雷根平运用大剂量药物经验

Lei Genping′s Experience in Using High Dosage Medicine

在长期临床实践中,雷根平主任医师逐渐形成以大剂量药物治疗慢性病及疑难杂症的临证思想。临床中有毒药物如附子根据病情用量为15~250 g;半夏视痰浊之轻重可用至15~60 g;细辛煎剂可用至15 g以上。无毒药物中,大剂量黄芪(90 g以上)利水有奇效,亦可用于肝气虚之证;麻黄视汗之有无,可用至45 g以上;干姜与炮姜用于中下焦阳虚;大剂量辛夷用于通鼻窍安全有效;苍术重用燥湿健脾之功倍增,最大可用至50 g。大剂量药物的应用应注意学习临床名家经验,从小剂量开始逐渐加量,并与患者进行良好的沟通,善于应用现代中药新剂型,增强疗效,避免不良反应。

In the long-term clinical practice,chief physician Lei Genping gradually formed the clinical thought of treating chronic diseases and difficult and miscellaneous diseases with high dosage medicine.In clinical,toxic medicine such as Fuzi(Appendages)can be used up to 15-250 g according to the condition of the disease;according to the degree of phlegm turbidity,Banxia(Pinellia ternata)can be used up to 15-60 g;Xixin(Asarum)decoction can be used to more than 15 g.In the non-toxic medicine,the high dosage Huangqi(Astragalus)(above 90 g)has remarkable effect on diuresis,and can also be used for the syndrome of liver qi deficiency;depending on the presence or absence of sweating,Mahuang(ephedra)can be used to more than 45 g;Ganjiang(dried ginger)and Paojiang(baked ginger)are used for Yang deficiency of middle and lower Jiao;high dosage of Xinyi(Flos Magnoliae)is safe and effective for nasal orifices;Cangzhu(Rhizoma Atractylodis Rhizoma)can be used to dry dampness and invigorate the spleen,with a maximum of 50 g.In the application of high dosage medicine,we should learn from the experience of famous clinical experts,increase the dosage gradually from small dose,and have good communication with patients.We should be good at using new dosage forms of modern Chinese medicine to enhance the curative effect and avoid adverse reactions.