基于药性结合药理的麻黄药证研究

Drug syndrome of ephedra based on its property and pharmacology

麻黄是一味经典中药,其"发表散寒、止咳平喘、利水消肿"的经典功效,从古一直沿用至今。后世逐渐发现了麻黄的新功效或突破了原有的应用禁忌,但对麻黄的研究主要集中在经典用途的阐明、发挥和使用禁忌方面,所拓展的很多功效在后世并没有得到广泛的应用,对拓展应用的原理也不能很好的阐明。笔者从麻黄功效特点及临床经典应用出发,从药性结合药理角度,探讨了麻黄临床拓展应用的可能原理。麻黄碱类物质是麻黄功效的重要物质基础,其拟肾上腺素作用是其功效的药理基础;把握阴与阳特点及互根互用的辨证关系,理解自主神经功能、交感/肾上腺髓质和肾上腺皮质之间交互作用是麻黄临床拓展应用的关键环节。笔者讨论了临床应用麻黄的基本思路和配伍原则,以及炮制对麻黄化学成分及药效的影响。最后,提出了药物临床拓展应用的基本研究流程,为中医学经验的传承和进一步发展提供思路。

Ephedra is a classic herb in traditional Chinese medicine( TCM). The new effects of ephedra were gradually found,and the contraindications of the drug were broken in later ages. Because the principles of expanded application were not well elucidated,it is difficult to use in the clinical flexibility. Based on the characteristics of ephedra and its classic clinical application,the authors summarized the possible principles of clinical application of ephedra and the drug property and pharmacological characteristics of ephedra.Studies showed that ephedrine substances are an important material basis for the efficacy of ephedra,and its adrenergic action is the pharmacological basis of its efficacy. It is the key to grasp the autonomic function and the interaction between sympathetic/adrenal medulla and adrenal cortex for the clinical application of ephedra. The authors discussed the principles of clinical application of ephedra and the effects of processing of ephedra. Finally,the authors put forward the basic research process of clinical application of drugs,and provide ideas for the inheritance and further development of TCM experience.