《新型冠状病毒肺炎诊疗方案(试行第八版)》中药用量分析  

Analysis of the Dose of Traditional Chinese Medicines in the Formula of TCM Treatment Regimens in the Diagnosis and Treatment Protocol for COVID-19(Trial Version 8)

作　　者：李玥[1] 石红霞 周俊[1] 杨林[1] LI Yue;SHI Hongxia;ZHOU Jun;YANG Lin(Department of Pharmacy,West China Hospital,Sichuan University,Chengdu,Sichuan,China 610041)

机构地区：[1]四川大学华西医院药剂科,四川成都610041

出　　处：《中国药业》2021年第14期117-122,共6页China Pharmaceuticals

摘　　要：目的分析《新型冠状病毒肺炎诊疗方案(试行第八版)(》简称《诊疗方案》)中涉及中医治疗方案的中药剂量,以及中药超剂量使用情况。方法对比《诊疗方案》纳入的9组中医治疗方案中各组方推荐剂量与2020年版《中国药典(一部)(》简称《药典》)的中药饮片用量,并对不同中药进行Apriori关联分析,支持度设为0.3,置信度下限设为0.75。结果9组方案中有8组(88.89%)中药超剂量使用,寒湿郁肺证和气营两燔证的推荐中药处方中超量味数较多,其中气营两燔证处方超量比例最高(75.00%),其次为湿毒郁肺证(46.15%),其余超量处方为1~2味药超剂量。涉及64味中药,其中26味(40.63%)超剂量;累计使用中药126味,累计超量中药30味(23.81%);地黄《诊疗方案》最大剂量较《药典》超标3倍,茯苓和马鞭草剂量超标2倍,白术、化橘红、知母和赤芍剂量超标1.5倍,玄参和细辛剂量超标1倍,其余中药剂量超标低于1倍;26味超剂量中药药性以寒性、温性居多,药味以苦味、辛味为主,归经以入肺、脾、肝、胃经为主;前25位高频次配伍药对中有24对超剂量使用。结论《诊疗方案》涉及的组方中药依证定量,依据中药配伍特点,慎重考虑了含毒性成分中药饮片的使用及其剂量确定,避免了药物毒性反应,其超量使用有其合理性。Objective To analyze the dose of traditional Chinese medicines(TCM)in the formula of TCM treatment regimens of the Diagnosis and Treatment Protocol for COVID-19(Trial Version 8),especially the over-dose usage of TCM.Methods The recommended dose of TCM in the formulas of nine TCM treatment regimens in the Diagnosis and Treatment Protocol for COVID-19 was compared with the prescribed dose of decoction pieces in the Chinese Pharmacopoeia(2020 Edition,VolumeⅠ),and the Apriori algorithm was performed on different TCMs,the support degree was set as 0.3 and the lower limit of confidence degree was set as0.75.Results Among nine formulas of TCM treatment regimens,eight formulas(88.89%)had overdose use of TCM,among which the number of overdose TCMs in the recommended prescriptions for the syndrome of cold dampness depressing lung and the syndrome of flaring heat in qifen and yingfen was more,and the proportion of overdose TCMs for the syndrome of flaring heat in qifen and yingfen was the highest(75.00%),followed by the syndrome of dampness toxin depressing lung(46.15%),and the over-dose TCMs in the other overdose prescriptions were 1-2 kinds.A total of 64 kinds of TCMs were involved,and 26 kinds(40.63%)of TCMs were overdose.There were 126 kinds of TCMs used in total,and 30(23.81%)kinds of TCMs were overdose.Compared with the standard in the Chinese Pharmacopoeia(2020 Edition,VolumeⅠ),the maximum dose of Rehmannia glutinosa in the Diagnosis and Treatment Protocol for COVID-19(Trial Version 8)more than threefold,with fourfold of the maximum dose in the Chinese Pharmacopoeia,the dose of Poria cocos and Verbena officinalis more than twofold,the dose of Atractylodes macrocephala,Citri Grandis Exocarpium,Anemarrhena asphodeloides and Radix Paeoniae Rubra more than 1.5 folds,the dose of Asarum sieboldii and Fructus Tsaoko more than doubled,and the dose of other TCMs exceeded less than doubled.Among the 26 overdose TCMs,most of them were cold and warm in nature,mainly bitter and pungent in flavour,mainly entering lung,spleen,l

关 键 词：《新型冠状病毒肺炎诊疗方案(试行第八版)》 中药 超剂量 《中国药典》 辨证分型 配伍 合理用药 

分 类 号：R932[医药卫生—生药学] R183[医药卫生—药学]