A Study On The Dosage Rule Of 50 Commonly Used Drugs In The "Shi Shi Mi Lu"

Shanghan Zabing Lun(Treatise on Cold Pathogenic and Other Diseases)was written by Zhang Zhongjing at the end of the Eastern Han Dynasty.The characteristics of its medication are as follows:it uses few medicines and specializes in powerful medicine,so it is called "the ancestor of prescriptions".The prescriptions in the book are also called "classical prescriptions",has been guiding the clinical use of traditional Chinese medicine for thousands of years."The Secret Records in a Stone Room" is a medical book based on the treatment method written by Chen Shiduo,a physician in the Qing Dynasty.It records many prescriptions and specific drug dosages,shows his rich clinical diagnosis and treatment experience,and reflects Chen Shiduo's unique drug dosage features;Many diseases recorded in it are still common in modern society,and the dosage of drugs still has certain reference significance for modern clinical treatment of similar diseases,and has high research value.Moreover,the prescriptions and medicines in Shanghan Zabing Lun often appear in The Secret Records in a Stone Room,and Chen often takes the name of Zhang Zhongjing to explain the effects of medicines and the methods of treatment,and the medicines used in the two have a relatively high degree of overlap.The dosage rule of 50 commonly used medicines in classical prescriptions can reflect Zhang Zhongjing's clinical medication experience to a certain extent.Therefore,it is possible to compare the usage rules of the two,and then to study and analyze the use of 50 commonly used medicines in classical prescriptions in The Secret Records in a Stone Room medication characteristics.Object?Based on the specific statistics,graphs and related literature,compare the dosages of 50 commonly used medicines in classical prescriptions in The Secret Records in a Stone Room and Shanghan Zabing Lun,The Secret Records in a Stone Room and Pharmacopoeia(2020 edition),we can clearly understand the difference between the doses in different periods,so as to improve the research related to the drug dosage theory,and provide a certain basis for the modern clinical formulation of safe,effective and reasonable drug dosages;?Understand Chen Shiduo's drug dosage in The Secret Records in a Stone Room through a series of data,which has certain reference value for clinical TCM physicians to learn Chen Shiduo's experience in medication and disease treatment,and can broaden the treatment thinking;?By sorting out the large-dose drugs used in The Secret Records in a Stone Room,it can help us to better understand the necessity,effectiveness and safety of the large-dose drugs in the Shanghan Zabing Lun.Under the premise of accurate syndrome differentiation,the large doses in Shanghan Zabing Lun can be boldly used in the treatment of chronic,critically ill or intractable diseases,which will help modern TCM clinical break through the shackles of small doses and provide theoretical basis and guidance for the inheritance and development of TCM.Methods?Using manual retrieval method and screening according to the inclusion and exclusion criteria,enter the dosage of the 50 commonly used in classical prescriptions in The Secret Records in a Stone Room into the Excel table and establish a database;?Enter only decoctions,and dosage forms such as pills,powders,ointments,Dan are not entered;?Data processing:use SAS8.2 statistical software to count the frequency,common dosage,average dosage,dose interval,common dosage range,etc.;?Analyze the data after completing the statistics,and put it in The Secret Records in a Stone Room.The dosage was respectively compared with Shanghan Zabing Lun and "Pharmacopoeia".Results?In terms of the commonly used doses,except for the common dose of polyporus umbellatus in The Secret Records in a Stone Room,which is slightly larger than Shanghan Zabing Lun.the commonly used doses of other medicines in The Secret Records in a Stone Room are less than Shanghan Zabing Lun.?In terms of average dosage,except for the two herbs of Angelica and Astragali,the average dosage in The Secret Records in a Stone Room is larger than that of Shanghan Zabing Lun,the dosage of other medicines in The Secret Records in a Stone Room is less than that in Shanghan Zabing Lun.?From the perspective of the dose distribution interval,there are 9 herbs in the dose distribution interval of the two books that do not overlap at all.These 9 herbs'dose distribution intervals in Shanghan Zabing Lun are all larger than those in The Secret Records in a Stone Room,among which the most notable are Fructus Evodiae and Fructus Aurantii Immaturus.The dose distribution interval of most herbs in Shanghan Zabing Lun is larger than that in The Secret Records in a Stone Room.?From the common dosage range,the lower limit of the common dosage range of all drugs in Shanghan Zabing Lun is larger than the lower limit of the The Secret Records in a Stone Room.In addition,except for the upper limit of the common dosage range of Astragalus root in The Secret Records in a Stone Room is larger than the upper limit in the Shanghan Zabing Lun(the difference is 51.9g),and the upper limit of the common dose range of other drugs in Shanghan Zabing Lun is larger than the upper limit in The Secret Records in a Stone Room.The usual dose range of most drugs in Shanghan Zabing Lun is larger than that in The Secret Records in a Stone Room.On the whole,the commonly used dose range of drugs in Shanghan Zabing Lun far exceeds that of The Secret Records in a Stone Room including Ophiopogon japonicus,unprocessed rehmannia root,Gypsum and medicinal evodia fruit.From the perspective of the dose range difference,there are 19 drugs in The Secret Records in a Stone Room that have a larger dose range difference than the "Pharmacopoeia".Among them,the drug with the largest difference is Astragalus,and the dose range of Astragalus in The Secret Records in a Stone Room is 55.1g larger than the dose range in the"Pharmacopoeia",and the difference between the two dose ranges is 2 times.Radix Puerariae and Radix Rehmanniae Recens also had a large difference in dose range,with a difference of more than 20g.There are 9 drugs in the "Pharmacopoeia" that exceed the dose range in The Secret Records in a Stone Room,including Bupleurum.Scutellaria,Zingiber,Gypsum,Evodiae.Ephedra,Herba Artemisiae,Radix Stephaniae Tetrandrae,and Fructus Forsythiae,among which the largest difference of the dosage range is Gypsum,with a difference of 18.9g in the dose range of the two.The dose range of the other 8 drugs is similar to the dose range in The Secret Records in a Stone Room and in the "Pharmacopoeia".including Herbaceous Peony,Rhizoma Pinelliae,Fructus Schizandrae,Moutan Cortex.Ramulus Cinnamomi.Rhizoma Cimicifugae,Rhizoma Anemarrhenae,Fructus Aurantii Immaturus.And most of the commonly used dose ranges of drugs overlap in The Secret Records in a Stone Room and in the "Pharmacopoeia",and the overlapping part is relatively large,only the commonly used dose range of Asarum does not overlap at all in the two,and the two former doses of range is 9 to 11 times the latter.From the classification of medicines,comparing the dosages of 50 commonly used medicines in classical prescriptions in The Secret Records in a Stone Room and Shanghan Zabing Lun,the results show that the doses in The Secret Records in a Stone Room are greater than those of Shanghan Zabing Lun.The most common medicine is tonic,with 7 flavors.The drug in Shanghan Zabing Lun with a dose greater than that of The Secret Records in a Stone Room the most is relieving exterior disorder drug,with 8 flavors;The Secret Records in a Stone Room has a higher dose than "Pharmacopoeia" with the most doses are tonic drugs with 7 flavors,and the drugs with the most doses in the "Pharmacopoeia" than those in The Secret Records in a Stone Room are the heat-clearing drugs,with 7 flavors.ConclusionBy comparing the commonly used doses,average doses,dose distribution intervals,and commonly used dose ranges of the 50 commonly used herbs in The Secret Records in a Stone Room and in the Shanghan Zabing Lun,it can be found that most of the drugs are in Shanghan Zabing Lun is significantly higher than the dosage in The Secret Records in a Stone Room.Among them,the relieving exterior drugs have the most doses greater than those in the The Secret Records in a Stone Room,and the drugs of the tonic drugs in the The Secret Records in a Stone Room have the most doses greater than those in Shanghan Zabing Lun.By comparing the commonly used dosage range of 50 herbs of classical prescriptions in The Secret Records in a Stone Room with that in the 2020 edition of the "Pharmacopoeia",it is founded that the dosages of 50 commonly used herbs of classical prescriptions in The Secret Records in a Stone Room compared with those of prescribed dose in the"Pharmacopoeia" is relatively close.Among them,the dose of tonic drugs in The Secret Records in a Stone Room is greater than that of the drugs in the "Pharmacopoeia",and the dose of the heat-clearing drugs in the "Pharmacopoeia" is greater than that of the drugs in the The Secret Records in a Stone Room.That is to say,the dosage of 50 commonly used medicines of classical prescriptions in Shanghan Zabing Lun is much larger than that in The Secret Records in a Stone Room and the 2020 edition of "Pharmacopoeia".And discovered that Chen Shiduo clinically used tonic drugs.Comparing the dosages between the three can help us understand the characteristics and differences of their respective dosages,and can also provide a better reference for the dosage of modern clinical Chinese medicine.Chen Shiduo is good at applying large-dose drugs in the treatment of serious illness,chronic illness,critical illness and intractable diseases in The Secret Records in a Stone Room.This is similar to Zhang Zhongjing's "large-dose" medication characteristics,suggesting that Zhang Zhongjing's large-dose medication is necessary,effective and safe.