Who can provide Zhongjing's classic prescription? It is best to be taught by accomplished seniors, such as ancient and modern measurement conversion.

General situation of dose research of Zhongjing classic prescription

Zhongjing's prescription is exquisite, and the medication is simple and effective, which is highly praised by doctors in past dynasties. The dosage of prescription drugs has changed with time, and the original appearance has not been seen, so there is a great debate. Dose and proportion are closely related to curative effect, which needs textual research. In recent years, there are many reports about the dosage of classical prescriptions. According to the related literature in recent ten years, its research trend is roughly as follows.

Textual research on ancient and modern weights and measures system

Zhongjing wrote a book at the end of the Eastern Han Dynasty, and the unit of measurement was what he used at that time. After nearly two thousand years, the unit of measurement has been changed repeatedly, and the original system is unknown. Nowadays, people use various methods to research and convert it.

The research shows that the dosage of classical prescriptions should be based on clinical efficacy, and the conversion standard of modern Treatise on Febrile Diseases accords with clinical practice.

2. The regularity and characteristics of prescription medication.

There are strict principles and rules for Zhongjing's dosage [10], which are as follows: (1) Make it shorter and stronger, such as the ratio of Fructus Trichosanthis, Bulbus Allii Cepae and Rhizoma Pinelliae decoction to pungent, hot medicine to cold-dampness medicine is 3: 1, so it is used to relieve cold; ② The dosage depends on the focus, that is, the dosage is determined according to the primary and secondary symptoms and severity; ③ Dynamic and static combination, that is, dynamic and static compatibility must be proportional; ④ Quantitative change, that is, the change of drug dosage will lead to the change of prescription properties. Therefore, we should pay attention to [11] when applying the classic prescription: ① The weight of a drug in each dose mainly affects the compatibility of drugs by adjusting the mutual ratio of various drugs; ② Each dose, that is, the dose taken each time, is usually the therapeutic dose of the drug, which shows the dose-effect relationship of the drug. According to the principle of dose-effect relationship, within a certain dose range, with the increase or decrease of the dose, the curative effect of the prescription will increase or decrease accordingly; (3) the daily dose, that is, the total dose of a drug in a day, is determined by the dose and the number of times of daily administration, that is, the influence of the drug time-effect relationship. According to the principle of time-effect relationship, each drug has a relatively stable incubation period, peak period and residual period after taking it, and repeated administration at regular intervals can maintain the continuity of drug efficacy. From another point of view, we should also pay attention to [12]: ① the dosage of drugs in a single prescription, especially the more important dosage in the prescription; ② Pay attention to the dosage of each ingredient in the compound prescription; ③ Pay attention to the dosage of prescriptions, that is, the dosage of basic prescriptions, the dosage of flavored drugs and the dosage of prescriptions with the same flavor; ④ Pay attention to the dosage of each prescription.

In short, the specific application of prescription dosage should pay attention to the absolute dosage of drugs, which reflects the effective dosage of drugs, but it should not be mechanically copied, and should be adapted to local conditions, such as serious illness should be large, light and shallow should be small, light drugs should be small, heavy drugs should be large, acute diseases should be heavy, and chronic diseases should be light. At the same time, we should pay more attention to the relative amount of drugs, which reflects the proportion of the dosage of each drug, including the prescription, and its change can not only affect the performance of the prescription, but also affect its curative effect; Although the ancient and modern measurements are different, their proportions are unchanged [8,9, 13, 14].

Discussion on dosage application of several commonly used drugs

Glycyrrhiza uralensis Fisch: The dosage of Glycyrrhiza uralensis Fisch in Treatise on Febrile Diseases is very strict. According to the different functions of the prescription, the large dose is selected as the monarch, which has the function of restoring yang and benefiting qi, and the small and medium doses are mostly adjuvant drugs, which can alleviate the medicinal properties [15]. The control of its dosage also depends on the following principles: (1) the exterior syndrome is light and the interior syndrome is heavy; The empirical evidence is light, and the virtual evidence is heavy; Heat syndrome is light and cold syndrome is heavy; Treating dampness lightly and astringing yin again; Treat dysentery lightly, and treat diarrhea severely [16].

Ginger and Jujube: The dosage of ginger and jujube in Treatise on Febrile Diseases has the following rules: ① For those who use less, 1 ~ 2 two (3 ~ 6g) ginger and 4 ~ 6 jujubes are mostly used for those who have mild cold, slow illness and need slight sweating; ② General dosage: 3 ~ 4 taels of ginger (9.5 ~12.5g) and jujube/kloc-0 ~15 pieces, which are mostly used for the syndrome of muscle surface of wind-cold bundle and fighting of pathogenic factors; ③ For those who use ginger in large quantities, 5 ~ 6 taels (15.5 ~18.7g) and 25 jujubes, Jiang Duo is widely used for diseases with severe pathogenic factors, and jujube is widely used for patients with qi deficiency [17].

Ramulus Cinnamomi and Radix Paeoniae Alba: Shihong [18] According to the changing law of the dosage of Ramulus Cinnamomi in Zhongjing, 6 ~ 9g is a medium dose, less than 6g is a small dose, and more than 9g is a large dose. When a large dose is used, it should be taken gradually and repeatedly. In classic prescriptions, Guizhi and Paeonia lactiflora are often used together, and their dosage characteristics are: constant dosage, small dosage, high dosage of Guizhi, low dosage of Guizhi, high dosage of Paeonia lactiflora, low dosage of Paeonia lactiflora and so on. All these are used in equal amounts, whether constant or small, and usually play a role in regulating nutrition and health; On the contrary, either the defense or the camp. Generally, cassia twig is mainly used to quell adverse events, and Paeonia lactiflora is mainly used to relieve pain; If the ratio of Cinnamomum cassia and Paeonia lactiflora is slightly changed, along with the change of compatible drugs, its curative effect mainly depends on the change of compatible drugs [19].

Gypsum: Gypsum is generally used in classical prescriptions, and so is modern clinical application. However, Angus [20] thinks that the dosage of decocted drugs should be determined according to the solubility of drugs, and the solubility of minerals and shellfish is small. Therefore, reducing the dosage of gypsum in Maxing Shigan Decoction and other prescriptions can also achieve the same effect as high-dose drugs.

Radix Aconiti Lateralis: The use of Radix Aconiti Lateralis in Treatise on Febrile Diseases has the following characteristics: ① According to the severity of illness and different causes, the dosage and raw and cooked quality of Radix Aconiti Lateralis are determined. Generally, the syndrome of yang deficiency should be reused in raw materials, the syndrome of yang deficiency should be used lightly, and the cold-dampness arthralgia should be reused; ② The dosage is determined according to sex and physical strength [2 1].

Pinellia ternata: generally 9 ~ 15g can be used to treat spleen dampness, phlegm retention, nausea and vomiting, such as Huandai Zhetang; Xiaobanxia decoction can also be used as 15g, but it should be basically the same as ginger, not significantly higher than its dosage; For severe subcardiac mass, intractable vomiting and swallowing due to qi-resistance or insomnia, a large amount of 30 ~ 60g or even 120g (long-term decoction) should be given, such as Ginger Xiexin Decoction. For syndrome types such as yin deficiency, spleen deficiency and excessive dampness, and poor stomach qi, a small amount of 6 ~ 9g should be used as Zuo Wei's envoy, especially for patients with spleen and stomach yin deficiency, the amount should be small but not large, such as Maimendong Decoction [22]. Hu [23] also thinks that it is enough to reduce phlegm and stomach (about 10g), and nausea and vomiting caused by excessive phlegm will increase appropriately, about 15g, and insomnia will be reused to 30 ~ 60g, with obvious effect.

Asarum: The dosage of asarum has been controversial. According to the custom of later generations, the dosage of prescription greatly exceeds the constant (except according to the ancient medicine scale). It is a classic prescription for later use, and asarum is often reduced. According to clinical practice, Wang [24] thinks that the patients with yang deficiency and severe cold and dampness can use a large dose (up to 20g), and the dosage must be reduced when the condition improves; If the onset is purely exogenous wind-cold and yang deficiency, moderate dosage (10g) should be used. If the symptoms of heat are severe and the symptoms are wet and turbid, a small amount of 2 ~ 5g can be used as an aid. Natural dysentery, diarrhea, cough and asthma, etc. If the course of disease is long and the deficiency and cold are serious, it can also be used in large quantities.

Four. Concluding remarks

To sum up, the research conclusions of ancient and modern weights and measures are not consistent, and the clinical application is not followed, emphasizing that it depends on factors such as illness and physique; We don't stick to the absolute quantity of classics, but pay more attention to the determination of relative quantity.

The author thinks that it is really necessary to study the changes of weights and measures in the study of the dosage of classical prescriptions, but it is not appropriate to make the past serve the present. We should know that ancient and modern physical fitness, climate, environment and other factors have changed greatly. How can we generalize? In addition, although the weights and measures system in Han dynasty was unified, it is difficult to determine whether Zhongjing's prescription dosage was measured according to the unified national measurement during the war, and it may be measured by folk methods or other medicine scales. Judging from his writings, the measurement units of the same drug are not consistent, such as the difference between a foot and a half of magnolia officinalis and a handful of bamboo leaves with gypsum. Therefore, in the future research, it is not appropriate to overemphasize the quantitative test, but to observe the curative effect of different doses and different proportions of prescriptions through experimental means on the basis of clinical practice. For example, taking an animal model as the experimental object, compare the ancient quantity with the present quantity, compare the classical ratio with the changing ratio, or compare the influence of factors such as different regions and different climates on the dosage of prescription drugs. Various advanced methods are widely cited to study it, which is expected to obtain more meaningful results in clinic.

refer to

[1] Jia Wencheng, et al. Preliminary study on the dosage of Treatise on Febrile Diseases and Synopsis of the Golden Chamber. Liaoning journal of traditional chinese medicine1985; (4):38

[2] Ke, et al. Dosage of Treatise on Febrile Diseases and Synopsis of the Golden Chamber. Journal of traditional chinese medicine1983; ( 12):36

[3] Gu, my opinion on the dosage of classical prescriptions, Beijing Traditional Chinese Medicine1987; (3): 14

[4] Zhang Treatise on Febrile Diseases and Synopsis of the Golden Chamber. Jilin Traditional Chinese Medicine1987; (6):42

[5] Ella, On the dosage of classical prescriptions, journal of traditional chinese medicine, Zhejiang1981; (5):8 1

Wang Yiming, Qingyuan, Journal of Beijing College of Chinese Medicine1986; 9(2): 10

[7] Mi Bolang, taking Guizhi Decoction as an example, discusses the transformation of traditional Chinese medicine prescription metrology, Proceedings of the Second Symposium on Zhongjing Theory in China 1987, 10: P2.

[8] Discussion on the dosage of traditional Chinese medicine prescriptions in Jiang Jianguo1986; 27( 1 1):864

[9] How does Professor Qi's mailbox view the dosage of new Chinese medicine in Treatise on Febrile Diseases1982; ( 1 1):43

[10] Wang Guosan's Theory on the Dose Application Law of Zhang Zhongjing Journal of Beijing College of Chinese Medicine1983; (4): 13

[1 1] Liu Jianqi. Dose research methods of Treatise on Febrile Diseases. Liaoning journal of traditional chinese medicine1988; (3): 12

[12] Cai Xujiang paid attention to the dosage of prescriptions in Treatise on Febrile Diseases. The 2nd China Symposium on Zhongjing Theory: 1987, 10: P80.

Journal of Shaanxi College of Traditional Chinese Medicine; (2):8

[14] Yue Meizhong's Discussion on Prescription Compatibility and Dosage, journal of traditional chinese medicine, Zhejiang1977; (4):35

[15] Zhao Zhijin on the dosage and contraindications of licorice in Treatise on Febrile Diseases journal of traditional chinese medicine1983; (5): 10

[16] Discussion on the application law of Hu Zhongjing to licorice. Sichuan Traditional Chinese Medicine1983; ( 1):2 1

[17] Liu Hantang, et al. Preliminary study on Zhongjing Jiangzao. Henan Traditional Chinese Medicine1982; ( 1):9

[18] Clinical application of Hongjia and Guizhi in internal medicine Shanghai Journal of Traditional Chinese Medicine1982; ( 1): 13

[19] Zhang Xiaoping et al. Discussion on the law of Zhang Zhongjing's Gui Shao combination. Liaoning journal of traditional chinese medicine1983; (8): 10

[20] Anton Zhu talks about the dosage of gypsum. Jilin Traditional Chinese Medicine1982; (4):47

[2 1] and Jian Qing. On the dosage of aconite and the use of raw guns from Treatise on Febrile Diseases. Journal of traditional chinese medicine1982; (5):37

[22] Niu Tan's dosage of Pinellia ternata journal of traditional chinese medicine1986; 27( 10):787

[23] Hu, on the dosage of Pinellia ternata, journal of traditional chinese medicine1986; 27( 10):787

[24] my opinion on the dosage of Herba Asari in Wang Zhenxiang and Jilin1982; (1): 48 Reprinted and added: The dosage units of prescriptions in Treatise on Febrile Diseases include Jin, Liang, fen, Zhu and Shu, which are different from the current dosage units. In this regard, the author consulted the relevant literature, and combined with his own clinical experience, confirmed that the study of Zhongjing dose unit must be combined with clinical practice, and only from clinical practice can we avoid literature-to-literature. According to Li Ming's Compendium of Materia Medica, "The ancient system is different today, and the ancient one or two can be used today." For another example, Qingcheng Zhi said in Notes on Treatise on Febrile Diseases: "In ancient times, about one or two were used, but now one yuan is enough." By "ancient" Li means the Eastern Han Dynasty, and "present" refers to the era in which he lived. Now the dosage units of prescriptions in Treatise on Febrile Diseases are converted into today's dosage units: one or two 3g, one inch 18 ~ 30g, one yuan 1.5 ~ 1.8g, one foot 30g, one cloud as chicken 48g, one (volume) 6 ~ 8ml. Aconitum carmichaeli 1 root 5g, almond and peach kernel cloud 40 10g, Fructus Aurantii Immaturus 1 ~ 2g, Aconitum carmichaeli 1 2~3g, bamboo leaves 1 tablet 10g. If Zhongjing talks about "money" in Zhong Fang, it can be calculated from "money". The "money" mentioned by Zhongjing and the "money" mentioned later cannot be converted into 3G. As for the word "points" in some prescriptions, it is not the word "points" in which ten millet is one baht, six baht is one minute and four baht is one or two, but the word "points" in the dosage division of each prescription. Therefore, understanding the word "fen" cannot be converted into about 0.8g However, in order to unify the dosage of prescriptions into international standard units of measurement, the "fen" of some prescriptions is now converted into 3g, such as mountain tablets, which can be used as a reference for clinical use. In this regard, we should also know that in clinical practice, the dosage of prescriptions can be appropriately increased or decreased according to the specific condition, so that the composition of prescriptions and drugs corresponds to the syndrome mechanism and the purpose of treating diseases can be achieved. & lt/p & gt；