中藥配伍十八反之研究——甘草反海藻之藥理研究

The ＂Eighteen Clashes＂ of Chinese Drug Combinations: Glycyrrhizae Radix Clashing with Sargassum

中藥方劑的配合，為依「君臣佐使」的法則進行，並恪遵本草中所述七情，十八反，十九畏之戒。但歷代醫經之名醫方劑中，不乏一些反畏之藥同用之例。為探討古文所載中藥十八反，其中所提“甘草反海藻”的藥理，在本研究中以甘草、海藻及甘草海藻混合物之煎煮濃縮液對小鼠進行有關利尿作用的研究。由本經：「海藻味苦寒，下十二水腫」可知海藻具利尿作用，今實驗為予小鼠口服海藻粗抽取液(5g/Kg)後，即可增加其尿量及尿中鈉、鉀、氯等離子含量。又本經：「甘草，味甘平，主五臟六腑，寒熱邪氣，堅筋骨，長肌肉倍力金瘡腫，解毒，久服輕身延年。」未言甘草是否與利尿有關，而本研究實驗結果，予小鼠口服甘草粗抽取液(3g/Kg)，會減少尿量及尿中鈉、鉀、氯等離子含量。依據本利尿實驗證實在事先投予甘草後再予海藻，甘草會抑制海藻之利尿作用，因此印證古文十八反中甘草反海藻之理論。

Chinese drugs are coventionally combined according to the principles of 'sovereign, minister, assistant, and courrier' (jun chen zuo shi), taking note of the rules contained in the pharmacopoeia concerning the 'seven relationships' (qi qing), the 'eighteen clashes' (shi ba fan), and the 'nineteen faers' (shijiu wei). However, in the various formularies of famous doctors, clashing and fearing relationships lack comprehensive discussion. In this study, we investigated the rule that 'licorice (gan cao) clashes with sargassum (hai zao)' giving rats concentrated extracts of Glycyrrhizae Radix, Sargassum, and a mixture of the two in order to gauge their diuretic effect. The Benjing states, 'Sargassum is bitter in flavor and cold fin nature]; it eliminates the twelve [kinds of J water swelling (i. e., edema), ' pointing to the diuretic effect of this drug. After administering rats with an extract of Sargassum per os (5g/Kg), we found that the sodium, potassium, and chloride ion in the urine increased. The Benjing states, 'Licorice is sweet in flavor and balanced [in nature]; it governs the five viscera and six vowels, and both cold and heat evil qi. It strengthens the sinew and bone,promotes the growth of flesh, and increase strength, [thereby treating] incised sores and swellings. It resolves toxin, and when taken over long periods, it can lighten the body and extend life.' This statement contains no mention of the diurectic status Glycyrrhizae Radix. Therefore, in the present study, we gave rats a liquid extract of Glycyrrhizae Radix per os (3g/Kg), and found that it reduced the sodium, potassium, and chloride ion particles in the urine. We then found that when Sargassum was administered after Glycyrrhizae Radix, its diuretic effect was inhibited, thus demonstrating the pharmacological basis of the traditional maxim 'licorice clashes with Sargassum.'