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国医大师周仲瑛应用雷公藤复方治疗类风湿关节炎用药规律探析

Explore the Medication Rule of Chinese Medicine Master Zhou Zhongying treating Rheumatoid Arthritis by Appling to Tripterygium Wilfordii Compound

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【作者】 杨昊偌孙鑫朱红赵蕊周学平

【Author】 YANG Haoruo;SUN Xin;ZHU Hong;ZHAO Rui;ZHOU Xueping;Nanjing University of Chinese Medicine;

【通讯作者】 周学平;

【机构】 南京中医药大学

【摘要】 目的:基于“异类相制”理论,探讨国医大师周仲瑛应用雷公藤复方治疗类风湿关节炎的临床用药规律及特点。方法:收集整理周仲瑛教授在1984年至2015年期间应用雷公藤复方诊治的类风湿关节炎医案,采用VisualFoxPro周仲瑛教授诊疗资料管理系统、Excel2019和TCMICS V3.0,分析处方用药的基本特点。结果:录入233例处方,药物共计3633味,四气以寒、温、平为主,五味以辛、甘、苦为主,功效以祛风湿类、清热类、补虚类和活血化瘀类为主,生地黄、黄芪等与雷公藤配伍使用的频次较高,常用药物组合有“雷公藤—生地黄”“雷公藤—黄芪”等,核心组合14个,聚类新方共5首。结论:国医大师周仲瑛善用雷公藤复方治疗类风湿关节炎,其配伍特点包括寒温相制、甘苦并用、甘辛相济等;治法常用清宣郁热以祛邪,益气固本以补虚,化瘀通络而不伤正,补益肝肾兼养血,充分凸显性味相制、异效相制、扶正制毒的综合减毒效应,为雷公藤的安全合理应用提供了临床依据。

【Abstract】 Objective To discuss the Clinical Medication Rule and characterization of Chinese Medicine Master Zhou Zhongying treating Rheumatoid Arthritis by appling to Tripterygium wilfordii compound based on“Heterogeneous Restriction”.Method Collect and sort out Medical Records about Prof. Zhou Zhongying?s treatment of Rheumatoid Arthritis, and use VisualFoxpro Prof. Zhou Zhongying?s diagnosis and treatment data Excel software(2019),and Traditional Chinese Medicine inheritance computing platform(V3.0)to analyze the basic characteristics of prescription medication.Result A total of 233 cases were recorded in this study, involving 3633 traditional Chinese medicines.Four Qi mainly include cold medicine, warm medicines and mild medicines.Five flavors mostly cover acrid medicines, sweet herbs and bitterness.The main therapy for RA is based on dispelling wind, clearing heat, promoting blood circulation and removing blood stasis, tonifying deficiency.Meanwhile, Radix Rehmanniae, Astragalus membranaceus and other durgs, which have high frequency of compatibility use with Tripterygium wilfordii compound.Commonly used drug combinations contain “Tripterygium wilfordii-Radix Rehmanniae”,Tripterygium wilfordii-Astragalus membranaceus”and others, besides that, there are 14 core combinations and 5 new TCM formula by clustering analysis.Conclusion Prof. Zhou Zhongying is good at treating Rheumatoid Arthritis with toxic drugs such as Tripterygium wilfordii.The treatment methods include: Cold and warm medicines are restricted each other; Acrid, sweet and bitter medicines are in harmonious proportion; Clearing Heat for eliminating evil; Eliminating stasis and dredging meridians in order to avoid harming body healthy energy; Tonifying Qi and consolidating vital base for benefiting pneuma; Nourishing Liver-Kidney and enriching blood.The above methods fully underline the way to decrease toxicity about nature and taste restriction, different effects restriction, strengthening the body and reducing toxin, which provide clinical basis for “Heterogeneous Restriction”.

【基金】 国家中医药管理局“国医大师周仲瑛传承工作室”建设项目(国中医药人教发[2010]59号);江苏省社会发展重点研发计划(编号:BE2019723)
  • 【文献出处】 中国民族民间医药 ,Chinese Journal of Ethnomedicine and Ethnopharmacy , 编辑部邮箱 ,2023年11期
  • 【分类号】R259;R249
  • 【下载频次】33
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