《中医方剂大辞典》含斑蝥方剂的用药规律分析

Analysis of Medication Rules of Prescriptions Containing Mylabris in the Dictionary of Traditional Chinese Medicine Prescription

目的 基于“减毒增效”,为斑蝥及其制剂的临床合理使用提供参考。方法 筛选出《中医方剂大辞典》中含斑蝥方剂,提取其方名、方源、组成、主治、制备方法、用法、用药途径等并建立数据库,分别统计出含斑蝥方剂用药途径、剂型、主治疾病以及斑蝥的炮制方法和特殊用法(“取其气不用其质”)的频数;运用中医传承辅助平台,对药物组成≤10的复方进行药物配伍规律分析。结果共纳入236首方剂,包括149首内服者、84首外用者和3首内外皆可者。内服方剂以丸散剂为主,主治体内外肿块性疾病、传染病和皮肤病;外用方剂以散剂、膏剂、酊剂及浸剂为主,主治癣、疮疡等皮肤病。绝大多数方剂使用斑蝥炮制品,以糯米拌炒为主要方式。22首方剂记载了取斑蝥之气而不用其质的特殊用法,多用于治疗疝气。154首内服、外用方剂中,麝香、巴豆、雄黄是与斑蝥配伍的常见药物。结论 现代使用斑蝥以其衍生物合成制剂、提取物制剂以及含斑蝥中成药为主,主治肿瘤疾病,疾病谱较之古时明显缩窄。配伍古籍中所记载的解斑蝥毒的药物、使用斑蝥炮制品以及取斑蝥之气而不用其质的用法均可减轻斑蝥毒性。内服与外用方剂中与斑蝥配伍的药物交叉出现,在内服时多配伍软坚散结、破瘀通络及补虚药,外用时多配伍解毒杀虫、活血止痛及敛疮生肌药。

Objective Based on “reducing toxicity and increasing efficacy”,it provides reference for the rational use of Mylabris and its preparations.Methods The prescriptions containing Mylabris were selected in the Dictionary of Traditional Chinese Medicine Prescription,and then the formula name,prescription source,composition,main treatment,preparation method,usage,medication route were entered and a database was established.The frequencies of medication route,dosage form,main diseases,and methods of processing and special usage( “taking its qi instead of its essence”) were counted separately.The TCM inheritance support system software was used to analyze the compatibility principles of the compound prescriptions with drug composition ≤10.Results A total of 236 prescriptions were included,including 149 for internal use,84 for external use,and 3 for both internal and external use.The formulations of oral prescriptions were mainly pills and powders,mainly for the treatment of lumps in vivo and in vitro,infectious diseases,skin diseases.The formulations of topical preparations were mainly powders,ointments,tinctures and infusions,mainly used to treat skin diseases such as ringworm and sores.The vast majority of prescriptions used processed products of Mylabris,and the main method was to stir-fry glutinous rice.22 prescriptions recorded the special usages of“taking Mylabri’s qi instead of its essence”,mostly used to treat hernia.Among the 154 internal and external prescriptions,Moschus,Crotonis Fructus,and Realgar were the core drug compatible with Mylabris.Conclusion The derivative synthetic preparations,extract preparations and Chinese patent medicines containing Mylabris are commonly used in modern times,which mainly treats tumor diseases,and the disease spectrum is significantly narrowed compared with that in ancient times.Compatibility with the detoxifying drugs recorded in ancient books,using processed products and the use of Mylabris’ s Qi instead of its essence,can all reduce Mylabris’ s toxicity.Drugs compatible with Mylabris appear in both oral and topical prescriptions.When used internally,Mylabris is compatible with drugs which have efficiency of“softening and resolving hard mass”,“promoting blood circulation for removing obstruction in collaterals”and“tonifying deficiency”.When used externally,Mylabris is compatible with drugs which have efficiency of“detoxicating and destroy intestinal worms”,“promoting blood circulation to arrest pain”and“healing sore and promoting granulation”.