海洋中药石决明古今应用研究

Research on Ancient and Modern Application of Marine Chinese Medicine Shijueming(Haliotidis Concha)

目的:分析含石决明方剂的古今应用情况,为石决明临床合理应用及相关产品研发提供依据。方法:基于2020年版《中华人民共和国药典》、《中华海洋本草》、《海洋中药方剂大辞典》等多部本草著作,及中国知网数据库,检索含石决明方剂及临床研究相关信息,进行频数分析、关联规则挖掘及可视化处理。结果:共筛选出古代含石决明方剂374首,现代含石决明方剂102首。通过分析发现,在剂型上,古代方剂剂型中散剂居多,现代方剂中以汤剂为主;在配伍上,古代方剂中与石决明配伍的中药频率由高至低依次是防风、甘草、菊花、羌活等;现代方剂与石决明配伍频率由高至低依次是钩藤、天麻、川芎、栀子等。古代方剂中常配伍清热平肝药决明子、密蒙花、青葙子,解表药羌活、蝉蜕治疗风热上攻之头痛、眩晕;配伍解表药、化湿药中具有明目作用的木贼、细辛、苍术、车前子等治疗翳障。在现代方剂中常配伍清热平肝药大黄、青葙子、栀子等治疗角膜炎;配伍清热泻火药夏枯草治疗高血压;配伍息风止痉药钩藤、天麻、全蝎等治疗头痛、眩晕。结论:自唐宋时期以来,我国医家对石决明的认知基本一致。石决明在古代多配伍清热、平肝解表药,剂型多为散剂,治疗翳障、目赤肿痛、胬肉侵睛等眼部疾病;在现代多配伍清热、平肝息风止痉药,剂型多为汤剂,治疗心脑血管疾病。相对于石决明古代方剂临床应用的广泛性,现代方剂在治疗夜盲症、痔漏、怕光等方面应用较少,有待进一步研发。

Objective:To analyze the ancient and modern applications of formulas containing Shijueming(Haliotidis Concha),and to provide the basis for the reasonable clinical application and the product development of Shijueming.Methods:Based on the 2020 edition of the Pharmacopoeia of the People’s Republic of China,Chinese Marine Materia Medica,Dictionary of Formulas of Marine Materia Medica,and other works of Chinese Materia Medica,as well as the database of China National Knowledge Infrastructure,the formulas containing Shijueming and the relevant information of clinical studies were retrieved,and frequency analysis,association rule mining and visualization processing were carried out.Results:A total of 374 ancient and 102 modern formulas containing Shijueming were selected through screening.Through analysis,it was found that in terms of dosage forms,the majority of ancient formulas were in powder form,while in modern formulas,decoction was the main form.In terms of compatibility,the compatibility frequency with Shijueming in the ancient formulas from high to low was followed by Fangfeng(Saposhnikovia Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Juhua(Chrysanthemi Flos)and Qianghuo(Notopterygii Rhizoma et Radix),etc.The compatibility frequency with Shijueming in the modern formulas from high to low was followed by Gouteng(Uncariae Ramulus Cum Uncis),Tianma(Gastrodiae Rhizoma),Chuanxiong(Chuanxiong Rhizoma)and Zhizi(Gardenia Fructus),etc.In the ancient formulas,it was often combined with medicinals for clearing heat and calming the liver,such as Juemingzi(Cassiae Semen),Mimenghua(Buddlejae Flos)and Qingxiangzi(Celosiae Semen),as well as medicinals for relieving exterior syndrome,such as Qianghuo(Notopterygii Rhizoma et Radix)and Chantui(Cicadae Periostracum)to treat headache and dizziness caused by wind-heat attacking upward.It was combined with Muzei(Equiseti Hiemalis Herba),Xixin(Asari Radix et Rhizoma),Cangzhu(Atractylodis Rhizoma)and Cheqianzi(Plantaginis Semen),etc.,which had the effect of improving eyesight in medicinals for relieving exterior syndrome and medicinals for resolving dampness.In modern formulas,it was often combined with medicinals for clearing heat and calming the liver,such as Dahuang(Rhei Radix et Rhizoma),Qingxiangzi and Zhizi to treat keratitis.It was also combined with medicinals for clearing heat and purging fire,such as Xiakucao(Prunellae Spica)to treat hypertension.It can be combined with medicinals for extinguishing wind and stopping convulsions,such as Gouteng,Tianma and Quanxie(Scorpio)to treat headaches and dizziness.Conclusions:Since the Tang and Song Dynasties,Chinese doctors have basically agreed on the cognition of Shijueming.In ancient times,Shijueming was often used in combination with medicinals for clearing heat,calming the liver,relieving exterior syndrome in the form of powder to treat eye diseases such as cataract,sore red swollen eyes and pterygiums,etc.In modern times,it was mainly combined with medicinals for clearing heat,calming the liver,extinguishing wind and stopping convulsions,in the form of decoction to treat cardiovascular and cerebrovascular diseases.Compared with the extensive clinical application of the ancient formulas containing Shijueming,the modern formulas are less used in the treatment of night blindness,hemorrhoids,fear of light,etc.,and need to be further developed.