1.上海中医药大学附属市中医医院风湿科(上海 200071)
2.上海中医药大学基础医学院(上海 201203)
黄慧萍,女,博士,主治医师,主要从事风湿免疫疾病临床研究工作
陈晓,教授,博士研究生导师;E-mail:chenxiao2121@126.com
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黄慧萍,陈晓.唐宋时期运用附子治疗肢体痹的文献研究[J].上海中医药杂志,2023,57(5):69-75.
HUANG Huiping,CHEN Xiao.Literature study on treatment of limb arthralgia with Aconiti Lateralis Radix Praeparata in Tang and Song dynasties[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(5):69-75.
黄慧萍,陈晓.唐宋时期运用附子治疗肢体痹的文献研究[J].上海中医药杂志,2023,57(5):69-75. DOI: 10.16305/j.1007-1334.2023.2209095.
HUANG Huiping,CHEN Xiao.Literature study on treatment of limb arthralgia with Aconiti Lateralis Radix Praeparata in Tang and Song dynasties[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(5):69-75. DOI: 10.16305/j.1007-1334.2023.2209095.
目的,2,通过对唐宋时期记载治疗肢体痹方剂中附子的应用研究,梳理附子使用剂量、炮制及配伍方法,以期指导现代临床应用。,方法,2,整理唐宋医籍中治疗肢体痹方剂,筛选其中含附子的方剂,经古今剂量换算等,分析附子的使用范围、剂量、炮制及配伍情况。,结果,2,唐宋时期肢体痹方中,附子应用范围广,不仅用于寒邪所致之痹,通过药物配伍,也运用到热痹的治疗中;痛痹、行痹、着痹三痹之中,以痛痹使用附子为多。唐宋时期肢体痹治疗方药中,汤、丸、散剂的附子常用剂量相仿,以汤剂剂量跨度最甚,最大使用量为160 g。宋代煮散剂中附子的每服剂量远远低于唐代剂量。肢体痹方中附子无特殊煎煮法;附子-防风是常见的减毒配伍药对。,结论,2,疼痛是应用附子治痹之契机,根据是否兼热酌情佐以清热;中小剂量、常规煎煮或许更能发挥附子抗炎镇痛之效,且无中毒之虞;防风与附子相配治痹,既能增效又可减毒。唐宋时期附子治痹经验对当今风湿病中医临床有重要参考价值。
Objective,2,Through the study on the treatment of limb arthralgia with Aconiti Lateralis Radix Praeparata in the Tang and Song dynasties, the dosage, preparation and matching methods of Aconiti Lateralis Radix Praeparata were summarized, which could guide modern clinical applications.,Methods,2,Through sorting the prescriptions for the treatment of limb arthralgia in the Tang and Song dynasties, and selecting prescriptions that contained Aconiti Lateralis Radix Praeparata, the use range, dose, preparation and synergy of Aconiti Lateralis Radix Praeparata were analyzed through dosage conversion between ancient and modern times.,Results,2,In the Tang and Song dynasties, Aconiti Lateralis Radix Praeparata had a wide range of applications, not only for the bi caused by cold evil, but also for the bi caused by hot evil through drug synergy. Among the three kinds of bi, such as painful bi, migratory bi and stationary bi, Aconiti Lateralis Radix Praeparata was most commonly used for painful bi. In the Tang and Song dynasties, the common dosage of Aconiti Lateralis Radix Praeparata in decoction, pill and powder was similar. The dosage span of decoction was the most, and the maximum dosage was 160 g. The dosage of Aconiti Lateralis Radix Praeparata in powder in Song Dynasty was much lower than that in Tang Dynasty.There was no special decoction method for Aconiti Lateralis Radix Praeparata in limb arthralgia. Aconiti Lateralis Radix and Praeparata-Saposhnikoviae Radix was a common detoxifying drug pair.,Conclusions,2,Pain was the opportunity to use Aconiti Lateralis Radix Praeparata. The method of clearing heat could be added accordingly depending on incorporating thermography. In small and medium dosage, conventional decoction might be more effective in anti-inflammatory and analgesic effects without poisoning. Aconiti Lateralis Radix Praeparata and Praeparata-Saposhnikoviae Radix were compatible for treating bi, which could both enhance the effect and reduce the toxicity. In brief, the experience of Aconiti Lateralis Radix Praeparata in the treatment of limb arthralgia in the Tang and Song dynasties had important reference value for the clinical treatment of rheumatology in traditional Chinese medicine.
风湿病肢体痹附子有毒中药剂量增效减毒文献研究
rheumatic diseaseslimb arthralgiaAconiti Lateralis Radix Praeparatatoxic herbsdosageefficacy enhancing and toxicity reducingliterature research
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