四物汤类方养血调经配伍功效探析

四物汤为补血剂的代表方,也是调经基本方,是后世众多补血方的祖方,临床应用广泛.本文探讨基于主证的四物汤配伍功效,以及四物汤衍化方的特点.四物汤具有补血调血之功,其补血作用不仅表现在对血液系统的影响,也包括对神经内分泌系统、妇女特异性生理物质及相关激素水平的影响;其调血之用,具有改善血液流变、维持凝血与抗凝平衡,同时还改善子宫平滑肌状态,其作用机制与调控血管内皮细胞分泌的多种因子相关.类方比较表明四物汤衍化方具有一定相似功效和特征差异,在四物汤基础上,桃红四物汤偏重于活血化瘀,改善血液流变学指标、抑制血小板聚集;香附四物汤偏重于理气止痛,抑制子宫平滑肌收缩频率、收缩幅度以及平均肌张力;芩连四物汤则偏重清热活血,抑制相关炎症因子.深化四物汤类方共性和差异效应表征的认识,有助于对经典方剂配伍应用的深入理解,对临床应用具有指导意义.

Analogous Formulae of Si-Wu Decoction for Nourishing Blood and Regulating Menstruation

Si-Wu Decoction act not only as the classic formula for nourishing blood but also as the basic formula for regulating menstruation, and therefore is widely applied in clinic. In this paper, we discuss the nourishing blood and regulating menstruation function of Si-Wu Decoction based on the main syndrome as well as the characteristics of it and its analogous formulae. Si -Wu Decoction can nourish blood by affecting blood system, neuroendocrine system, specific physiological matter of women and related hormones. It also can regulate blood by improving blood rheology, regulating the relationship between coagulation and anti-coagulation and improving uterine smooth muscle, whose mechanism involves different cytokines secreted by vascular endothelial cells. The comparison between analogous formulae indicates that the derived analogous ones share similar function and featured differences. For example, Tao -Hong -Si -Wu Decoction lays particular stress on activating blood and resolving blood stasis by improving blood rheology, preventing blood platelets aggregation; Xiang-Fu-Si-Wu Decoction regulates Qi and relieves pain by inhibiting contraction frequency and amplitude of uterine smooth muscle as well as the average muscular tension. Qin-Lian-Si-Wu Decoction clears heat and activates blood by inhibiting inflammatory factors. Therefore, effect manifestations of the similarity and difference of Si-Wu Decoction analogous formulae helps go deep into the study of classic formulae to guide clinical practice.