The dosage of traditional Chinese medicine is mainly considered according to the patient's constitution, symptoms, living area, climate, and the selected prescriptions and drugs. Due to the different purposes of use, the dosage is also different. The same drug, depending on the dosage, will have different effects or produce new functions, thus exerting a greater effect. In particular, oversized doses, when used properly, often have unexpected miracle effects.
Therefore, the relationship between the dosage and effect of Chinese medicine deserves our attention, as the Japanese Watanabe Xishi said: "The secret of Chinese medicine is not told, that is, in the dosage." "That's a very insightful word. Examples are given in the practice of the nearest person and the individual.
First, motherwort 90g water to reduce swelling
This product is hard and cold, the main role is to activate the blood to regulate menstruation, so it is generally used for menstrual irregularities, postpartum blood distention and internal damage and stasis. Although the Shennong Materia Medica once mentioned the utility of "removing water vapor", few later generations applied it, or thought that "the work of water consumption is not significant", which is the reason why it is not mastered.
When this product is used as a "menstrual invigorating blood", its dosage is generally 9 to 15g. If it is used for "water reduction", it will take a large amount to be effective. The diuretic effect of motherwort, I observed clinically, with 30 ~ 45g per day has not yet worked, and then increased to 60 ~ 90g, the first obvious effect. Try to treat acute nephritis of oliguria, puffiness, constant one dose to know, two doses have been.
Prescription: Motherwort 60g, Zelan leaf 20g, hibiscus flower 12g, licorice 3g.
【Flavor with evidence】Feng Shui type people add ephedra 3 ~ 5g; real heat type increase yellow 5 ~ 8g, raw locust horn 15g; qi and blood weak people add angelica 10g, astragalus skin 20g. In addition, for single abdominal distension (cirrhosis of the liver with ascites) or other edema, 90g of this product can be added to the dialectical treatment to enhance the effect of water reduction.
Second, 250g of cabbage to treat urinary retention
This is a wild vegetable that is used for medicinal and food, the stems and leaves are mostly used as vegetables, seeds, flowers into medicine, in fact, the whole herb has a medical effect. Ganwen is non-toxic, and all the herbs are said to be able to benefit the liver and eyesight, benefit the stomach and medium, and tonify the five internal organs. Its main effects are two: one is to stop the blood, which is used for hemoptysis and leakage; and the other is to stop diarrhea.
The pharmacology teaching and research group of Jiangxi Medical College has conducted experimental research on its pharmacological effects, and believes that the decoction and flow extract have the effect of directly stimulating smooth muscle such as uterus, shortening the clotting time of animals, and reducing blood pressure. The dosage of seeds and flowers into medicines is generally 10 to 15g. However, the unilateral use of large doses in the folk to treat urinary retention is effective, and it is also the result of increasing the dose and exerting a greater role.
Urinary retention is a sequelae of febrile diseases, especially enteritis and polio, which often appear after the initial improvement of urinary catheterization can only alleviate the symptoms for a while, and may not solve the problem. However, after taking this product, it can resume automatic urination within 6 to 24 hours and heal quickly.
The basis for its treatment can also be found in the literature with some clues, such as Tang's "Medicinal Materia Medica": "Tonic deficiencies in the five viscera ... Cure bloating", "Daming Family Materia Medica": "Li Wu Viscera", so it has the effect of adjusting and restoring urinary disorders after illness.
Modern pharmacological research has proved that it has the effect of directly exciting smooth muscles such as the uterus, of course, the bladder that belongs to the smooth muscle tissue will inevitably get the effect of excitement, contraction and urination at the same time. Take about 250g of fresh cabbage per day, halve the light, decoct the soup, take it once every 3 to 4 hours, take it continuously, until it works, pregnant women are contraindicated.
3, Half summer 9-18g cured pregnancy prevented
Because of the dry and poisonous heat of the raw half summer, it is generally made of ginger and reduced in its dosage. In the clinic, it is used to reduce gastric reversal and dry and humidify phlegm, although it has a certain effect, but for the comprehensive medical effect of half summer, it is greatly weakened.
Regarding the poisonous and non-toxic problem of raw half a summer, I agree with Jiang Chunhua's opinion, although the living are poisonous, but once they are cooked, the raw ones are cooked, and the toxicity is greatly reduced. Yu Di used 9 to 18g of raw half summer to treat pregnancy obstruction, Heng a dose that is, flat, experienced and unhappy, never seen poisoning and abortion cases. If one-sided fear of its hardness and not use it, and do not exhaust it, it is regrettable that it has done its full work and is regrettable.
Pregnancy obstruction is a relatively stubborn phenomenon in the treatment, but Banxia has a special contribution to this. In the Han Dynasty Zhang Zhongjing's "Outline of the Golden Plateau", he used dried ginger ginseng half-summer pills to treat pregnancy obstruction, which did not hinder the fetus. However, because the "Famous Doctors' Catalogue" contained the saying of "abortion", they were afraid and did not use it, resulting in the loss of the merits of good medicine. Yu used half a summer as a main drug to treat malignancy, and none of the cases failed. In the past, they all used to use the raw half summer, but some patients had doubts, but they switched to the system of half summer, and the effect was not satisfactory, but the stubborn people were not alive and did not heal.
Prescription: half summer 9 ~ 18g (first use a small amount, not effective and then add; if the manufacturer is ineffective, then switch to the raw person, and take 3 slices of ginger), cassia seeds 12g, raw ochre 15g, spiral flower 9g, tangerine peel 3g.
Take 1 bowl of water and take it slowly; if it is half summer, drink only one sip at a time, swallow slowly, every 15 minutes, take another bite, about half a day to finish, should not drink it all. Constant one dose is flat, the dramatist continues to take it, there is no shortage.
Fourth, betel nut 75g break the stagnation insecticide
This product is a famous drug for breaking the stagnation and killing insects, generally with other insecticidal or anti-accumulation products, such as single flavor as a way to drive away hookworms or tapeworms, must use a large number of raw people to start the effect. It has been observed that the dose of hookworm disease is 30g each time, which is ineffective, and 45g is also ineffective, until it is increased to 75 to 90g, and the worm eggs in the stool begin to turn yin. The trail is used in large quantities, and it is a fistula at one time.
This reflects the close relationship between dosage and utility. However, when taking more than 75g at a time, in about half to 1 hour, there are heart failure reactions such as dizziness, sagging qi, pale face, and weak pulses, which are solved after about 2 hours, which also proves the truth that "the medicine does not dizziness, and the disease is not paralyzed".
Prescription and its production: betel nut (the living have a good effect, broken, its tablets due to water immersion, the effect is greatly reduced) 75 ~ 90g, soaked overnight, decoction in the next morning, warm on an empty stomach. If the anemia is serious and the physique is weak, it is necessary to take the product of nourishing qi and blood first, and then take this formula, not Menglang.
5. 30g of summer dry grass for hepatitis
This product tastes hard and cold, good at clearing the liver fire and scattering the knots. Clinically coordinated with yin and soft liver drugs, the treatment of yin deficiency and liver prosperity of hypertension, with soft and firm anti-gall products to cure fistula, the effect is satisfactory. However, the treatment of hepatitis in large doses has developed on the basis of previous practices.
Take summer dry grass decoction or stream extract (can be added sugar as appropriate), each time taking about 30g of raw herbs, 3 times a day, rinse with boiling water. For hepatitis and elevated transaminases, there is an effect of abrupt adjustment; generally take 5 to 7 days, that is, the effect can be seen. Because when the aminotransferase is elevated, it symbolizes that the hepatitis disease has some activity, and in the dialectics of Traditional Chinese medicine, it is mostly the blame for liver fever depression and damp heat stagnation. Summer dry grass is bitter and cold and non-toxic, specialized in the liver and gallbladder two meridians, can replenish the blood of the yin liver family, and the hard can be scattered, and the bitter cold can be discharged to remove damp heat, so it can receive satisfactory results.
6. 60g of goji berries can stop bleeding
This product tastes sweet and flat, work to moisten the lungs and nourish the liver, nourish the kidneys and benefit the qi, for the liver and kidney yin deficiency, insufficient fatigue is the most suitable, the general dosage is 9 ~ 15g, but the dosage is increased to 60g per day, it has the effect of hemostasis, where the tooth Xuan, epistaxis and subcutaneous bleeding (such as thrombocytopenic purpura, etc.) for a long time can not be cured, the symptoms of stubborn people, take the uniform test; daily use of this product 60g, decoction, continuous service 3 to 5 days can be effective. If the dosage is less than 45g, the effect is not obvious, which also reflects the relationship between dosage and action.
Seven, 120g of ear grass to cure leprosy
This product tastes bitter and warm, can dispel weathering and dampness, and is generally used for head wind and nose, rheumatism and pain and sores, swelling and scabies. The commonly used amount is 9 to 15g, but increasing its dose can treat leprosy and tuberculous empyema, and its dose for treating leprosy has been divided into three kinds: 120g decoction once a day, 360g twice a day, and 960g three times a day, and its efficacy is also improved with the increase of the dose.
As for the treatment of tuberculous empyema, it is also necessary to use about 210g per day, which works at the beginning, and after taking it, it can reduce and dilute the pus, reduce the erythrocyte sedimentation rate, and take it for 3 months, and the sores will gradually heal. If you only use the common amount, it will not work.
8. Huanglian 120g for diabetes treatment
This product is cold, bitter taste, good at diarrhea and detoxification, hot and dry, generally commonly used for about 3 to 5g, because of its cold taste bitter, a large number or long service, easy to damage the stomach, so often used with warm medicine, such as with wood fragrant incense pills, with dried ginger ginger liansan, with evodia, white peony pentahex pills, with cinnamon Jiaotai pills and so on.
As Li Shizhen said: "One cold and one hot, yin and yang are harmonious, the most ingenious way to make the formula, and there is no harm in winning.". Therefore, its dosage is generally above and below the commonly used amount.
In recent years, Professor Kobayashi, who has been fornicating for many years, has made breakthroughs in the treatment of diabetes and is worth participating in. He said: "Huang Lian is the most bitter, but the treatment of diabetes is a sweet disease." I use huanglian, usually the dose is 30g per day, and the treatment of diabetic ketosis, up to 120g a day, reduces diabetes rapidly."
Through retrospective analysis, it was shown that 35% of patients reduced the amount of hypoglycemic Western medicine, 30% only used traditional Chinese medicine to maintain stable and ideal blood sugar levels, many patients who had used a large amount of insulin, and even completely stopped insulin, which brought good news to diabetic patients.
Chen Mou, male, 36 years old. He was admitted on July 9, 2010. Present at the doctor for 1 month due to an increase in blood glucose. The patient checked FBG20mmol/L 1 month ago due to obvious thirst, diagnosed with diabetes, injected insulin for a few days, and did not continue treatment due to busy work. Immediate symptoms: dry mouth and bitter mouth, drinking water, fatigue is obvious, sweating more, small frequency, tongue red, moss yellow, pulse slip number. Check: FBG22.1mmol/L, 2hPG34.99mmol/L.
Diagnosis of Western medicine: diabetes mellitus. TCM Diagnosis: Quench thirst. TCM dialectics: fire poison is blazing, consuming qi and yin.
Treatment: Clear the fire and nourish the yin.
Prescription: Dried turmeric with skullcap ginseng soup plus or minus: huanglian 90g, dried ginger 20g, skullcap 30g, American ginseng 9g, Zhimu 60g, mulberry leaf 30g, Huai yam 30g, dogwood 30g.
On July 13, 2010, the second diagnosis: the patient took 4 doses of medicine, thirst, fatigue and other symptoms were significantly reduced, check FBG15mmol/L, 2hPG21mmol/L, adjust the prescription as: Huanglian 90g, raw plaster 60g, Zhimu 60g, smallpox pollen 60g, American ginseng 9g, dogwood 30g, kudzu root 30g, Huai yam 30g, mulberry leaf 30g, rhubarb 3g, ginger 5 tablets.
The patient took 10 doses of medicine, thirst, bitterness, fatigue, sweating and other symptoms relieved by about 80%, check FBG6 ~ 7mmol / L, 2hPG9 ~ 11mmol / L, so the adjustment prescription is: Huanglian 30g, skullcap 30g, Zhimu 30g, smallpox pollen 30g, Kudzu root 30g, ginger 5 tablets, continue to regulate blood sugar.
Press: The patient's initial diagnosis shows a fiery heat, the consumption of qi and yin, and there is a tendency to become more and more intense, so it is urgent to quickly control the fire and break the vicious circle of fire poison as a disease. At this time, the conventional medication is afraid of cup water salary, and it will be necessary to directly fold the fire poison with a large dose of bitter cold and clear fire products, so the lord will use 90g of yellow to detoxify the fire, directly suppress the fire, and use 20g of dried ginger to protect Zhongyang to prevent bitter cold from coming out.
At the same time, with a large number of yin and heat-clearing medicines such as Zhimu, mulberry leaves, and Huai yam, it is necessary to quickly remedy the depletion of qi and yin, prevent it from drying up due to fire tension, and cooperate with Huang Lian as a symptom and root cause. The second diagnosis has obviously achieved results, the fire has been controlled, so a drum, continue to 90g huanglian, remove the residual atmosphere of poisonous fire, to the third diagnosis of fire poison has been completely controlled, so the disease is reduced, changed to huanglian to 30g treatment.
discuss
These are just examples, and the list goes on. Such as the use of large doses of windproof antitrusion, guizhi to treat chronic hepatitis and cirrhosis, wood turtle to cure cancer, Aoki xiang to cure hypertension, houttuynia cordata to cure lobular pneumonia, acacia peel to treat lung abscess, thistle root to cure menstrual autism, citrus shell to cure prolapse, and so on. However, as far as the those listed in this article are concerned, it has been fully explained that the relationship between the dosage and effect of Traditional Chinese medicine is very close and important.
The decision on the dosage of Chinese medicine is to be considered from many aspects, but when it is to play a new role or play a specific role, it is necessary to break through the common dosage and break the concern. As Sun Taishi said in the "Concise Medical Journal": "Whoever has a strange danger in the treatment of medicine, if he wants to see the truth of the disease, he can apply it without scruples." ”
The dose is the core and soul of the prescription, whether the prescription is effective, in addition to the clear dialectic, the treatment is appropriate, the dose is the key to improving the efficacy. Ran Xuefeng, the nearest sage, said it well: "All serious diseases need to use large medicines (large doses), and if the medicine is used properly, the greater the power, the greater the work." "Therefore, the relationship between the dosage and effect of Chinese medicine is very close, which is also an important aspect of the use of Chinese medicine."
Why does increasing the dose enhance or produce new effects? The reasons for this are, of course, many and complex. But in general, can it be said that it is in line with the law of "quantitative change and qualitative change"? From the deduction of this law, more pharmacological mechanisms may be found to exert a greater role of the drug.
However, the increased dose must be determined under certain conditions and within a certain limit, in order to change from a reasonable quantity, causing a benign quality change, otherwise it lacks certain conditions and exceeds a certain limit, and the qualitative change of this quantitative transformation will change from a good thing to a bad thing. Produce undesirable effects or serious consequences.
For example, betel nut with 75 to 90g is deworming, but if the dose is increased, the patient's body adaptability will be unbearable, and shock or serious consequences will occur.
Ming Zhang Jingyue once said in his "Jingyue Quanshu": "To treat diseases and medicines, this is noble and specialized, and it is especially advisable to be brave... But with one taste for the king, two or three flavors for the adjuvant, the large dose into it, the more the merrier. Where is the way to use many? Care must depend on its strength, and those who are harmless are bold enough to use it. "It can be used as a reference for us.
Increasing the dose is not blind and arbitrary affirmation, but based on the extension of clues in ancient and modern literature, or the facts of folk practical experience, through clinical practice and systematic observation. For example, the use of a large number of cabbage to treat urinary retention, on the one hand, folk legend has this experience, on the other hand, modern pharmacological analysis, confirmed that it has the effect of directly stimulating the uterus, bladder and other smooth muscles, so it is reasonable and reliable to use it to treat urinary retention.
Another example is the increase in the transaminases for the treatment of hepatitis in the summer subtilis, which is deduced from its functions of being good at draining liver and gallbladder damp heat, dispersing depression knots, and replenishing liver blood, and only after clinical practice has it been proposed for application. Therefore, increasing the dosage is not speculation out of thin air, but has a clue basis, extends deduction, and after practical observation, it is determined and promoted.
It is worthy of our attention to increase the dosage of traditional Chinese medicine, produce new functions, and play its greater role, but in the specific application, it is also necessary to dialectically discuss the treatment, choose the prescription for the evidence, add flavor with the evidence, and cannot be simple and sloppy. For example, the use of motherwort to treat nephritis edema, with the addition of flavor, the effect is good. This is a key to the use of Chinese medicine, and if this is ignored, it will be the biggest and error of principle.
Finally, it should be explained that it is necessary to increase the dosage of drugs, so that it plays a greater role, to be selective, purposeful, not all drugs increase the dose, will strengthen and produce new effects; at the same time, can not because the increase in the dose can strengthen the efficacy, ignore the role of small doses, the formation of abuse of large doses of bias, both waste of medicinal materials, increase the burden of patients, more damage to the body, this is an aspect that must be prevented.
Because the level of efficacy depends on whether the drug certificate is appropriate, the so-called "medicine is expensive and the disease", the combination is effective, and a small dose can also cure the disease. "Light can go to the real" and "four or two strokes of a thousand pounds", this is the meaning. Therefore, Dai Fu'an said: "The theory of the two (referring to too much and not enough), only in the middle; too much and not enough, are all partial waste", which is a dialectical equality theory that deserves deep consideration.
This article is excerpted from the Complete Works of Chinese Medicine Master Zhu Liangchun · Linzheng Zhizhi Volume", author/Zhu Liangchun, publisher: Central South University Press
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