葛根芩连汤临床用药规律及量效关系的现代文献研究

Literature study on medication rule and dose-effect relationship of Gegen Qinlian Decoction(Pueraria Root,Scutellaria Root,and Coptis Decoction)

目的挖掘葛根芩连汤的主治病证分布、药物加味规律及量效关系,为葛根芩连汤现代应用提供依据。方法以中国知网、万方数据库、维普数据库为文献来源,对其主治病证、处方组成及剂量进行统计,运用EXCEL建立数据库,挖掘用药规律及量效关系。结果葛根芩连汤主治人群包括成人和小儿,主治病证主要为泄泻病、小儿泄泻、消渴病,给药方式主要包括口服和灌肠。成人内服时加味药物按频次高低依次为茯苓、白术、木香、白芍、陈皮等,成人灌肠时加味药物按频次高低依次为地榆、槐花、白芍、白术、败酱草等,小儿内服时加味药物按频次高低依次为茯苓、白术、苍术、车前子、六神曲等。用药大多随症加减,原方药物剂量以葛根10~15 g(小儿5~10 g),黄芩6~10 g(小儿3~6 g),黄连6~10 g(小儿3~6 g),甘草6~10 g(小儿2~6 g)常见。葛根芩连汤主治病证与药物剂量之间存在量效关系,治疗2型糖尿病、溃疡性结肠炎、急性胃肠炎/急性肠炎时,葛根常用量分别为30 g、10~15 g、10~15 g,黄芩常用量分别为12~20 g、6~10 g、6~10 g,黄连常用量分别为6~10 g、6~10 g、6~10 g,甘草常用量分别为5~15 g、6~10 g、6 g。葛根芩连汤现代应用最多的比值为5∶3∶3∶2,2味药之间的比值不同可影响主治病证。结论葛根芩连汤用药规律及量效关系分析可为临床实践及进一步药理研究提供依据。

Objective To explore the distribution of main treatment syndromes,law of addition of herbal ingredients and dose-effect relationship of Gegen Qinlian Decoction(Pueraria Root,Scutellaria Root,and Coptis Decoction),and to provide basis for modern application of the formula.Methods The main symptoms,prescription composition and dosage were collected from CNKI,Wanfang database and VIP database and statistically analyzed,and EXCEL was used to establish a database,and medication rule and dose-effect relationship were explored.Results Gegen Qinlian Decoction can be administered to both adults and children,the syndromes it can be used to treat were diarrhea(also in children)and diabetes,and the administration method mainly included oral administration and enema.When the medicine is ingested orally by adults,the herbal ingredients added to the original formula are,in descending order of frequency,Fuling(Poria),Baizhu(Rhizoma Atractylodis Macrocephalae),Muxiang(Radix Aucklandiae),Baishao(Radix Paeoniae Alba),and Chenpi(Pericarpium Citri Reticulatae),etc.;for adult enema,Diyu(Radix Sanguisorbae),Huaihua(Flos Sophorae),Baishao(Radix Paeoniae Alba),Baizhu(Rhizoma Atractylodis Macrocephalae),and Baijiangcao(Herba Patriniae);for oral administration to children,Fuling(Poria),Baizhu(Rhizoma Atractylodis Macrocephalae),Cangzhu(Rhizoma Atractylodis),Cheqianzi(Semen Plantaginis),and Liushenqu(Massa Medicata Fermentata).Addition or reduction of these herbs are generally made as necessary.The most common version of the original formula consists of Gegen(Radix Puerariae Lobatae)10-15 g(5-10 g in children),Huangqin(Radix Scutellaria)6-10 g(3-6 g in children),Huanglian(Rhizoma Coptidis)6-10 g(3-6 g in children),Gancao(Radix et Rhizoma Glycyrrhizae)6-10 g(2-6 g in children).There is a dose-effect relationship between the syndromes and dosage.In the treatment of type-2 diabetes,ulcerative colitis,acute gastroenteritis/acute enteritis,the usual dosage of Gegen was 30 g,10-15 g,10-15 g,respectively,Huangqin 12-20 g,6-10 g,6-10 g,Huanglian 6-10 g,6-10 g,6-10 g,and Gancao 5-15 g,6-10 g and 6 g.The most widely used ratio of the basic ingredients is currently 5∶3∶3∶2.The syndromes that it is effective for may vary according to different ratios between two herbs.Conclusion Analysis of medication rules and dose-effect relationship of Gegen Qinlian Decoction can provide basis for clinical practice and further pharmacological research.