Research On Incompatibility Of The "Eighteen Incompatible Medicaments" In Song Jin And Yuan Dynasties

OBJECTIVE:The concept of18incompatible drugs is the core of incompatibility of traditional Chinese medicine (TCM). With thousands of years of history, it is of guiding significance for clinical practice. All the versions of Pharmacopoeia of People’s Republic of China record the18incompatible drugs as the incompatibility. It is also a hot issue in the modernization of TCM. Many scholars have engaged in the research of the18incompatible drugs. Especially in recent years, medical security problem which is attracting extensive attention led to realize the need for multi-angle and multi-level researches into the18incompatible drugs, such as the exploration of the toxic mechanism, transformation conditions so as to interpret traditional incompatibility and to guide clinical practice.Compared with the importance of the18incompatible drugs in the development of TCM and related pharmacology, its historical literature research needs to be strengthened, such as taboo words used in the ancient literatures about Chinese Meteria Medica, the impact of social and medical environment on it, the process of naming the incompatible TCM drugs after the18incompatible drugs, development of the related poems, its theory connotation as well as clinical observation and records. In addition, medical literature on the18incompatible drugs in different periods should be integrated and standardized to build data platform for further discussion.METHODS:This thesis studied into the important period, Song, Jin and Yuan Dynasties, in which the theory of the18incompatible drugs bloomed by applying traditional literature research method to analyze its taboo words, connotation, development as well as the related poems and the issue about the incompatible pairs used in the same formula after collecting relevant medical books during this period. In combination with modern literature database and the classic association rule, the literature resources of the18incompatible drugs in the medical books about Chinese medicine and formulas of Song, Jin and Yuan Dynasties were collected and standardized to establish its document database and to mine the formulas containing the incompatible pairs.RESULTS:1. Song, Jin and Yuan Dynasties is the critical time in the development of the theory of the18incompatible drugs, which is characterized by the following aspects:(1) TCM incompatibility theory recorded in Shen Nong’s Classic of the Materia Medica changed in Song, Jin and Yuan Dynasties. The incompatible drugs are separated from drugs belonging to the seven emotions and firstly listed alone in Formulas from Benevolent Sages Compiled during the Taiping Era (992).(2) In the Southern Song Dynasty, the name of18incompatible drugs appeared.the18incompatible drugs was used to generalize all the incompatible drugs recorded in Shen Nong’s Classic of the Materia Medica. The earliest records appeared in the general book called The Trivials in the Southern Song Dynasty.(3) In Jin and Yuan Dynasties, poem was applied to record the incompatible drugs. Medical books like Book to Safeguard Life (1216), Baoqing Materia Medica(1248), Yanxia Effective Formulas (1199-1282), and Confucians’Duties to Their Parents (1224-1231) recorded these poems, which made a far-reaching impact on the spread of the18incompatible drugs in the ages to come.(4) We found the corresponding detoxicating formulas. Chen Yanzhi before Song Dynasty pointed in his book of The Short Formulas that the vilating the incompatible taboo will cause prolonged injure. Zhu Danxi recorded his clinical observation on Radix el Rhizoma Veratri Nigri’s resveratrol failure of Radix et Rhizoma Ginseng (Supplement to the ’Extension of the Materia Medica’); Doctor Zhu’s Effective Medical Formulas Arranged by Category also recorded the earliest poisoned formula containing the incompatible drugs.(5) The mechanism of incompatible drugs used in one formula. The relevant theoretical interpretation and clinical observation data such as Jifeng Formulas for Universal Relief recorded the viewpoint that the incompatible drugs enhance each other; Formulas for Universal Relief put forward that the incompatible drugs restrict each other.2. the disease and syndrome characteristics of formulas containing incompatible drugs are as follows:(1) The incompatible drugs used in the same formula in the period of Song, Jin and Yuan Dynasties.19formula books were collected, getting283formulas containing incompatible pair of drugs, including180pieces of Radix Aconiti group,27Radix et Rhizoma Veratri Nigri group,26Radix et Rhiuzoma Glycyrrhizae group,5with more than one pair of incompatible drugs. The most frequently used incompatible drugs are Rhizoma Pinelliae and Radix Aconiti, appearing in71formulas, accounting for25.08%.(2) Disease characteristics of the formulas containing incompatible drugs in Song, Jin and Juan Dynasties. They were mainly used in the acute and severe condition, and chronic diseases. Radix Aconiti group mainly treated the disease caused by wind combined with phlegm and dampness, such as stoke, tetanus and arthritis. The medicine was usually taken orally. The Radix et Rhizoma Veratri Nigri group mainly treated carbuncle-abscess and oral diseases, which were used externally and had the function of detoxification, desinsection and detumescence. The Radix et Rhiuzoma Glycyrrhizae group mainly treated scrofula and gall. In the aspect of incompatible drugs used in one formula, drugs with the function of reducing phlegm, warming yang, promoting the blood circulation and nourishing the body were applied.3. Ancient literature database of the18incompatible drugs was established.The establishment of. It has included151medical literatures in Song, Jin and Juan Dynasties, a total of1032related records. The database is an open type, whose content will continue to expand.CONCLUSION:1. The period of Song, Jin and Juan Dynasties is an important period of the development of the18incompatible drugs. The recording formation and type in Shen Nong’s Classic of the Materia Medica changed, single recording and poems appeared, and the name of the18incompatible drugs was begun to be used. These changes promoted the spread of this concept in the coming ages.2. There were plenty of documents discussing this issue by many TCM doctors in Song, Jin and Juan Dynasties. Not only did they record the clinical observation, for example, Zhu Danxi put down Radix et Rhizoma Veratri Nigri’s resveratrol failure of Radix et Rhizoma Ginseng, but also discussed the rationality of the incompatible drugs in one formula and put forward the viewpoint that the incompatible drugs can enhance each other as well as the detoxified formulas.3. In Song, Jin and Juan Dynasties, the incompatible drugs have certain characteristics in disorder and compatibility environment, which is of significance of further study into the scientific mechanism and transformation condition of the18incompatible drugs.