《中医方剂大辞典》中含马钱子方剂的用药规律分析

Analysis of Medication Rules of the Prescription Containing Strychnos nuxvomica in the Dictionary of Traditional Chinese Medicine Prescription

目的:为马钱子的临床合理使用及其药物剂型开发提供参考。方法:从《中医方剂大辞典》中收集整理含马钱子的方剂,将方名、方源、治疗疾病名、组成、用法用量、用药途径等信息录入Access 2010软件并建立数据库,根据用法将这些方剂的用药途径分为内服和外用,分别统计出内服/外用方剂所治疾病的频数;采用SPSS Modeler 18.0软件中的Apriori算法对含马钱子的复方进行药物组方规律分析。结果:共纳入含马钱子方剂78首,其中42首为内服方剂,33首为外用方剂,3首为既可内服又可外用的方剂。内服方剂主要用于治疗痿病、痹病、痔疮、肛瘘、筋骨疼痛等疾病;外用方剂主要用于治疗皮肤疾病、瘤、痞块等疾病;内服外用皆可的方剂主要用于治疗疮疡病、跌打损伤和骨折。在内服方剂中,马钱子常配伍乳香、没药、血竭、穿山甲、自然铜、当归、麻黄、草乌;在外用方剂中,马钱子常配伍赤芍、地黄、黄柏、黄连、黄芩、当归、白芷、全蝎。马钱子绝大多数经炮制后使用,且以麻油作辅料炮制为主(占77.97%)。结论:含马钱子的方剂主要治疗疾病包括风湿痹痛、肢体瘫痪,跌打损伤、骨折以及痈疽肿毒、顽癣三类。马钱子在外用方剂中多配伍清热燥湿、凉血活血、止痛药,在内服方剂中多配伍活血化瘀药。此外,用麻油炮制马钱子是保证其安全性的重要措施。

OBJECTIVE:To provide reference for the clinical use and dosage form development of Strychnos nuxvomica.METHODS:The prescriptions containing S. nuxvomica were collected and sorted from the Dictionary of Traditional Chinese Medicine Prescription,and then formula name,prescription source,name of treatment disease,composition,usage and dosage,medication route were input into Access 2010 and database was established. According to the usage,these prescriptions were divided into internal use and external use,and the frequencies of diseases treated by internal/external use prescriptions were counted respectively. Apriori algorithm of SPSS Modeler 18.0 software was used to analyze the drug combination rule of compound prescription containing S. nuxvomica. RESULTS:A total of 78 prescriptions were included,of which 42 were oral prescriptions,33 were external prescriptions and 3 were both oral and external prescriptions. Internal prescriptions were used to treat diseases such as atrophy-flaccidity disease,arthralgia,hemorrhoids,anal fistula,bones and muscles pain. The external prescriptions were mainly used to treat skin diseases,tumors,lump. Internal and external prescriptions could treat sore,injuries and fractures. In internal prescriptions,S. nuxvomica was often compatible with Boswellia carterii,myrrha,Daemonorops draco,Manis pentadactyla,pyritum,Angelica sinensis,Ephedra sinica,Aconitum kusnezoffii. In external prescriptions,S. nuxvomica was often compatible with Radix Paeoniae,Rehmannia glutinosa,Phellodendron chinense,Coptis chinensis,Scutellaria baicalensis,Angelica sinensis,Angelica dahurica,Buthus martensii. Most of S. nuxvomica were used after processing,and mainly took sesame oil as an auxiliary material(77.97%). CONCLUSIONS:Diseases treated with the prescriptions containing S. nuxvomica can be classified into three types of diseases,i.e. polymyalgia rheumatica and paralysis,bruise and bone fracture,carbuncle and stubbornness tinea. In external prescriptions,S. nuxvomica is often compatible with drug for clearing heat and drying dampness,cooling blood and activating blood,and relieving pain. In internal prescriptions,S. nuxvomica is often compatible with the agents for blood-activating and stasis-resolving medicinal. In addition,the processing of S. nuxvomica with sesame oil is an important measure to ensure its safety.