【作者】 张建美； 许皖； 钟赣生； 郭岩松； 柳海艳； 欧丽娜； 赵桐； 刘佳； 王思睿；

【Author】 ZHANG Jian-mei;XU Wan;ZHONG Gan-sheng;GUO Yan-song;LIU Hai-yan;OU Li-na;ZHAO Tong;LIU Jia;WANG Si-rui;School of Basic Medical Sciences,Beijing University of Chinese Medicine;

【机构】 北京中医药大学基础医学院；

【摘要】 目的:查阅用甘遂甘草反药组合进行实验研究的文献,总结归纳甘遂甘草反药组合配伍使用的宜忌条件,为今后的研究提供参考。方法:利用中国知网、万方、维普、PUBMED数据库,系统检索1949年以来关于"十八反"中甘遂甘草反药组合同用的研究文献,检索文章的过程中剔除综述及临床研究类文章,选取实验研究方面的文章,总结归纳甘遂甘草反药组合配伍使用的适宜和禁忌条件。结果:甘遂与甘草反药组合配伍的药效和毒性受多方面的影响,总结归纳为配伍剂量、配伍比例、入药方式、炮制品种、给药途径、给药时间等多方面。其中配伍剂量、配伍比例方面的研究较多,初步认为低剂量(接近临床用量)及甘遂甘草1:15或1:10比例配伍属于配伍的适宜条件。在这两种条件下,不仅使甘遂甘草发挥出了利水的作用,还能一定程度上减少毒性。而禁忌条件是高剂量(临床用量的数十倍)及甘遂甘草1:1或1:2比例配伍。其中1:1或1:2比例配伍时对心肝。肾等造成不同程度的损害,且毒性大于甘遂甘草单味药的毒性。而入药方式、炮制品种、给药途径、给药时间方面的研究相对较少。现有的文献显示生甘遂与炙甘草配伍,两药入汤剂先分煎后合并,口服以及短时间给药为配伍适宜条件;而醋甘遂与炙甘草、醋甘遂与生甘草、生甘遂与生甘草配伍,腹腔注射以及长时间给药为配伍禁忌条件。但由于后几方面的文献数量不多,很难从少量的实验中总结归纳出宜忌条件,今后应增加相关方面的研究。结论:中药"十八反"的配伍问题一直是各医家争论的焦点,相关的实验研究也很多,学者们从不同方面在不同条件下探讨甘遂甘草到底反不反。但现状是研究条件往往侧重于某些方面,而在其他方面则数量不足,难以总结归纳出哪些是适宜条件,哪些是禁忌条件。且笔者认为甘遂甘草能否同用不能一概而论,而是受到不同条件的限制。由于各条件不是单独存在,而是互相交叉、互相影响的,因此单一条件下得出的结果只能作为参考,而不能成为定论。在今后的科学研究中,应增加多条件交叉、多层次深入的研究,丰富和完善甘遂甘草配伍的宜忌条件,进而对临床应用提供可参考的指导意见。更多还原

【Abstract】 Objective:To review the literatures of experimental study in the Gansuigancao anti-drug combination,and summarize the suitable and contraindicated conditions of the combination,and then provide a reference for future research.Methods:Using CNKI,Articles,VIP,Pubmed database,we systematically retrieve the research literatures of gansui and gancao using together.In this process,we remove summary and clinical research articles,and select experimental studies,and then summarize the suitable and contraindicated conditions of the anti-drug combination.Results:The efficacy and toxicity of gansuigancao anti-drug combination is affected by many conditions,Including proportion,dose,extracting manner,prepared varieties,route of administration,and time.There are more researches concentrated in proportion and dose conditions.The result is that low dose(near to the clinical dose) and 1:15 or 1:10 ratios are the suitable conditions.With these conditions,the efficacy of gansui and gancao is ensured,and the toxicity is reduced.The contraindicated conditions are high dose and 1:1 or 1:2 ratios.The latter conditions cause varying degrees of damage on the heart,liver and kidney.What’s more,they show more serious toxicity than a single drug.There are few researches involved in extracting manner,prepared varieties,route of administration and time.Literatures suggest that gansui and prepared gancao decocting respectively and then mixing together,and gavaging for a short time are suitable conditions.While vinegar-preparing gansui and prepared gancao,vinegar-preparing gansui and gancao,gansui and gancao injecting intraperitoneal for a long time is contraindicated condition.For the reason that the number of documents about these latter conditions is not so much,it is hard to summarize the suitable and contraindicated conditions.Relevant research should be increased.Conclusion:Chinese "Eighteen antagonisms" compatibility issue has been the focus of controversy for all physicians,and related studies are so much that scholars explore the question under different conditions in different aspects.But the status quo is that studies tend to focus on certain aspects,and pay less attention to other aspects.The number is not enough to summarize the appropriate conditions and contraindicated conditions.In my opinion,whether gansui and gancao can use together or not is limited by different conditions but can’t generalize in a few words.Because the conditions are not alone,but cross and influence each other.So,the results obtained under the single condition can only be used as a reference but not a conclusion.Research should increase the number and depth in the future,and enrich suitable and contraindicated conditions for gansui and gancao compatibility,and then provide guidance for the clinical application.更多还原