Study On Compounding Rules Of The Prescriptions With Aconite In Combination With Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino Or Rhizoma Bletillae

As everyone knows, eighteen clashes are regarded as the key content of incompatibility of drugs in a prescription, and play an important role in guiding the clinically safe administration of traditional Chinese medicine.'Do not use the prescriptions with Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino or Rhizoma Bletillae'was an important element of eighteen clashes. In this paper, we compared and analyzed compositions, effects, the main indications and compatibilities of these prescriptions, extracted the characteristic association relationship, and explored the disease features in practice, which might provide references for clinically safe and reasonable administration of these prescriptions.This article mainly included two parts, and the first part was about compounding rules of the prescriptions with Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino and Rhizoma Bletillae in different dynasties. We retrieved84464prescriptions in traditional Chinese prescription of traditional Chinese medicine database (TCMDB) from the Han Dynasty to the initial stage of new China. There were1297prescriptions touching on application of Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino and Rhizoma Bletillae. By means of data mining, the compatibility features, major symptoms and diseases were studied. The results were showed as follows.1. The prescriptions relative to Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino and Rhizoma Bletillae were more than any other prescriptions toughing on concerted application of eighteen clashes. Radix Aconiti Lateralis Preparata was more frequently applied than Radix Aconiti and Radix Aconiti Kusnezoffii. Radix Aconiti Lateralis Preparata was the most frequently compounded with Pinellia of all incompatibilities of drugs in a prescription.2. The prescriptions of Radix Aconiti Lateralis Preparata compounded with Pinellia were the most common of all prescriptions of Aconite compounded with Pinellia. Main drug classes included tonic drugs, interior-warming drugs, and phlegm-resolving drugs, and that specific drugs included Rhizoma Zingiberis Recens, Cortex Cinnamomi, Radix Ginseng, Radix Glycyrrhizae, Poria and Rhizoma Atractylodis Macrocephalae. Major pathogenesis was Yang deficiency and cold manifestation, as well as phlegm, dampness and Qi stagnation. These prescriptions were commonly used to treat spleen-stomach diseases and lung diseases, and some prescriptions were related to heart diseases, liver diseases, kidney diseases, Qi-blood-fluid diseases and limb-meridian diseases. Common symptoms include inappetence, fear of cold, cold in abdomen, fatigue and oppression in chest. There were relatively close association relationships in Radix Glycyrrhizae and Rhizoma Zingiberis Recens, Radix Glycyrrhizae and Radix Ginseng, cold in abdomen and fear of cold, Rhizoma Zingiberis Recens and inappetence, Radix Ginseng and inappetence. Main drug classes in the prescriptions of Radix Aconiti compounded with Rhizoma Pinelliae included antirheumatic drugs, blood-activating&stasis-removing drugs, tonic drugs and superficies-resolving drugs. Frequently-used drugs included Rhizoma Arisaematis, Radix Aconiti, Radix Angelicae Dahuricae, Radix Angelicae Sinensis, Radix Saposhnikoviae and Herba Asari. Major pathogenesis was that pathogenic wind, cold, phlegm and blood stasis blocked the meridians. These prescriptions were mainly used for limb-meridian diseases and Qi-blood-fluid diseases. The former symptoms mainly included headache, facial paralysis and arthralgia, the latter symptoms primarily included mass in abdomen, scrofula and phlegm nuclear lingers. There were relative close association relationships in Myrrha and Olibanum, Radix Angelicae Pubescentis and Rhizoma et Radix Notopterygii, bloody purulent stool and tenesmus, diarrhea and tenesmus, Radix Aconiti Kusnezoffii and phlegmon, Radix Aconiti Kusnezoffii and traumatic injuries. Compounding rules of Radix Aconiti Kusnezoffii combined with Pinellia were similar to those of Radix Aconiti combined with Pinellia.Radix Trichosanthis was the most frequent drug of all the prescription of Aconite compounded with Melon Trichosanthis drugs. Main drug classes included tonic drugs, interior-warming drugs and heat-clearing drugs, and that frequently-used drugs included Rhizoma Atractylodis Macrocephalae, Radix Ginseng, Radix Saposhnikoviae, Poria, Cortex Cinnamomi and Radix Glycyrrhizae. Main pathogenesis was Yang deficiency, lack of body fluid and heat-toxin. The prescriptions were mainly used to treat Qi-blood-fluid diseases and surgical diseases. Main symptoms included sores, scrofula, carbuncle, deep-rooted carbuncle, carbuncle in shoulder and back. There were relatively close association relationships in Radix Saposhnikoviae and Herba Asari, Cortex Cinnamomi and Herba Asari, shoulder-back carbuncle and carbuncle, Cortex Cinnamomi and fear of cold, Radix Saposhnikoviae and fatigue. Main drug classes in the prescriptions of Radix Aconiti Kusnezoffii compounded with Radix Trichosanthis included heat-clearing drugs, superficies-resolving drugs and antirheumatic drugs, and that frequently-used drugs included Radix Angelicae Dahuricae, Radix Saposhnikoviae, Cortex Phellodendri, Radix Angelicae Sinensis, Rhizoma et Radix Notopterygii, Olibanum and Radix et Rhizoma Rhei. Main pathogenesis was toxin stagnation and blood stasis. The prescriptions were primarily used to treat surgical diseases, and that common symptoms included sores, phlegmona, carbuncle, deep-rooted carbuncle, traumatic injuries, and shoulder-back carbuncle. There were relatively close association relationships in Myrrha and Olibanum, Radix Angelicae Sinensis and Radix Saposhnikoviae, mass in abdomen and lumbago, carbuncle and deep-rooted carbuncle, Semen Ricini and phelgmona, Semen Ricini and sores. Compounding rules of Radix Aconiti concerted with Radix Trichosanthis were similar to those of Radix Aconiti Kusnezoffii concerted with Radix Trichosanthis. Main drug classes in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Snakegourd Fruit included heat-clearing drugs, superficies-resolving drugs, antirheumatic drugs, and drugs for-promoting blood circulation and removing blood stasis. Frequently-used drugs included Radix Angelicae Dahuricae, Radix Saposhnikoviae, Radix Angelicae Sinensis, Rhizoma et Radix Notopterygii and Radix Aconiti Kusnezoffii. Main pathogenesis was toxin stagnation and blood stasis, and that these prescriptions were mainly used to treat surgical diseases. Common symptoms included sores, phelgmona, carbuncle, traumatic injuries and mass in abdomen. There were relatively close association relationships in Radix Trichosanthis and Radix Aconiti Kusnezoffii, Radix Angelicae Sinensis and Radix Saposhnikoviae, arthralgia and lumbago, mass in abdomen and arthralgia, Semen Momordicae and sores, Semen Ricini and sores. Main drug classes of Aconitine (exclusive of Radix Aconiti Lateralis Preparata) compounded with Snakegourd Fruit included heat-clearing drugs, antirheumatic drugs, tonic drugs and superficies-resolving drugs. Frequently-used drugs included Radix Saposhnikoviae and Herba Asari, Cortex Cinnamomi, Radix Angelicae Dahuricae and Radix Angelicae Sinensis. Main pathogenesis was toxin stagnation and blood stasis. These prescriptions were mainly used to treat surgical diseases and limb-meridian diseases. The former mainly included sores, phelgmona and carbuncle, the latter primarily included arthralgia and headache. There were relatively close association relationships in Myrrha and Olibanum, Radix et Rhizoma Rhei and Cortex Phellodendri, carbuncle and deep-rooted carbuncle, Myrrha and carbuncle, Rhizoma Coptidis and carbuncle.Bulbus Fritillariae Thunbergii was the most frequently compounded with Radix Aconiti in the prescriptions of Aconite concerted with Fritillary. Main drug classes in the prescriptions of Radix Aconiti compounded with Bulbus Fritillariae Thunbergii included superficies-resolving drugs, antirheumatic drugs, phlegm-resolving drugs and tonic drugs, and that frequently-used drugs included Myrrha, Radix et Rhizoma Rhei, Radix Angelicae Sinensis, Squama Manis and Olibanum. Main pathogenesis was intermingled phlegm and blood stasis, and that the prescriptions were primarily applied to treat Qi-blood-fluid diseases and surgical diseases. The former mainly included mass in abdomen in symptom, the latter primarily included carbuncle and deep-rooted carbuncle in symptom. There were close association relationships in Squama Manis and Radix et Rhizoma Rhei, Squama Manis and Radix Angelicae Sinensis, bellyache and alternate attacks of chill and fever, Rhizoma Atractylodis and bellyache, Pericarpium Citri Reticulatae Viride and bellyache. Main drug classes in the prescriptions of Aconitine (exclusive of Radix Aconiti Lateralis Preparata) compounded with Fritillary heat-clearing drugs, superficies-resolving drugs, drugs for promoting blood circulation and removing blood stasis and antirheumatic drugs. Frequently-used drugs included Radix Angelicae Sinensis, Radix Angelicae Dahuricae, Radix et Rhizoma Rhei, Cortex Cinnamomi and Radix Glycyrrhizae. Main pathogenesis was that pathogenic wind, cold, phlegm and blood stasis blocked meridians. The prescriptions were mainly used to treat surgical diseases and Qi-blood-fluid diseases. The former mainly included phlegmona, sores and carbuncles in symptom, the latter primarily included mass in abdomen in symptom. There were close association relationships in Radix Angelicae Pubescentis and Rhizoma et Radix Notopterygii, Myrrha and Olibanum, Radix Paeoniae Rubra and phlegmona, Branch Willow and phlegmona.Radix Aconiti Lateralis Preparata was most frequently compounded with Ampelopsis Japonica Makino in the prescriptions of Aconite concerted with Ampelopsis Japonica Makino, and that main drug classes included tonic drugs, interior-warming drugs, heat-clearing drugs and drugs for promoting blood circulation and removing blood stasis. Frequently-used drugs included Cortex Cinnamomi, Radix Angelicae Sinensis, Rhizoma Ligustici Chuanxiong, Radix Saposhnikoviae, Radix Glycyrrhizae, Herba Asari and Radix Angelicae Dahuricae. Main pathogenesis was Yang deficiency, toxin stagnation and blood stasis. The prescriptions were mainly applied to treat surgical diseases and limb-meridian diseases. The former mainly included sores, traumatic injuries, carbuncles and deep-rooted carbuncles in symptom, the latter primarily included arthralgia and limb numbness. There were relatively close association relationships in Radix Angelicae Dahuricae and Radix Aucklandiae, Rhizoma Ligustici Chuanxiong and Radix Angelicae Sinensis, carbuncle and deep-rooted carbuncle, Radix Angelicae Sinensis and traumatic injuries, Rhizoma Ligustici Chuanxiong and traumatic injuries.Main drug classes in the prescriptions of Radix Aconiti compounded with Ampelopsis Japonica Makino included heat-clearing drugs, antirheumatic drugs and drugs for promoting blood circulation and removing blood stasis, and that frequently-used drugs included Radix Angelicae Sinensis, Radix Angelicae Dahuricae, Rhizoma Bletillae, Cortex Cinnamomi and Myrrha. Main pathogenesis was pathogenic wind, cold, dampness, toxin stagnation and blood stasis. The prescriptions were mainly applied to treat surgical diseases and limb-meridian diseases. The former mainly included sores, traumatic injuries and phlegmona, the latter primarily included arthralgia and spasm of limbs. There were relatively close association relationships in Myrrha and Olibanum, Radix Aconiti Kusnezoffii and Radix et Rhizoma Rhei, sores and phlegmona, carbuncles and deep-rooted carbuncles, Radix Achyranthis Bidentatae and arthralgia, Radix et Rhizoma Rhei and sores. Compounding rules of Radix Aconiti Kusnezoffii concerted with Ampelopsis Japonica Makino were similar to those of Aconitine (exclusive of Radix Aconiti Lateralis Preparata) concerted with Ampelopsis Japonica Makino.Radix Aconiti Lateralis Preparata was usually compounded with Rhizoma Bletillae in the prescriptions of Aconite conbined with Rhizoma Bletillae, and that main drug classes included interior-warming drugs, drugs for promoting blood circulation and removing blood stasis, heat-clearing drugs and tonic drugs. Frequently-used drugs included Radix Angelicae Sinensis, Cortex Cinnamomi, Radix Angelicae Dahuricae, Ampelopsis Japonica Makino and Rhizoma Ligustici Chuanxiong. Main pathogenesis was Yang deficiency, toxin stagnation and blood stasis. The prescriptions were mainly applied to surgical diseases, and that common symptoms included sores, traumatic injuries, deep-rooted carbuncles, carbuncles and carbuncles in shoulder and back. There were relatively close association relationships in Radix Angelicae Sinensis and Cortex Cinnamomi, Radix Angelicae Dahuricae and Radix Angelicae Sinensis, deep-rooted carbuncles and carbuncles, carbuncles in shoulder and back and deep-rooted carbuncles, Radix Astragali seu Hedysari and carbuncles, Radix Saposhnikoviae and sores. Main drug classes in the prescriptions of Radix Aconiti compounded with Rhizoma Bletillae included antirheumatic drugs, heat-clearing drugs, drugs for promoting blood circulation and removing blood stasis and superficies-resolving drugs, and that frequently-used drugs included Radix Aconiti Kusnezoffii, Radix Angelicae Sinensis, Ampelopsis Japonica Makino, Radix Angelicae Dahuricae, Radix et Rhizoma Rhei and Myrrha. Major pathogenesis was pathogenic wind, cold, dampness, toxin stagnation and blood stasis, and that the prescriptions were primarily applied to treat surgical diseases. Common symptoms included phlegmona, traumatic injuries, carbuncles and deep-rooted carbuncles. There were close association relationships in Olibanum and Myrrha, cough and asthma, deep-rooted carbuncles and carbuncles, Radix Saposhnikoviae and sores, Squama Manis and sores. Compounding rules of Radix Aconiti Kusnezoffii concerted with Rhizoma Bletillae were similar to those of Aconitine (exclusive of Radix Aconiti Lateralis Preparata) cocerted with Rhizoma Bletillae.The second part was mainly application status and analysis of eighteen clashes in grassroots hospitals. We collected78238prescriptions from nine health clinics in towns and townships as well as Chinese Medicine Hospital of Wei-Chang County in He-Bei Province in the last3years. There were255prescriptions touching on eighteen clashes, and there were198prescriptions of Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino or Rhizoma Bletillae. The same research methods as the first part were used to analyze the compounding rules. The findings were shown as follows.1. The ratio of prescriptions of Aconite in combination with Pinellia, Snakegourd Fruit, Fritillary, Ampelopsis Japonica Makino or Rhizoma Bletillae had the highest application frequency, and reached77.65%in all prescriptions toughing on eighteen clashes. Radix Aconiti Lateralis Preparata had the higher application frequency than Radix Aconiti and Radix Aconiti Kusnezoffii. Radix Aconiti Lateralis Preparata was more frequently compounded with Pinellia of all incompatibilities of drugs in a prescription. The prescriptions with eighteen clashes were generally applied for common diseases and frequently-occurring diseases. The amount of prescriptions with eighteen clashes was in proportion to the ages of doctors.2. Main drug classes in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Pinellia was Qi-tonifying drugs, and that frequently-used drugs included Poria, Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Radix Salviae Miltiorrhizae, Radix Astragali seu Hedysari and Pericarpium Citri Reticulatae. The prescriptions were commonly used for heart diseases, lung diseases, spleen-stomach diseases and kidney diseases. Main symptoms included fear of cold, palpitation, vomiting, epigastric oppression and edema. The were relatively close association relationships in Rhizoma Atractylodis Macrocephalae and Poria, Radix Salviae Miltiorrhizae and Radix Astragali seu Hedysari, Fructus Corni and soreness of loins, Radix Rehmanniae Preparata and soreness of loins. Drug class in the prescriptions of Radix Aconiti and Radix Aconiti Kusnezoffii in combination with Pinellia was antirheumatic drugs, and that frequently-used drugs included Radix Glycyrrhizae, Lumbricus, Radix Astragali seu Hedysari, Rhizoma Ligustici Chuanxiong and Rhizoma Gastrodiae. Main pathogenesis was affected by exterior wind, cold and dampness. There were close association relationships in Lumbricus and Radix Glycyrrhizae, Radix Glycyrrhizae and Radix Astragali seu Hedysari, Radix Glycyrrhizae and fear of cold, Cortex Eucommiae and arthralgia.Main drug classes in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Snakegourd Fruit was Qi-tonifying drugs, and that frequently-used drugs were Radix Salviae Miltiorrhizae, Radix Astragali seu Hedysari, Ramulus Cinnamomi, Radix Glycyrrhizae, Rhizoma Ligustici Chuanxiong and Poria. Main pathogenesis was Yang deficiency, coagulated cold and phlegmatic blockage. The prescriptions were commonly used for heart diseases and spleen-stomach diseases. Main symptoms included palpitation, chest pain, oppression in chest, hiccough and epigastric oppression. There were close association relationships in Rhizoma Ligustici Chuanxiong and Radix Curcumae, Radix Salviae Miltiorrhizae and Semen Ziziphi Spinosae, Radix Salviae Miltiorrhizae and palpitation, Rhizoma Ligustici Chuanxiong and palpitation.Main drug classes in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Bulbus Fritillariae Cirrhosae was phlegm-resolving drugs, and that frequently-used drugs included Poria, Radix Astragali seu Hedysari, Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba and Radix Glycyrrhizae. Main pathogenesis was Yang deficiency of heart and kidney, and fluid retention. The prescriptions were commonly used for lung diseases and heart diseases. Main symptoms included cough, palpitation and edema. There were relatively close association relationships in Radix Paeoniae Alba and Poria, Radix Salviae Miltiorrhizae and Poria, Carapax Trionycis and mass in abdomen, Pseudobulbus Cremastrae seu Pleiones and mass in abdomen. Main drug classes in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Bulbus Fritillariae Thunbergii was Qi-tonifying drugs, and that frequently-used drugs were Radix Paeoniae Alba, Rhizoma Corydalis, Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae and baked ginger. Main pathogenesis was Yang deficiency of spleen and kidney. The prescriptions were commonly used for spleen-stomach diseases and lung diseases. Main symptoms included stomachache, hiccough, epigastric oppression and cough. There were relatively close association relationships in Radix Paeoniae Alba and Radix Glycyrrhizae, Radix Paeoniae Alba and Rhizoma Corydalis, inula flower and hiccough, ruddle and hiccough. Main drug class in the prescriptions of Bulbus Fritillariae Cirrhosae in combination with Bulbus Fritillariae Thunbergii was antirheumatic drugs, and main drugs included Radix Achyranthis Bidentatae, Radix Aconiti Kusnezoffii, Olibanum and Myrrha. Major pathogenesis was that pathogenic wind, cold, dampness, phlegm and blood stasis blocked meridians. The prescriptions were primarily used for limb-meridian diseases, and that common symptoms included arthralgia and lumbago. There were relatively close association relationships in Olibanum and Myrrha, Myrrha and Radix Achyranthis Bidentatae, Rhizoma Cibotii and lumbago, Radix Rehmanniae Preparata and lumbago. There were no markedly difference in compounding rules when Bulbus Fritillariae Thunbergii was in combination with Radix Aconiti or Radix Aconiti Kusnezoffii.Main drug class in the prescriptions of Radix Aconiti Lateralis Preparata compounded with Rhizoma Bletillae was Qi-regulating drugs, and that frequently-used drugs included Pericarpium Citri Reticulatae, Fructus Meliae Toosendan, Rhizoma Curcumae Longae, Fructus Amomi Villosi, Rhizoma Atractylodis Macrocephalae and Radix Glycyrrhizae. Main pathogenesis was Yang deficiency of spleen and kidney, and that the prescriptions were commonly used for spleen-stomach diseases. Main symptoms included fear of cold, abdominal distention, bellyache and epigastric oppression. There were relatively close association relationships in Pericarpium Citri Reticulatae and Rhizoma Curcumae Longae, Pericarpium Citri Reticulatae and Fructus Meliae Toosendan, Semen Litchi and bellyache, Semen Raphani and bellyache.Main drug classes in the prescriptions of Sargassum in combination with Radix Glycyrrhizae were tonic drugs, phlegm-resolving drugs and heat-clearing drugs, and that frequently-used drugs included Bulbus Fritillariae Thunbergii, Radix Bupleuri, Concha Ostreae, Thallus Eckloniae and Radix Scrophulariae. Main pathogenesis was intermingled phlegm and blood stasis and stagnation of Qi. The prescriptions were primarily applied for Qi-blood-fluid diseases, and that common symptoms included abdominal mass, distending pain of breasts during menstruation, scrofula and hypochondriac pain. There were close association relationships in Concha Ostreae and Bulbus Fritillariae Thunbergii, Bulbus Fritillariae Thunbergii and Radix Bupleuri, Radix Scrophulariae and distending pain of breasts during menstruation, Radix Scrophulariae and abdominal mass.