从中医经典方剂剂型转变分析中药饮片处方总剂量

Total dosage of Chinese herbal pieces from changes of traditional Chinese medicine prescriptions

目的分析临床使用处方总剂量存在的问题及剂型因素、提取工艺、量效关系对处方总剂量的影响,为临床合理用药提供参考。方法选取《中华人民共和国药典》(2020年版)一部中10个中医经典方剂,对其制成中成药不同剂型的日服用剂量和日处方剂量对比分析,从提取方法和量效关系角度探讨影响中药饮片总剂量的因素。结果经典方剂在制成不同剂型后日服用剂量和日处方剂量差异较大,日处方剂量基本小于100 g,且中成药不同剂型之间的日服量也存在较大差异。进一步分析发现溶剂选取、溶剂用量、提取温度和时间、药材粒度、提取方法等都对药材溶出度和处方总剂量有影响。结论中药处方总剂量与疗效和用药安全密切相关。制定统一的中药处方剂量标准,对临床医师科学拟定处方用量具有重要意义。

Objective To analyze the problems with the total dose of clinical prescriptions and the effects of dosage forms,extraction technology and dose-effect relationships on the total dose of prescriptions so as to provide reference for clinical rational use of drugs.Methods The daily dosage and prescribed daily dosage of different dosage forms of Chinese patent medicines prepared according to 10 classic prescriptions of traditional Chinese medicines in Volume One of Pharmacopoeia of People’s Republic of China(2020 edition)were compared and analyzed.The factors that influenced the dosage of Chinese patent medicines were discussed in terms of extraction methods and dose-response relationships.Results The daily dosage and prescribed daily dosage of classical prescriptions included in the Pharmacopoeia varied widely after the drugs were made into different dosage forms.The prescribed daily dosage was basically within 100 g,and the daily dosage was considerably different between different dosage forms of Chinese patent medicines.Further analysis showed that the solvent selected,solvent dosage,temperature and time for extraction,drug particle size and extraction methods all had effects on the dissolution and total dose of prescriptions.Conclusion The total prescription dose of traditional Chinese medicines is closely related to the curative effect and drug safety.It is of great significance for clinicians to formulate a unified prescription dose standard for traditional Chinese medicines.