Compounding refers to the purposeful selection of two or more drugs for use in combination according to the needs of the condition and the characteristics of the drugs. Formerly, the application of single drugs and the relationship between the drugs are summarized in seven cases, known as the “seven conditions”. The “Materia Medica Jing Jiezhu” has the expression “single line of path used to emergency”, which means that when the condition is urgent, it can be used only for emergency. However, if the condition is more serious, or the condition is more complex, single drug power is limited, and it is difficult to take into account the full range; some drugs are strong bias, with toxic side effects, single application is difficult to avoid adverse reactions, when the corresponding drugs with the support system. Most of the single formula, from the chemical composition point of view, is also a compound formula. Previously summarized “seven feelings”, in addition to the single line, the remaining six aspects are about the relationship between the matching. They are summarized as follows.
(A) must be
Similar performance and efficacy of the drug with the application, can enhance the original therapeutic effect, known as phase beard. Such as gypsum and Zhimu with, can significantly enhance the therapeutic effect of purging and diarrhea; rhubarb and manganese nitrate with, can significantly enhance the therapeutic effect of attacking and diarrhea; scorpion, centipede with, can significantly enhance the antispasmodic effect.
(B) make
Performance and efficacy of certain drugs in common with the same, to a drug as the main drug, another drug as a complementary, auxiliary drugs can enhance the efficacy of the main drug, known as the phase make. For example, if astragalus, which tonifies qi and promotes water, is combined with poria, which promotes water and strengthens the spleen, poria can enhance the therapeutic effect of astragalus, which tonifies qi and promotes water.
The common point between the phase make and the phase beard is to produce synergistic effect through the combination of drugs, thus enhancing the therapeutic effect. The difference is that the drugs are parallel and side by side, while there is a main and auxiliary relationship in the combination, i.e. one drug is the main drug and the other drug is the auxiliary drug. This main and auxiliary relationship is not fixed, but based on the therapeutic purpose and the significance of the role of drugs in the treatment to determine. For example, if Scutellaria baicalensis is used with rhubarb for the purpose of clearing heat and diarrhea, it is the main medicine to clear heat and diarrhea, and rhubarb is the main medicine to attack the lower part of the body and diarrhea the heat, i.e., it is to enhance the therapeutic effect of Scutellaria baicalensis in clearing heat and diarrhea by taking away the heat from the bottom. If the therapeutic purpose is to pass stool or attack down the heat knot, then we can use rhubarb to pair with thick park which regulates qi and removes fullness, at this time, rhubarb is the main medicine, thick park regulates qi, and enhances rhubarb's attacking effect as a supplement. Therefore, the relationship between the main and auxiliary of the combination is based on the condition, the therapeutic purpose to determine.
(iii) Fear
The toxic reaction or side effect of a drug can be reduced or eliminated by another drug, known as phase fear. For example, the toxicity of raw half-summer and raw southern star can be reduced or eliminated by ginger, so it is said that raw half-summer and raw southern star fear ginger.
(D) kill each other
A drug can reduce or eliminate the toxicity or side effects of another drug, known as phase killing. For example, ginger can alleviate or eliminate the toxicity or side effects of Semen xia and Sheng Nan Xing, so it is said that ginger kills the toxicity of Semen xia and Sheng Nan Xing.
Phase fear, phase kill is actually two references of the same compounding relationship, can be understood as the main object isotope.
(E) phase evil
Combination of two drugs, a drug can make the other drug original effect is reduced, or even lost, known as phase evil. For example, ginseng is evil to turnip seed, because turnip seed can weaken the ginseng's qi effect. The two medicines are only weakened or lost in one or more aspects of their efficacy, but not all of their efficacy. For example, ginger is evil to Scutellaria baicalensis; it is only that ginger's effect of warming the lungs and stomach and Scutellaria baicalensis's effect of clearing the lungs and stomach inhibit each other and reduce the efficacy, but ginger can also harmonize with the middle and open the stomach to cure the symptoms of slow herbage and vomiting, and Scutellaria baicalensis can also clear and drain the lesser yang in order to remove the heat evils, and the two medicines are not necessarily evil to each other in these aspects.
Whether or not the two drugs are mutually exclusive is also related to the symptoms treated. If ginseng is used to treat deficiency of vital energy or pure deficiency of the spleen and lungs without solid evidence, and is paired with Laptop seed to eliminate accumulation and stagnation, the effect of ginseng in replenishing vital energy will be reduced. However, if ginseng alone is used to benefit qi in the case of food accumulation and qi stagnation of spleen deficiency, it is not favorable to the case of accumulation and flatulence. The use of Laptop seed alone to eliminate stagnation will aggravate the deficiency of qi. The two together with each other, so the “New Series of Materia Medica” said: “ginseng has Laptop, its function is more God.” Therefore, in principle, should be avoided, but there is also a side that can be utilized. This can explain, why successive generations of materia medica listed in the literature of the evil drugs up to more than a hundred, and clinical practitioners are not the evil pairing as a contraindication to the treatment of matching.
(F) the opposite
Combination of two drugs, can produce or enhance the toxic reaction or side effects, known as the opposite. Such as “eighteen against”, “nineteen fear” in a number of drugs.
The above six aspects, the relationship between the changes can be summarized as four, that is, in the case of compounding applications: ① some drugs due to synergistic effects and enhance the efficacy of clinical use of drugs to be considered to take full advantage of, such as the phase must, make; ② some drugs may be antagonistic to each other and offset, weakening the original efficacy of the medication should be careful to avoid, such as the phase of evil; ③ some drugs due to interactions, but the original can be reduced or eliminated toxicity or side effects, in the application of toxic drugs or potent drugs when appropriate, such as kill each other, fear each other; (4) some drugs due to interactions and produce or enhance the toxic side effects, is a contraindication, in principle, should be avoided.
