海洋中药海螵蛸的古今应用研究

Research on the ancient and modern application of marine traditional Chinese medicine endoconcha sepiae

目的 挖掘含海螵蛸方剂中蕴含的历代临床医家用药经验和用药信息,分析海螵蛸的古今应用情况,为海螵蛸临床合理应用及相关产品研发提供依据。方法 基于2020版《中华人民共和国药典》第一部、《中华海洋本草》《海洋中药方剂大辞典》等多部本草著作和方书,国家知识产权局专利检索系统及中国知网数据库,检索含海螵蛸方剂及临床研究相关信息,并进行频数分析、关联规则挖掘、文献计量学分析及可视化处理。结果 共筛选出历代含海螵蛸的方剂595首,现代含海螵蛸临床专利方剂数据364条。分析发现,历代方剂中与海螵蛸配伍频率由高至低依次是当归、龙骨、麝香、乳香、黄连等;现代方剂与海螵蛸配伍频率由高至低依次是白芍、黄芪、白术等;在主治上,古代方剂中常配伍温里药干姜和附子治疗疮疡;配伍清热解毒药木鳖子治疗崩漏;配伍安神药、清热解毒药中的贝齿、密陀僧等治疗目翳、眼疾。在现代方剂中常配伍白芍、木香、砂仁等治疗慢性胃炎;配伍白芍、茯苓、蒲公英治疗十二指肠溃疡;配伍当归、苍术、黄连治疗胃溃疡。现代海螵蛸临床文献计量学分析筛选得到含海螵蛸相关临床文献703篇,在2016年达到发文量高峰并且2000年后海螵蛸治疗胃脘痛成为研究重点。结论 古今不同年代海螵蛸的配伍和主治病症有所不同,在古代海螵蛸多配伍活血类药物,常用散剂用于治疗崩漏、目翳、疮疡、眼疾等疾病;而现代多用于治疗胃肠溃疡、慢性胃炎等消化道疾病。因此,海螵蛸的临床应用和产品研发,不但要传承古代医家经验,也应该结合现代疾病谱系改变和现代科学技术,进行深度开发和应用。

Objective To explore the drug use experience and medication information of previous generations of clinicians contained in prescriptions containing endoconcha sepiae,analyze the ancient and modern applications of endoconcha sepiae,and provide basis for the rational clinical application of endoconcha sepiae and the development of related products.Methods Based on the 2020 edition of the first part of the"Pharmacopoeia of the People's Republic of China","Chinese Marine Materia Medica","Dictionary of Marine Traditional Chinese Medicine Prescriptions"and other herbal works and prescription books,the patent retrieval system of China National Intellectual Property Administration and China national knowledge infrastructure,Retrieve information related to prescriptions containing endoconcha sepiae and clinical research,and conduct frequency analysis,association rules analysis,bibliometric analysis and visualization processing.Results A total of 595 formulas containing endoconcha sepiae in the past dynasties were screened,and the data of modern endoconcha sepiae-containing clinical patent formulas were 364 items.Through analysis,it was found that in terms of compatibility,the compatibility frequency of ancient prescriptions and endoconcha sepiae,from high to low,was Angelica sinensis,Ossa draconis,Musk,Frankincense,Coptis chinensis,etc.;the compatibility frequency of modern prescriptions and endoconcha sepiae,from high to low,was Cynanchum otophyllum Schneid,Astragalus membranaceus,Atractylodes macrocephala Koidz.,etc.;in terms of indications,ancient prescriptions were often combined with warming herbs like dried ginger and aconite to treat sores;combined with the heat-clearing and detoxifying herbs Cochinchina Momordica Seed to treat metrorrhagia.Shellfish tooth and litharge,which are herbs for soothe the nerves and heat-clearing and detoxifying,are often used to treat pannus and eye diseases.In modern prescriptions,it is often combined with Cynanchum otophyllum Schneid,Radix Aucklandiae,Amomum villosum,etc.to treat chronic gastritis;Cynanchum otophyllum Schneid,Poria cocos and Taraxacum mongolicum are used to treat duodenal ulcer;Angelica sinensis,Rhizoma atractylodis and Coptis chinensis are used to treat gastric ulcer.Modern endoconcha sepiae clinical bibliometric analysis screened 703 endoconcha sepiae-containing clinical literature,which reached a peak in 2016 and became the focus of research on endoconcha sepiae treatment of gastroparesis after 2000.Conclusion The compositions and treatments of cuttlebone are different in ancient and modern times.In ancient times,endoconcha sepiae was mostly used with blood-activating drugs,and commonly used in bulk for the treatment of metrorrhagia,pannus,sores,eye diseases and so on.while in modern times,it is mostly used for the treatment of gastrointestinal diseases such as gastrointestinal ulcers,chronic gastritis,etc.Therefore,the clinical application of endoconcha sepiae and the research and development of its products should not only be inherited from the experience of the ancient doctors,but also be combined with the change of the disease spectrum in the modern times and the modern science and technology,and then be developed and applied in depth.