首页|中成药处方点评的标准与尺度探索(九):寒热并用

中成药处方点评的标准与尺度探索(九):寒热并用

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寒热并用点评是中成药处方点评的内容之一，虽然点评频次不高，但却是与中药药性理论关系最为密切的点评内容，也自然成为了临床药师关注的焦点。从目前现状上看，寒热并用点评主要集中在感冒、脾胃病等较狭窄的范围内，合理性评价方法也存在一系列模糊和争议之处。反对寒热并用的观点认为:寒热属性作为阴阳对立关系的经典代表，本身就具有不相容的含义，且隐藏着潜在的药不对证风险;而支持寒热并用的观点认为:寒热并用不仅是寒热错杂证的标准治法，而且其中蕴含的佐制、中和等特性，是相反相成配伍的核心内容。实际上，中药药性理论的科学研究表明，寒热属性绝非对立和抵消这么简单，寒热并用的内涵也十分复杂，应关注其中的整体调和关系。基于此，在处方点评时，应首先明确中成药的寒热之性及其强弱，摈弃寒热一定不能并用的局限认识，关注寒热属性单纯且明显的特定药品和特定病证阶段，并加强相关内容的科研工作，在不断完善和更新的认识中开展寒热并用点评工作。
The exploration on criteria and compromise in the prescription review of Chinese patent medicines Ⅸ ： the combined use of drugs with Cold property and Heat property
Among the items of prescription review of Chinese patent medicines,the evaluation of combined-use of drugs with Cold nature and Heat nature is focused by clinical pharmacists,which is closely related to herbal property theory.Currently,this work was usually applied on the prescriptions of common cold and Pi-wei diseases.The evaluation methods were also doubted.The against view of the Cold-Heat combined usage believed that Cold and Heat should be opposite concepts which contain the risk of irrational therapy.The support view believed the Cold-Heat combined use would be the normal cure for Cold-Heat complicated syndrome.This kind of combination may be the key to form harmonious and controlled relations.However,the scientific knowledge of herbal property theory did not show a counteract relation between Cold and Heat but a complicated essence of their relationships.Therefore,this paper gave several suggestions for prescription review of Cold-Heat combined usage,such as specifying the properties of Chinese patent medicines,thinking of the traditional understandings,focusing on the drugs and syndromes with clear Cold or Heat nature and strengthening the scientific researches in this field.

Chinese patent medicineherbal medicineprescription reviewclinical pharmacycombined use of drugs with cold property and heat propertythe essence of cold/heat nature theory

金锐、王宇光、薛春苗、孙路路、鄢丹

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首都医科大学附属北京世纪坛医院药剂科,北京100038

北京中医药大学第三附属医院药学部,北京100029

北京中医药大学附属东直门医院药学部,北京100700

中成药 中药 处方点评 临床药学 寒热并用 寒热本质

首都卫生发展科研专项重点攻关项目北京市中医管理局中西医结合项目北京药学会临床药学研究项目首都医科大学附属北京世纪坛医院中青年学科骨干培养专项临床合理用药生物特征谱学评价北京市重点实验室项目

首发2011-2008-012014-ZYJ142013-03院国青2015-QB04

2017

10.13286/j.cnki.chinhosppharmacyj.2017.03.01

中国医院药学杂志
中国药学会

中国医院药学杂志

CSTPCD北大核心
影响因子：1.198
ISSN：1001-5213
年,卷(期)：2017.37(3)
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