基于"消托补"理论探析《外科正宗》补法主导治疗肛痈的用药规律及临床启示OA

Objective To explore the medication regularity of the tonic method in the treatment of anal abscess based on the theory of"resolving-expressing-tonifying"in the Orthodox Lineage of External Medicine and analyze its clinical value in combination with modern pharmacology.Methods Taking the formulas for treating anal abscess in the Orthodox Lineage of External Medicine as the research object,a formula database was established,frequency statistics and medicinal pair cluster analysis were conducted,and the mechanisms of drug action were verified in combination with modern pharmacological literature.Results A total of 41 for-mulas and 125 Chinese medicinals were included,and the tonic method was used most frequently.High-frequency drugs included Danggui(Angelicae Sinensis Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Chuanxiong(Chuanxiong Rhizoma),Baizhu(Atractylodis Macrocephalae Rhizoma),Renshen(Ginseng Radix et Rhizoma),Fuling(Poria),Baishao(Paeoniae Radix Alba),Dahuang(Rhei Radix et Rhizoma),Huanglian(Coptidis Rhizoma),etc.The results of medicinal pair cluster analysis showed that Danggui-Gancao,Danggui-Chuanxiong,Danggui-Shudihuang(Rehmanniae Radix Praeparata)were the core combina-tions.Modern pharmacological studies have confirmed that these drugs have effects on immune regulation,anti-inflammation,anti-oxidation and improvement of microcirculation,involving key signaling pathways such as NF-κB and PI3K/Akt.Conclusion The tonic method plays an important role in the treatment of anal abscess.The high-frequency drugs and core medicinal pairs reflect the academic idea of"strengthening healthy qi to express toxin and replenishing qi to promote granulation".Their modern pharmacological basis provides support for clinical application.The results of this study provide ideas for wound healing after anal abscess sur-gery and integrated traditional Chinese and Western medicine intervention during the perioperative period,but further clinical verification is still needed.