半夏临床用量及毒性分析

目的:统计分析现代临床中药汤剂中半夏的用量,为半夏的临床安全使用剂量提供依据。方法:以“半夏”+“中医”、“半夏”+“临床”、“半夏”+“中毒”等为关建词,从中国知网检索现代临床应用半夏的文献共5380篇,经筛选排除,纳入病案信息完整的合格文献832篇,建立半夏的用量数据库、不同炮制品频次数据库、半夏中毒情况数据库,用SPSS软件分析其临床运用规律。结果:半夏临床用量范围较广,从1.5~90.0 g不等,10.0~12.0 g使用频率最高;在临床处方中半夏名称繁杂多样,大多使用制半夏,其中又以法半夏使用频率较高,占44.4%;有明确半夏中毒剂量的报告中,使用生半夏中毒者较多,剂量以9.0~12.0 g中毒者最多。结论:半夏作为有毒中药,临床用量不可过大过猛,不同的炮制方法均可减轻其毒性,临床以应用制半夏为主,但是“有故无殒,亦无殒也”,临床运用时又不能拘泥,应根据病情需要确定应用剂量,并合理选用生半夏或不同的炮制品。

Clinical Dosage and Toxicity Analysis of Banxia

Objective:To provide a reference for the safe application of Banxia(Rhizoma Pinelliae) in clinic,by statistically analyze the dosage of Banxia in modern clinical decoction of traditional Chinese medicine.Methods:Totally 5380 research papers of modern clinical application of Banxia were retrieved from China National Knowledge Internet(CNKI) with the keywords of Banxia + traditional Chinese medicine,Banxia + clinical,Banxia + toxication. After screening,832 qualified papers were included to establish the usage database of Banxia,the frequency database of different processed Banxia,and the database of Banxia toxication,and the clinical application rules were analyzed with SPSS software. Results:The clinical dosage range of Banxia was wide,ranging from 1.5 to 90 g,and the highest frequency of use was from 10 to 12 g. In the clinical prescription,the names of Banxia was varied,and most of them were Zhi Banxia,and the frequency of Fa Banxia was the highest,accounting for 44.4%;there were reports with toxication dosage of Banxia,in which Sheng Banxia often cause toxication with the dosage between 9 and 12 g. Conclusions:As a toxic Chinese medicinal,Banxia should not be used cautiously with a small dosage. Different methods of processing can alleviate the toxicity. In clinic,Zhi Banxia is mainly applied. However,since medicinals are of no toxication for disease,and therefore there would be no toxication,Banxia should be used with flexibility. The dosage should be determined according to the needs of the disease,and Sheng Banxia or different processed Banxia should be used rationally.