《小儿药证直诀》天南星科中药应用规律

The Law of Traditional Chinese Medicine Application of Araceae in Key to Therapeutics of Children’s Diseases

目的:天南星类中药作为常用的止咳化痰药在临床中应用广泛,作为有毒中药其中毒剂量与治疗剂量非常接近。分析与研究《小儿药证直诀》中天南星科中药方剂,总结天南星科有毒中药儿童的用药规律和特点。方法:收集和整理《小儿药证直诀》含天南星科中药的方剂,建立天南星科中药处方数据表,统计与分析方剂中的天南星科中药、剂量、剂型、适应症及炮制品等。结果:共收集《小儿药证直诀》中含天南星、半夏、白附子3种天南星类中药方剂总计21首占《小儿药证直诀》总收载方量的17.50%。处方治疗疾病9种,主要是诸风、惊风、疳、消化障碍、伤寒、吐泻、虚热等。天南星类中药剂量最小为0.0325克,最大者为298.4克,方剂以内服剂型为主,且66.67%为丸剂。使用炮制品的方剂有19首,占90.48%,采用特殊服法的方剂有14首,“薄荷水”所占比例最高。结论:天南星科中药方剂占《小儿药证直诀》的比例较少,用药剂量在不同方剂剂型用药剂量存在差异。研究结果可为儿童安全、有效地合理使用天南星科有毒中药提供参考。

Objective: As a commonly used antitussive and expectorant medicine, Chinese herbal medicines of Araceae are widely used in clinical practice. As a toxic Chinese medicine, its toxic dose is very close to the therapeutic dose. Analyze and study the prescription of Chinese medicine of Araceae in “Key to Therapeutics of Children’s Diseases”, and summarize the law and characteristics of the use of toxicity Chinese medicine of Araceae in children. Methods: Collect and sort out the Araceae traditional Chinese medicine prescriptions in the “Key to Therapeutics of Children’s Diseases”, establish the Araceae prescription data sheet, and count and analyze the Araceae traditional Chinese medicine, dosage, dosage form, indications and processed products in the prescriptions. Results: A total of 21 traditional Chinese medicine prescriptions containing of Arisaema heterophyllum, Pinellia ternata and Typhonium giganteum were collected, accounting for 17.50% of the total prescriptions. Prescription can treat nine diseases, mainly wind diseases, convulsion, chancre, digestive disorders, typhoid fever, vomiting and diarrhea, asthenic fever. The minimum dosage of Araceae traditional Chinese medicine is 0.0325 g, and the maximum is 298.4 g. The formula is mainly taken orally, and 66.67% of it is pills. There are 19 prescriptions using processed products, accounting for 90.48%, 14 prescriptions using special methods, and the proportion of “mint water” is the highest. Conclusion: Araceae traditional Chinese medicine prescriptions accounted for a small proportion of “Key to Therapeutics of Children’s Diseases”, and the dosage of drugs in different formulations was different. The results can provide reference for the safe and effective rational use of Araceae toxic traditional Chinese medicine in children.