随症施量用药策略研究思路与方法

Research approach and method of drug strategy of dose according to the disease

在中医药临床治疗过程中,当患者病证及方药确认之后,医师需要通过患者的病情进行药物剂量的调整,这种动态变化的给药方法称为“随症施量”策略。这一策略充分体现中医个体化治疗的特点,对本策略的研究可补充中医药在治疗过程中对药物剂量调整缺乏科学性、准确性依据的方法学空白。目前已探索和发展出通过文献研究、流行病学调查研究、临床研究数据挖掘的3种“随症施量”用药策略研究方法。文中举例说明了如何从不同研究角度,对特定疾病治疗中“随症施量”策略三要素,即“症”“时机/拐点”与“量”,进行明确,形成相应的“随症施量”策略,在后期临床应用中可继续进行升级与迭代,达到提高临床有效性与安全性的目的。

In the process of clinical treatment of traditional Chinese medicine(TCM),when the patient’s syndrome and prescription are confirmed,the doctor needs to adjust the drug dose according to the patient’s condition.This dynamic change of drug administration method is called‘Sui-Zheng-Shi-Liang’(dose according to the disease)strategy.This strategy fully reflects the characteristics of individualized treatment of TCM.Scientific research on this strategy can supplement the methodological gap of the lack of scientific and accurate basis for drug adjustment in the treatment process of TCM.We have explored and developed three research methods of strategy of dose according to the disease,including literature research methods,epidemiological survey research methods,and clinical research data mining methods.The article gives examples of how to determine the three elements of the strategy of dose according to the disease in the treatment of specific diseases from different research perspectives.The elements include‘symptoms’,‘timing/inflection point’and‘quantity’.After form the corresponding strategy of dose according to the disease,we can continue to upgrade and iterated in the later clinical application to achieve the purpose of improving clinical effectiveness and safety.