大剂量附子不同水平临床使用研究进展

doi:10.19803/j.1672-8629.20230060

摘要/Abstract

摘要： 目的梳理大剂量附子的临床应用情况,为附子临床应用提供参考。方法以《中华人民共和国药典》（2020年版）中附子用量3~15 g为标准,通过查阅学术文献对超药典剂量使用附子的情况进行梳理,从毒理学研究、古方应用考究、现代临床应用等方面,再从不同剂量层次及其应用辩证实例等角度,讨论不同时期多种剂量范围附子对不同病症的治疗方法。结果大剂量使用附子具有特殊功效。不同时期、不同病症对附子的使用剂量区别较大,文献中30~200 g,甚至200 g以上均有记载,多数在30~60 g;使用时必须炮制或以水煎使用,超过《中华人民共和国药典》（2020年版）3~15 g的规定范围,使用的医学名家往往采用配伍减毒、炮制减毒等多种手段减少其毒性。结论大剂量附子配伍使用报道较多,对多种疾病的治疗效果显著,但在临床使用时仍需辩证使用附子以保证用药安全。

关键词: 附子, 大剂量, 临床病症, 古代, 配伍, 炮制, 减毒

Abstract: Objective To review the clinical applications of Radix Aconiti Lateralis Preparata at large doses, and provide reference for related treatments. Methods Based on the dosage of Radix Aconiti Lateralis Preparata specified in the Pharmacopoeia of the People's Republic of China (2020 Edition) and by means of literature review, the current usage of Radix Aconiti Lateralis Preparata at large doses was investigated. Treatments within different dosage ranges, in different stages and for different diseases were discussed in terms of toxicology, applications, studies on ancient prescriptions, modern clinical applications, different dosages and real cases. Results Large dosages of Radix Aconiti Lateralis Preparata had special effect. The dosage of Radix Aconiti Lateralis Preparata, which varied greatly depending on the stage and type of the disease, ranged from 30 to 200 g or even exceeded 200 g as was recorded in literature. However, most of the dosages ranged from 30 to 60 g. When used, fuzi had to be processed or decocted in water. When the prescribed range was 3 to 15 g stated in the Pharmacopoeia of the People's Republic of China, its toxicity was usually reduced via compatibility, processing or otherwise. Conclusion The use of high-dose Radix Aconiti Lateralis Preparata has been widely reported, and the therapeutic effect against a variety of diseases is remarkable. However, Fuzi should still be used with caution in clinic to ensure safety.

Key words: Radix Aconiti Lateralis Preparata (fuzi), large dose, clinical symptoms, ancient, compatibility, processing, detoxification

中图分类号:

R969.3

杨亮, 陶瑞, 胡慧子, 王紫翰, 张彦, 董艳, 储兆亿, 章子臻, 耿嘉浩, 李帅, 徐诺, 马增春, 高月. 大剂量附子不同水平临床使用研究进展[J]. 中国药物警戒, 2023, 20(8): 946-949.

YANG Liang, TAO Rui, HU Huizi, WANG Zihan, ZHANG Yan, DONG Yan, CHU Zhaoyi, ZHANG Zizhen, GENG Jiahao, LI Shuai, XU Nuo, MA Zengchun, GAO Yue. Research progress in clinical use of large-dose Radix Aconiti Lateralis Preparata[J]. Chinese Journal of Pharmacovigilance, 2023, 20(8): 946-949.

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