2020年版《中国药典》调经中成药特点分析与思考

Analysis and Reflection on Characteristics of Menstrual Regulating Chinese Patent Medicines in the 2020 Edition of the Chinese Pharmacopoeia

目的:整理和分析2020年版《中华人民共和国药典》收录的调经相关中成药的功能主治、组方、剂型和用药特点,为临床合理用药提供参考。方法:逐一录入2020年版《中华人民共和国药典》收录的调经相关中成药,并对功效、剂型、服用方法、用药注意事项进行统计、分类和归纳。同时对纳入中成药组成相关中药进行录入,明确调经相关高频中药,并分析其功能主治、性味归经,以期指导临床用药。结果:共纳入调经中成药142种,根据功效共分为12类,以调经、理血、补益、活血消癥为主,代表中成药分别为八珍益母丸、少腹逐瘀丸、驴胶补血颗粒、桂枝茯苓丸,符合“气血宣行”“调肝理脾”的月经病中医药治疗原则;调经中成药剂型以丸剂和胶囊剂居多,特殊用法有以黄酒或生姜汤送服。注意事项以妊娠禁忌占比最多,其次为经期禁忌、饮食禁忌;高频药物功效以补虚药、活血化瘀药、清热药为主,频次前3位的是当归、白芍、川芎。性味以温性,甘、苦、辛为主,主归肝、脾经。结论:治疗月经不调用药应以养血活血理气、补肾扶脾、养肝和胃为主,并根据患者具体情况选用相应的剂型,辨证应用药引和服用方法,注意用药禁忌,在中医药理论指导下,辨证论治,合理选择调经中成药。

Objective:To analyze the functions,formulae,dosage forms,and methods of administration of the menstruation-regulating Chinese patent medicines included in the 2020 edition of the Chinese Pharmacopoeia,so as to provide reference for rational clinical use.Method:The relevant Chinese patent medicines were recorded one by one,and the efficacy,dosage forms,methods of administration,and contraindications were counted,classified,and summarized.Further,we analyzed the Chinese medicines used in these Chinese patent medicines,identified the high-frequency Chinese medicines for menstrual regulation,and analyzed their natures,tastes,meridian tropism,and functions,aiming to guide the clinical use.Result:A total of 142 Chinese patient medicines for menstrual disorders were included in this study.They were classified into 12 categories according to their efficacy,mainly for regulating menstruation and blood,tonifying,activating blood,and eliminating mass.The representative Chinese patent medicines were Bazhen Yimu pills,Shaofu Zhuyu pills,Lyujiao Buxue granules,and Guizhi Fuling pills,which are in line with the principles of moving Qi and blood and regulating liver and spleen.Menstruation-regulating Chinese patents medicines are mostly in pills and capsules and are mainly taken with yellow wine or ginger decoction.Pregnancy was the contraindication with the highest frequency,followed by menstruation and dietary precautions.The highfrequency Chinese medicines mainly had the functions of tonifying,activating blood,resolving stasis,and clearing heat,with the top three being Angelicae Sinensis Radix,Paeoniae Radix Alba,and Chuanxiong Rhizoma.These medicines mainly had warm nature,sweet,bitter,and pungent tastes,and tropism to liver and spleen meridians.Conclusion:The treatment of menstrual disorders should focus on nourishing and activating blood,regulating Qi,tonifying kidney,supporting spleen,nourishing liver,and harmonizing stomach.The appropriate dosage form should be selected according to the patient's specific conditions.The medicinal guide and the method of administration should be selected on the basis of syndrome differentiation with attention to the contraindications.In summary,the Chinese patient medicines for menstrual regulation should be chosen based on the patient's syndrome under guidance of the theory of traditional Chinese medicine.