【作者】 李卫民；

【导师】 邓中甲；

【作者基本信息】 成都中医药大学 ， 方剂学， 2009， 博士

【摘要】 目的：研究影响地黄功效发挥方向的多种因素；阐明地黄常用配伍结构的作用机理,总结地黄在方剂中的运用规律。方法：以《中医方剂大辞典精选本》为据,收集含生地黄方剂1034·首,含熟地黄方剂739首。用EXCEL建立数据表,统计分析地黄配伍、剂量、炮制、剂型、用法、产地对地黄功效的影响。结果：与生地黄配伍使用的前六位的药类依次为：补益药、清热药、解表药、活血化瘀药、利水渗湿药、止血药。生地黄发挥养阴生津功效多配伍当归、白芍、阿胶、麦冬、酸枣仁等,常用5-20克,选用干地黄或酒地黄为宜,以汤剂、丸剂入药为主。发挥清热凉血功效常配伍赤芍、玄参、黄芩、石膏、木通等,常用5-20克,鲜用为佳,米汤送服为佳。生地黄发挥活血化瘀功效常配伍红花、牛膝、大黄等,用量可参考3-12克,鲜用为佳；用于新瘀血选汤剂、散剂、酒剂,久瘀选丸剂;酒送服较佳。生地黄发挥止血功效常配伍蒲黄、侧柏叶、阿胶等,常用5-60克；用生地黄炭加强止血功效；内服用汤剂、自然汁;外用散剂。发挥明目功效常配伍防风、细辛、车前子、菊花等,常用量5-20克,清茶送服较佳。与熟地黄配伍使用的前六位的药类依次为：补益药、清热药、活血祛瘀药、利水渗湿药、收涩药和温里药。发挥滋阴补血功效常配伍当归、白芍、阿胶、麦冬、牡丹皮、黄柏、知母等；发挥补血功效常用5-20克,米汤送服尤佳；发挥滋阴功效常用15-60克,以盐汤送服为佳。发挥益精填髓功效常配伍枸杞子、鹿茸、山茱萸、山药等,常用15-60克,以盐汤送服为佳。发挥滋阴益气功效常配伍人参、黄芪等,常用5-20克,米汤送服较佳。发挥滋阴助阳功效常配伍肉桂、制附子等,常用15-40克,酒送服尤宜。结论：配伍、剂量、炮制方法、剂型、用法、产地对地黄功效的发挥的影响情况和程度不尽相同。配伍对地黄功效发挥方向起着主要影响作用；剂量是影响其功效强弱的重要因素；剂型主要影响其功效发挥的快慢和持续时间的长短。服药时间可影响其功效走向部位：送服材料和炮制增强其某些功效和制约偏性；产地影响其功效强弱。更多还原

【Abstract】 Objective:To study the influence factors of oriented efficacy exertion of Dihuang (Rhizoma Rehmannia) in formula. Clarifying the compatible mechanisms of usual compatible structures between Dihuang and other herbs and summarizing Dihuang’s applying law in formula.Methods:1034 pieces of formulae containing Shengdihuang (Raw Rhizoma Rehmannia) and 739 pieces of formula containing Shudihuang (Rhizoma Rehmannia Praeparatae) from The classic format of Formula Dictionary of Traditional Chinese Medicine were collected, and these formulae data bank in Micro-Excel were set up. Then statisticsing and analyzing the effectiveness influence factors of Dihuang including compatibility, dosage, processing, dosage form, usage and provenience place by statistic methods of classification.Results:The leading six kinds of Chinese herb that compounded with Shengdihuang are tonic drugs, heat-clearing drugs, diaphoretic drugs, drugs of activating blood circulation, drugs of eliminating Dampness through diuresis, and hemostyptic drugs. Shengdihuang usually compound with Dangui (Radix Angelicae Sinensis), Baishaoyao (Radix Paeoniae), Ejiao (Colla Corii Asini), Maimendong (Radix Ophiopogonis), Suanzaoren (Semen Zizyphi Spinosi), etc, with usual dose of 5-20g when enducing effect of nourishing Yin and promoing the production of body fluid. When enducing effect of removing heat to cool blood, Shengdihuang usually compound with Chishaoyao (Radix Paeoniae Rubra), Xuanshen (Radix Scrophulariae),Huangqin (Radix scutellariae), Shigao (Gypsum Fibrosum), Mutong (Caulis Akebiae),etc, with usual dose of 5-20g, and usually take medicine with congee, and the fresh is best. When enducing effect of activating blood circulation, Shengdihuang usually compound with Honghua (Flos Carthami), Niuxi (Radix Achyranthis Bidentatae), Dahuang (Radix et Rhizoma Rhei),etc, with usual dose of 3-12g;and it would be better if use the fresh product and take medicine with wine; the medicina broth., pulveres, or vina is usually taked in fresh haemostasis, and pilula is usually taked in long time stagnant blood. When enducing hemostyptic effect, Shengdihuang usually compound with Puhuang (Pollen Typhae), Cebaiye (Cacumen Biotae), Ejiao (Colla Corii Asini), and so on, with usual dose of 5-60g; and it would be better if use the carbo processed product, it is usually taked in medicina broth, raw juice for oral use and pulveres for external use.When enducing the effect of improving acuity of vision, Shengdihuang usually compound with Fangfeng (Radix Ledebourellae), Xixin (Herba Asari), Cheqianzi (Semen Plantaginis), Juhua (Flos Chrysanthemi),etc, with usual dose of 5-20g; and it would be better if take medicine with green tea.The leading six kinds of Chinese herb that compounded with Shudihuang are tonic drugs, heat-clearing drugs, drugs of activating blood circulation, drugs of eliminating Dampness through diuresis,astringent drugs and drugs for dispelling internal cold.When enducing effect of nourishing Yin and blood,Shudihuang usually compound with Dangui (Radix Angelicae Sinensis), Baishaoyao (Radix Paeoniae), Ejiao (Colla Corii Asini), Maimendong (Radix Ophiopogonis), Mudanpi (Cortex Moutan Radicis); Huangbai (Cortex Phellodendri), Zhimu (Rhizoma Anemarrhenae), etc, with usual dose of 5-20g for nourishing the blood, and 15-60g for nourishing Yin, it would be better if take medicine with congee for nourishing the blood, and with salt soup for nourishing Yin. When enducing effect of tonifying didney essence and replenishing marrow,Shudihuang usually compound with Gouqizi (Fructus Lycii), Lurong (Hairy Deerhorn), Shanzhuyu (Fructus Corni), Shanyao (Rhizoma Dioscoreae), etc, with usual dose 15-60g, it would be better if take medicine with salt soup. When enducing effect of nourishing Yin to tonifying Qi, Shudihuang usually compound with Renshen (Radix Ginseng), Huangqi (Radix Astragali seu Hedysari), etc, with usual dose 5-20g, it would be better if take medicine with congee. When enducing effect of nourishing Yin to help Yang, Shudihuang usually compound with Rougui (Cortex Cinnamomi), Zhifuzi (Radix Acontile Praeparatae), etc, with usual dose 15-40g, it would be better if take medicine with wine.Conclusion:Compatibility, dosage, processing, dosage form, usage and provenience place have different influence on efficacy exertion of Dihuang. The compatibility has the key influence on the oriented exertion of Dihuang efficacy. The dosage has the key influence on the efficacy magnitude of Dihuang. Dosage form mainly influent the exertting velocity and persistence time of Dihuang efficacy. Time for taking drugs can influent the effective location of Dihuang,.The material taking medicine and processing method can enhance some efficacy and restrict bias of Dihuang. provenience place influent the efficacy magnitude of Dihuang.更多还原