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历代中医有关急诊证治的论述和处理经验十分丰富,有效急诊方药沿用至今。但方药以汤剂口服为主,而煎煮往往费时,影响急诊抢救应用。因此,急诊中药剂型改革,当前颇受重视。但这并不等于完成了剂型改革就能解决了中医急诊工作的一切,中药剂型改革还会带来许多新的问题,需要进行一系列研究和探索。本文就此问题,略谈管见。一、剂型改革可能改变药物的作用:例如口服大黄的缓泻作用和生大黄粉治疗溃疡病出血的疗效,如果制成大黄注射液,便都不起作用。又如口服天花粉有泻火生津作用,而其注射液则有抗早孕、致流产和抗绒毛膜上皮癌的效果。主要是因为注射液中天花粉蛋白有损害滋养叶细胞的作用。而该蛋白口服时由消化道分解破坏,失去上述功效。
The history of the treatment and treatment of emergencies in traditional Chinese medicine has been very rich. Effective emergency medicines are still in use today. However, traditional Chinese medicines are mainly taken from soups and decoctions are often time-consuming, affecting emergency rescue applications. Therefore, the pharmacy reform in the emergency department is currently highly regarded. However, this does not mean that the reform of the dosage form will solve all problems in the emergency medical treatment of TCM. The Chinese pharmacy reform will also bring about many new problems and a series of studies and explorations are needed. This article briefly discusses this issue. First, dosage form reform may change the role of drugs: for example, the rhubarb effect of oral administration of rhubarb and the efficacy of rhubarb powder in the treatment of ulcer bleeding may not work if it is made into rhubarb. Another example is that oral trichosanthin has the effect of purging fire and producing fluid, and its injection has anti-pregnancy, induced abortion and anti-chorionic epithelial cancer. It is mainly because the trichosanthin protein in the injection damages the role of trophoblast cells. When the protein is orally administered, it is destroyed by the digestive tract and loses its efficacy.