世界中医药
世界中醫藥
세계중의약
WORLD CHINESE MEDICINE
2014年
7期
904-907
,共4页
大承气汤%大黄%阳明腑实证%煎煮时间%临床疗效
大承氣湯%大黃%暘明腑實證%煎煮時間%臨床療效
대승기탕%대황%양명부실증%전자시간%림상료효
LargeChengqidecoction%Rheum%Yangmingfu-visceraexcess%decoctingtime%clinicaleffect
目的：探讨大承气汤中大黄后下时间对阳明腑实证患者的临床治疗效果。方法：选择自2012年3月至2014年1月广东省中西医结合医院消化门诊或住院部的符合纳入标准的阳明腑实证便秘患者150例。按照口服大承气汤大黄后下时间的不同，随机分10 min组，20 min组，30 min组，每组50例，每组均煎煮10 min、20 min、30 min、60 min、90 min。各组给药1次/d，至排出大便通气时止。观察各组用药后肛门排气、排便时间；计算不同大承气汤煎液中各游离、结合、总蒽醌类衍生物的含量。统计分析后下大黄最佳煎煮时间，从而为大承气汤临床提供用药指导。结果：1）大黄后下时间相同，煎煮时间不同会对大承气汤中总蒽醌含量有影响，2）大黄中有效成分的回归方程分别为：芦荟大黄素Y＝104681X-39806（r＝0.9999）；大黄酸Y＝54967X-23089（r＝0.9999）；大黄素Y＝298764X-90874（r＝0.9999）；大黄酚Y＝188096X-38046（r＝0.9999）；大黄素甲醚Y＝83997X-28765（r＝0.9999）；3）研究表明，20 min大黄后下，共煎煮30 min时大承气汤中结合蒽醌含量最高，结合蒽醌的泻下效应较强；4）20 min煎煮30 min时，大承气汤排便时间、次数、排气时间以及肛门直肠压力与各时间段比较差异有统计学意义（P＜0.05）。结论：大承气汤在煎煮20 min后加入大黄后共煎煮30 min的药液中结合蒽醌的含量高于其他后下时间，为其致泻作用提供物质基础，避免了中药煎煮时间过短或过长，防止了不良反应的发生，减轻了患者的痛苦。
目的：探討大承氣湯中大黃後下時間對暘明腑實證患者的臨床治療效果。方法：選擇自2012年3月至2014年1月廣東省中西醫結閤醫院消化門診或住院部的符閤納入標準的暘明腑實證便祕患者150例。按照口服大承氣湯大黃後下時間的不同，隨機分10 min組，20 min組，30 min組，每組50例，每組均煎煮10 min、20 min、30 min、60 min、90 min。各組給藥1次/d，至排齣大便通氣時止。觀察各組用藥後肛門排氣、排便時間；計算不同大承氣湯煎液中各遊離、結閤、總蒽醌類衍生物的含量。統計分析後下大黃最佳煎煮時間，從而為大承氣湯臨床提供用藥指導。結果：1）大黃後下時間相同，煎煮時間不同會對大承氣湯中總蒽醌含量有影響，2）大黃中有效成分的迴歸方程分彆為：蘆薈大黃素Y＝104681X-39806（r＝0.9999）；大黃痠Y＝54967X-23089（r＝0.9999）；大黃素Y＝298764X-90874（r＝0.9999）；大黃酚Y＝188096X-38046（r＝0.9999）；大黃素甲醚Y＝83997X-28765（r＝0.9999）；3）研究錶明，20 min大黃後下，共煎煮30 min時大承氣湯中結閤蒽醌含量最高，結閤蒽醌的瀉下效應較彊；4）20 min煎煮30 min時，大承氣湯排便時間、次數、排氣時間以及肛門直腸壓力與各時間段比較差異有統計學意義（P＜0.05）。結論：大承氣湯在煎煮20 min後加入大黃後共煎煮30 min的藥液中結閤蒽醌的含量高于其他後下時間，為其緻瀉作用提供物質基礎，避免瞭中藥煎煮時間過短或過長，防止瞭不良反應的髮生，減輕瞭患者的痛苦。
목적：탐토대승기탕중대황후하시간대양명부실증환자적림상치료효과。방법：선택자2012년3월지2014년1월광동성중서의결합의원소화문진혹주원부적부합납입표준적양명부실증편비환자150례。안조구복대승기탕대황후하시간적불동，수궤분10 min조，20 min조，30 min조，매조50례，매조균전자10 min、20 min、30 min、60 min、90 min。각조급약1차/d，지배출대편통기시지。관찰각조용약후항문배기、배편시간；계산불동대승기탕전액중각유리、결합、총은곤류연생물적함량。통계분석후하대황최가전자시간，종이위대승기탕림상제공용약지도。결과：1）대황후하시간상동，전자시간불동회대대승기탕중총은곤함량유영향，2）대황중유효성분적회귀방정분별위：호회대황소Y＝104681X-39806（r＝0.9999）；대황산Y＝54967X-23089（r＝0.9999）；대황소Y＝298764X-90874（r＝0.9999）；대황분Y＝188096X-38046（r＝0.9999）；대황소갑미Y＝83997X-28765（r＝0.9999）；3）연구표명，20 min대황후하，공전자30 min시대승기탕중결합은곤함량최고，결합은곤적사하효응교강；4）20 min전자30 min시，대승기탕배편시간、차수、배기시간이급항문직장압력여각시간단비교차이유통계학의의（P＜0.05）。결론：대승기탕재전자20 min후가입대황후공전자30 min적약액중결합은곤적함량고우기타후하시간，위기치사작용제공물질기출，피면료중약전자시간과단혹과장，방지료불량반응적발생，감경료환자적통고。
To investigate the clinical effect of Large Chengqi decoction Rheum decocting later in patients with Yangmingfu-visceraexcess.Methods:1 50 patients with Yangmingfu-visceraexcess in Outpatients and In-patient Department of Gastroenterology in In-tegrated Chinese and Western Medicine Hospital of Guangdong Province from March 201 2 to January 201 4 were the research object,and they were divided into 1 0 minutes group,20 minutes group,30 minutes group with 50 cases in each group according to the time1 0 min,20 min,30 min,60 min and 90 min of decoction later,each group were treated with qd to the time of stool.Then the evacuation time,defeca-tion time of all the groups were observed,and the free,binding,total anthraquinone derivatives of different Large Chengqi decoction were detected.And the best time of decoction later were analyzed,in order to provide guidance for the application of Large Chengqi decoction. Results:1 )The different decocting time had influence for the total anthraquinone content at the same time of decoction later,2)the re-gression equation of active constituents in Rhubarb were respectively:aloe-emodin Y=1 04 681 X-39 806(r=0.999 9);parietic acid Y=54 967X-23 089(r=0.999 9);emodin Y=298 764X-90 874(r=0.999 9);chrysophanic acid Y=1 88 096X-38 046(r=0.999 9);physcione Y=83 997X-28 765(r=0.999 9);3)The research showed that the binding anthraquinone derivatives of different Large Chengqi decoction at 20 minute of decoction later in 30 minutes together were highest,the purgative effect of binding anthraquinone deriv-atives were greater;4)At 20 minute of decoction later in 30 minutes together were highest(P<0.05).Conclusion:The binding anthra-quinone derivatives content of different Large Chengqi decoction decoction 20 minute later at 60 minute are higher than other times,it provides the material foundation for its purgative effect and avoids the too long or too short decocting time itraditional Chinese medicine, so it prevents the toxicity and other adverse reactions andreduces the pain of patients.
