基于经典丹参药对“丹参—冰片”、“丹参—红花”的药动学研究探讨中药配伍增效的药动学研究策略

张翠英+任伟光

[摘要] 药对是中医临床遣药组方常用的配伍形式和复方来源之一，基于体内药动学研究是阐述药对配伍增效减毒机制的1个重要内容。该文全面总结整理丹参-红花（君臣配伍）和丹参-冰片（君使配伍）2类经典丹参药对的“标识成分”药动学研究报道，评价其阐释药对配伍的合理性和科学性，为今后药对配伍的药动学机制提出可行性建议。基于药对的药效组分“标识成分”的药动学比较研究，基本上考虑了中药的复杂体系存在背景、未脱离与其天然共存的化学体系，可以较好阐述药对配伍的君臣、君使增效机制，佐证了中药的“药辅共生”理论，这种药动学研究思路能较好地诠释药对配伍的增效机制。而基于单体化学成分、脱离中药复杂化学环境的“标识成分”药动学研究阐释药对配伍的增效机制尚存在一定空间，其科学性和合理性有待商榷。

[关键词] 丹参-冰片药对； 丹参-红花药对； 药对配伍； 药动学

[Abstract] Herb pairs are usual clinical compatibility forms and one of compound prescription sources in Chinese medicine. Pharmacokinetic research in vivo is one of the important items in elucidating the mechanism for synergistic and attenuated mechanisms of herb pairs. The paper comprehensively summarized and systemized the pharmacokinetic researches of marker-ingredients about Danshen-Honghua and Danshen-Bingpian in order to elucidate the rationality and scientificity of herb pairs and provide some feasible suggestions on the pharmacokinetics of drugs in the future. In view of complicated system of Traditional Chinese medicines and a chemical system that is not separated from its natural state， comparative pharmacokinetic researches on marker-ingredients from the herb pairs are reasonable to elucidate the synergistic and attenuated mechanisms of monarch-subjects compatible herbs and monarch-guide compatible herbs. Such pharmacokinetic research can better explain the mechanism of drug compatibility， while the pharmacokinetic researches based on the monomer chemical compositions and marker-ingredients that have been separated from complex chemical environment of traditional Chinese Medicine are still unreasonable and should be discussed deeply.

[Key words] Danshen-Bingpian herb pair；Danshen-Honghua herb pair；compatibilities of herb pairs；pharmacokinetics

藥对是2个相对固定药物的配伍组合，是中医临床遣药组方常用的配伍形式，亦是历代医药学家长期临床实践的经验总结。尽管药对组成简单，但具备中药配伍的基本特征，是以“七情和合”为主要配对原则，强调两药之间的配伍关系、且疗效较单味药更佳，充分体现了药对配伍的功效。有些药对本身就是1个方剂，如丹参-红花、天麻-川芎药对分别是丹红注射液和大川芎丸[1-2]。所以研究药对的配伍特点和临床应用规律，对于掌握遣药组方、提高临床治疗水平、发展中医药配伍理论和创制现代中药都具有十分重要的理论意义与实践价值。……