to calculate the effective relative dosage, identify the principal medicines in prescriptions, and calculate the indexes of principal medicines. Characteristics of taste and belonging meridians, and the degree of conformity between identified principal medicine and identified principal medicine by ancient doctors were analyzed. Results Totally 61 prescriptions were included, covering 64 kinds of Chinese materia medica, among which 57 prescriptions were with 1 kind of principal medicines and 4 prescriptions were with two kinds of principal medicines. 26 kinds of principal medicines were obtained after removing repetition. The principal medicines with the biggest index were was Aconiti Lateralis Radix Praeparaia, followed by Gardeniae Fructus, Coptidis Rhizoma, Gypsum Fibrosum, and Pinelliae Rhizoma. The rate of coincidence between identified principal medicines and the established principal medicines in the literature was 83.87%. Compared with the characteristics of non-principal medicines, the characteristics of principal medicines were cold and bitter, and more principal medicines belonged to gallbladder, bladder, kidney meridians. Principal medicines were fewer warm and sweet, and belonged to lung, kidney, spleen and liver meridians than non-principal medicines. Conclusion The analysis on the compatibility of principle medicines showed that prescriptions in Fu Xing Jue in Dunhuang mainly treat cold and heat epidemics. This study can identify principal medicines with high accuracy, which can provide references for research on prescriptions in Fu Xing Jue in Dunhuang.