基于多维宏观量化方法解读《伤寒论》寒热错杂证组方规律

Law of Prescription Composition of Intermingled Cold and Heat Pattern in Treatise on Febrile Disease(Shanghan Lun)Based on Multidimensional Macro-quantitative Methods

目的:基于多维宏观量化方法解读《伤寒论》寒热错杂证组方规律。方法:采用量化计算方法对《伤寒论》中7首寒热错杂证代表方药进行四气五味作用度比较,分析方证的寒药热药比例轻重、药物五味偏重及处方整体偏性;运用数学方法设定四气五味计分,并将中药实际剂量转化为标准化相对剂量,通过计算得到四气五味作用度。结果:1)7首方剂的四气作用度量化(偏寒性作用度/偏热性作用度)如黄连汤为32.03%/67.97%。2)7首方剂五味作用度量化(按酸、苦、甘、辛、咸、淡、涩顺序)如乌梅丸分别为12.34%、31.2%、11.54%、35.04%、0、0、9.87%。3)方药按偏温热性到偏寒凉性依次为:黄连汤、半夏泻心汤、麻黄升麻汤、乌梅丸、栀子干姜汤、柴胡桂枝干姜汤、附子泻心汤;偏温热方药适宜寒热错杂证中寒性症状较重者,偏寒凉方药适宜寒热错杂证中热性症状较重者。4)方药五味以辛、苦、甘为主,辛能发散能开宣,苦能敛降能泻火,甘能补益能调和。结论:通过对组方药物气味的整体把握来调理脏腑阴阳升降,维持其五行平衡关系,从而达到阴阳调和的状态,而将方剂功效、作用部位与数学方法结合进行研究可促进中医诊疗的数字化、信息化,临证中可更加精准地把握处方用药与剂量。

Objective:To illustrate the law of prescription composition of intermingled cold and heat pattern in Treatise on Febrile Disease Shanghai Lun based on multidimensional macro-quantitative methods.Methods:Four properties and five flavors of seven representative prescription for intermingled cold and heat pattern in Shanghan Lun were compared using quantitative calculation,to analyze the proportion of cold medicine and heat medicine in the formulae,the preference of five flavors of the medicine and the overall preference of the prescriptions;to set the scores for the four properties and five flavors using mathematical methods,and to convert the actual dose of Chinese medicine into standardised relative dose,and the degree of action of the four properties and five flavors was obtained by calculation.Results:1)Quantification of the degree of action of the four properties in seven prescriptions(degree of of cold-biased/heat-biased action),e.g.Huangliang Tang:32.03%/67.97%.2)Quantification of the degree of action of the five flavors in seven prescriptions(In the order of sour,bitter,sweet,pungent,salty,mild,astringent),e.g.Wumei pills:12.34%,31.2%,11.54%,35.04%,0,0 and 9.87%,3)The prescriptions ranked from warm-biased to cold-biased successively:Huangliang Tang,Banxia Xiexin Tang,Mahuang Shengma Tang;Wumei pills,Zhizi Ganjiang Tang,Chaihu Guizhi Ganjiang Tang and Fuzi Xiexin Tang;warm-biased prescriptions are suitable for these with more severe cold symptoms among the patients of intermingled cold and heat pattern,cold-biased prescriptions are suitable for these with more severe warm symptoms among the patients of intermingled cold and heat pattern.4)the five flavors of the prescriptions are mainly pungent,bitter and sweet,pungent medicine could disperse,open the lungs and expel Qi,bitter medicine could restrain and descend Qi,purge fire,sweet medicine could tonify and mediate the organs.Conclusion:The regulation of the rise and fall of Yin and Yang in the internal organs,and maintaining the balance of five elements are realized through grasping the properties and flavors of the prescriptions entirely,thereby achieving a state of harmony between Yin and Yang,while the integration of the efficacy of the prescription,site of action with mathematical method could promote the digitalisation and informatisation of Chinese medicine diagnosis and treatment,and control the prescription and dosage in clinical practice more precisely.