方剂与复方的名实辨析

方剂与复方是中医药学中具有不同内涵的两个概念。方剂是中医运用中药的主要形式,其运用基础是中药药性理论和病证病机及治法理论,以中药的配伍运用为特征,充分体现了中医与中药的紧密关系。复方是中药现代化的产物,其运用基础是中药活性物质和疾病病理及药理学理论,以中药部位或成分的组合运用为特征,体现了天然药物学中的药学与中药的关系。方剂和复方两者虽都涉及到中药运用,但前者"依证显效",后者"据病显用",二者在内涵上有着本质差别。复方与方剂在概念上的混淆,不仅使基于传统学理建立起的方剂学学科面临中医制方学理,临床运用基础等重要理论问题的困惑;也使基于现代药学建立的中药复方学陷入诸如复方的中医药效评价,辨证应用等问题的诘难。基于不同的学科背景,内涵及功能,中医方剂和中药复方理应有各自的研究目标和领域。一方面,方剂的现代研究应谨守辨病/证论治及"方证相关"的经验背景,以探查方药配伍与其所主病证之间的关系,即"方证相关"的规律及其生物学内涵为主要定位,同时基于方剂化学及其调控作用的复杂性,在方药化学成分认识的基础上,探索方证体系中的复方—生物效应模式对于从新的视角认识中医方剂效用原理具有重要学术意义;另一方面,复方的研究似乎没有必要束缚于传统中医药学的经验背景(基于病证和方药配伍的经验),即利用中药化学分析及分离的最新技术,跟踪系统生物学及合成生物学的进展,建立起中药成分配伍的生物效应评价体系,发现治疗现代疾病的中药化学部位或组分或成分的新配方,可能更具有现实意义。

Analysis on Connotation of Formulae and Compounds in Traditional Chinese Medicine

Formulae and compounds are two concepts with different connotations in traditional Chinese medicine(TCM). Formulae are the main form of using TCM based on the theory of drug properties, syndrome pathogenesis and therapeutic method, and characterized by the combination of TCMs, which fully reflects the close relationship between TCM and TCM herbs. But as the product of TCM modernization, compounds are characterized by the combination of effective parts or components of TCMs based on theory of active substances, disease pathology and pharmacology, which shows the relations between natural medicines and TCMs. There are essential differences in the connotation between formulae and compounds although their similarity in the use of TCMs. The confusion of the definitions of formulae and compounds makes theoretical difficulties for TCM formulary, clinical application base, compounds' efficacy evaluation and application based on syndrome differentiation. TCM formulae and compounds shall have their own research objectives and fields based on different subject backgrounds, connotations and functions. For one thing, modern research of formulae shall follow the experience background in the treatment based on syndrome or disease differentiation and the correlation between the disease syndrome and formulae, and focus on the correlation of drug compatibility and disease or syndrome, namely the regularity of the correlation between the disease syndrome and formulae and the biological connotation. Meanwhile, based on the formula chemistry and its complicated regulating effect, and the identification of formulae's chemical components, efforts shall be made to explore the compound-biological effect mode, which is academically significant in identifying TCM formulae's efficacy principle form a new perspective; For another, compound studies are not necessarily restricted to the experience background in TCM. It is of more practical significance to track the progress in systematic biology and synthetic biology, set up the biological effect evaluation system for the combination of TCM components and discover the new formulae containing TCM chemical fractions, components or ingredients for treating modern diseases by using TCM chemical analysis and the latest separation technology.