As a commonly used Chinese herbal medicine in clinical practice, aconite is widely favored by doctors because of its remarkable curative effect. In the ancient books of traditional Chinese medicine and modern medical works, the research on aconite is abundant, and scholars have analyzed it in depth. However, despite the long history of aconite's application, there is still much to be clarified about its efficacy. In addition to some superficial insights I have briefly mentioned earlier, the following items on the true meaning of aconite need further research in order to promote the flourishing of scholarship.
First of all, the pharmacodynamic mechanism of aconite still needs to be further explored. Although aconite has significant efficacy in clinical application, its mechanism of action has not been fully understood. Although some progress has been made in modern pharmacology research, there are still many details that need to be further revealed. In-depth understanding of the pharmacodynamic mechanism of aconite will help to better understand the principle of its disease and provide a more powerful scientific basis for clinical use.
Secondly, the compatibility law of aconite is worthy of in-depth study. Traditional Chinese medicine pays attention to compatibility, and the compatibility of aconite in different prescriptions is very important for the exertion of medicinal efficacy. Through the study of the compatibility law of aconite, the intrinsic mystery of traditional Chinese medicine compound can be further revealed, and guidance can be provided for the rational use of drugs in clinical practice.
In addition, the safety of aconite cannot be ignored. As a toxic drug, aconite should be used with caution. In the process of clinical application, the dosage and timing of medication should be strictly controlled to ensure the safety of medication. At the same time, the rescue methods of aconite poisoning should also be studied in depth to reduce the risk of adverse drug reactions.
1.On the issue of the separation of raw and cooked
Chen Zhongquan, a close friend, mentioned in his book: "The effects of the same drug, raw and cooked, are very different, and their indications are also different. Aconite is a good example. (Dictionary of Chinese Pharmacy) In traditional Chinese medicine, the raw and cooked use of aconite can be seen in Zhang Zhongjing's writings. After studying the various prescriptions in the Treatise on Typhoid Fever and Miscellaneous Diseases, Chen concluded: "The main purpose of using cooked aconite is to tonify the kidney yang, and its main treatment is to focus on warm supplements;The use of raw aconite is mainly used to return to the yang and save the adversity, and its main treatment is mostly focused on first aid. Such a description is quite similar to the "Compendium of Materia Medica" in "raw aconite diverges, cooked aconite is supplemented". Zhang Shanlei further explained: "In a critical condition, where the true yang is submerged, the limbs are cold, and the pulse is weak, raw aconite must be used;For other milder cold syndromes, cooked aconite can be used. It can be seen that ancient physicians attached great importance to the raw and cooked use of aconite. However, the results of modern pharmacological research differ from conventional wisdom. "Chinese Materia Medica" (trial textbook, 1978) pointed out that the active ingredient of aconite cardiotonics is the non-alkaloid part, and after processing, aconitine is decomposed and the toxicity is weakened, but the cardiotonic effect is not weakened. This means that both raw and cooked aconite have the effect of rejuvenating yang and relieving adversity, while cooked aconite has relatively low toxicity. Therefore, Chen Zhongquan's "reversal and misuse, useless and harmful" may be too absolute. After all, the results of pharmacological studies do not fully correspond to traditional experience. This makes people wonder: is there a balance between modern pharmacology and traditional experience in the raw and cooked use of traditional Chinese medicine?Or, should we take a more in-depth look at the processing methods and principles of use of traditional Chinese medicine in order to better exert its efficacy and reduce its ***
2.On the issue of taking poisoning
The Compendium of Materia Medica once mentioned: "Wufu is a kind of poison, some people feel extremely irritable after taking only a small amount, but the ancients often used it as a tonic." "This suggests that aconite can easily lead to poisoning if used incorrectly. Although the ancients have recognized this, the reason for the irritability after taking it, Li Shizhen blames "different luck", which is obviously not conclusive. If it is really due to luck, then the poisoning of aconite when it should be used in one year will be greatly reduced, but when it is used in another year, a large number of people will be poisoned, if not all of them will be poisoned. Therefore, judging by the word "someone", this possibility can be ruled out. The "Dictionary of Chinese Medicine" mentions: "Aconitum is extremely toxic, and its toxicity varies depending on the variety, collection time, processing method, decoction time and other factors. In fact, the situation with aconite is similar. According to the Dictionary of Traditional Chinese Medicine, the toxicity results of attached tablets in different regions may vary by as much as 8 times. In addition, whether or not symptoms of poisoning occur is also related to factors such as the method of use and individual patient differences. Li Shizhen's "only to take the money dagger" should be to grind aconite into powder and then make it into pill powder to take. This way of taking is more toxic than decoction. The "Dictionary of Chinese Medicine" mentions: "The toxic dose of aconite is 0."5 2 taels (15 60 grams), which refers to the decoction. "However, there have been no clear reports on swallowed doses. Considering that aconite is often taken as a pill powder, it is necessary to determine the dosage of aconite. Is that so?3.On the issue of cold administration of hot medicine
Li Shizhen once said: "In all the use of Wufu drugs, it should be taken cold, which belongs to heat and cold." Because the yin and cold are below, the void and yang float up, if the cold medicine is used, then the yin qi will even worsen the disease;If you take hot drugs**, then you will refuse to accept it. Therefore, after taking the hot medicine cold, after swallowing, the cold body is gone, the heat will occur, and the sick qi will be cured, which is the mystery of the anti-treatment method. According to Miao Xiyong's saying: "Dissipate cold medicine, it is advisable to take it hot." "This is the general rule of taking medication. However, in special circumstances, such as true cold and false heat, and Ge refuses to accept it, ** hot medicine should be taken as a workaround. Although this method is extremely rare in clinical practice at present, it is not unique. What Li Shizhen said is reasonable, and it is necessary to retain this method. However, there are no clinical reports to confirm the effect of this method, and it needs to be further confirmed in practice. 4.On the issue of using dried ginger
There is a saying: "Aconite is not dry and ginger is not hot." It can be seen that aconite is often compatible with dried ginger in clinical applications, forming a unique medicinal effect. In fact, aconite is quite widely used and does not necessarily have to be paired with dried ginger. However, Dai attaches great importance to the combination of dried ginger and aconite, which is likely to be derived from the four inverse formulas, especially when used to treat the evidence of yin and yang. In recent years, scientific research results have also confirmed that boiling dried ginger and licorice with cooked slices can greatly reduce the toxicity of the latter. This finding undoubtedly provides a safer and more reliable basis for the application of aconite. However, the specific mechanism of the co-cooking of these three herbs, especially whether they have a synergistic effect, still needs to be further developed. If it is used alone with dried ginger, can it also reduce the toxicity of aconite or improve its efficacy?The above examples are just the tip of the iceberg, and there are still many uncharted areas to be explored in TCM. With the continuous deepening of scientific research and the increasing revitalization of traditional Chinese medicine, it is believed that the research on aconite will gradually deepen and make greater contributions to the cause of human health.