中医“有故无殒”理论对藏药安全性研究的启示

The enlightenment of traditional Chinese medicine theory of"symptom-based prescription"on Tibetan medicine safety research

目的:通过"有故无殒"理论对中药用药安全的指导,进一步探讨其对藏药安全性研究的启示,提高藏药安全性评价的针对性、精准性和可转化性,为藏药安全使用提供借鉴和理论依据。方法:本文以中医"有故无殒"理论为切入点,将传统鉴定方法与现代科学方法相融合,采用SWOT分析法深入分析,对藏药中的毒性成分进行安全性评价,使藏药的安全性研究逐渐现代化、规范化。结果:"有故无殒"理论指出药物毒与不毒,不仅在于其自身,更在于其是否对证或对病。藏医对"毒"的认知也有较为详细的论述,即"有毒就有药;毒是所有可以导致人体疾病的物质与形式;毒是药物的毒副作用"。结论:《内经》"有故无殒"的中药辨证减毒理论来源于临床实践,并在几千年的临床实践中反复验证,对临床用药的安全性有指导意义。藏药安全性研究与用药安全息息相关,以"有故无殒"理论为基础,既阐明藏药的安全性,又弘扬炮制减毒、配伍减毒、辨证减毒的藏医药特色及其科学性。

Objective:Through the guidance of "symptom-based prescription" theory on the safety of traditional Chinese medicine,this paper further discussed its enlightenment on the safety study of Tibetan medicine,so as to improve the pertinence,accuracy and transferability of the safety evaluation of Tibetan medicine,and provide reference and theoretical basis for the safe use of Tibetan medicine.Method:Based on the theory of "symptom-based prescription" in traditional Chinese medicine,the traditional identification method and the modern scientific method were integrated.SWOT analysis method was used for in-depth analysis to evaluate the safety of the toxic components in Tibetan medicine,so that the safety research of Tibetan medicine can be gradually modernized and standardized.Result:The theory of "symptom-based prescription" pointed out that whether a drug was toxic or not depends not only on itself,but also on whether it was used by the nature of syndrome or disease.Tibetan medicine also had a more detailed discussion on "poison", that was,"poison is medicine;poison is all substances and forms that can lead to human diseases;poison is the toxic and side effect of drugs".Conclusion:The theory of TCM syndrome differentiation and attenuation in Internal Classic comes from clinical practice and has been repeatedly verified in clinical practice for thousands of years,which has guiding significance for the safety of clinical medication.On the basis of the theory of "symptom-based prescription",the study of the safety of Tibetan medicine not only expounds on the safety of Tibetan medicine,but also carries forward the characteristics and scientificity of Tibetan medicine,such as the preparation,compatibility and syndrome differentiation.