中医古籍偏头痛方剂服用法和用药规律分析

Administration Methods and Medication Rules of Prescriptions Against Migraine in Ancient TCM Books

目的收集整理古代治疗偏头痛的方剂,分析其服用法与相应方剂的用药规律,为临床辨治偏头痛提供参考。方法筛选中医古籍知识共享服务平台和《中医方剂大辞典》中载治偏头痛的方剂,统计主要服用法对应方剂的组成药物及其四气、五味、归经和功效,并进行复杂网络和关联性分析。结果筛选出386首方剂,以散剂内服、丸剂内服、汤剂内服、鼻腔给药和皮肤给药五种服用法为主,相应方剂为128、117、19、88和27首,方药性味多为温、辛、苦,归经多为肝、脾、肺,多具有止痛、祛风、燥湿与活血等功效。三种内服法方剂多含川芎、甘草、防风、白芷、细辛、荆芥、当归等辛散通行之药,川芎与白芷、甘草、防风、细辛常配伍应用;外用法方剂内除常见祛风除湿活血药物,还常用竣猛之品或矿物、树脂药,如鼻腔给药方剂中的石膏、芒硝、雄黄、乳香、没药、麝香、草乌、川乌、大皂角、全蝎等,皮肤给药方剂中的草乌、川乌、穿山甲、天南星、半夏、大黄等。结论五种服用法的方剂用药思路基本相同,但内服法和外用法的方药选用互有异同。临床可通过辨析偏头痛患者的病况,选用适宜服用法及相应的方药进行辨证论治,以冀获得最佳疗效。

Objective To collect ancient prescriptions used for treating migraine and analyze their administration methods and corresponding medication rules,to provide references for clinical diagnosis and treatment of migraine.Methods Prescriptions against migraine were retrieved from Knowledge Sharing Service Platform for Ancient TCM Books and Dictionary of Traditional Chinese Medicine Prescriptions.The drug composition,four qi properties,five flavors,meridian tropism,and efficacy of prescriptions corresponding to administration methods were statistically analyzed,followed by complex network and correlation analyses.Results A total of 386 prescriptions were selected,with five main administration methods:powder by oral administration,pill by oral administration,decoction by oral administration,nasal administration,and percutaneous administration,with corresponding 128,117,19,88,and 27 prescriptions,respectively.The drugs were mainly those with warm property,pungent and bitter flavors,and acted on the liver,spleen,and lung meridians,possessing the effects of pain relief,wind dispersion,dampness drying,and blood circulation promotion.Three types of prescriptions by oral administration primarily contained dispersing drugs by pungent flavor,like Chuanxiong Rhizoma,Glycyrrhizae Radix et Rhizoma,Saposhnikoviae Radix,Angelicae Dahuricae Radix,Asari Radix et Rhizoma,Schizonepetae Herba,and Angelicae Sinensis Radix.Chuanxiong Rhizoma was frequently paired with Angelicae Dahuricae Radix,Glycyrrhizae Radix et Rhizoma,Saposhnikoviae Radix,and Asari Radix et Rhizoma.In addition to wind-dispelling,dampness-removing,and blood-activating drugs,prescriptions by external administration primarily contained potent drugs or mineral and resin-based substances,such as Gypsum Fibrosum,Natrii Sulfas,Realgar,Olibanum,Myrrha,Moschus,Aconiti Kusnezoffii Radix,Aconiti Radix,Gleditsiae Sinensis Fructus,Scorpio,etc.in prescriptions by nasal administration,and Aconiti Kusnezoffii Radix,Aconiti Radix,Manis Squama,Arisaematis Rhizoma,Pinelliae Rhizoma,Rhei Radix et Rhizoma,etc.in percutaneous administration.Conclusion The medication ideas of prescriptions by five methods are basically the same,but there are similarities and differences in the drug selection of prescriptions for internal and external administration.Clinicians can discern appropriate administration methods and corresponding prescriptions based on individual patient conditions,aiming for optimal therapeutic effects.