基于有效物质“分布-效应”差异的血府逐瘀汤中桔梗、牛膝引经机制研究

“引经”，又称“引经报使”，是方剂配伍理论中极富中医特色的组方配伍形式。引经药的临床应用广泛，但其作用机制缺乏系统研究。本课题在前期研究基础上，从药代动力学的分布层面提出研究假说：引经药影响方剂中药物的体内分布，为其发挥“引经”作用的机制之一。本课题以血府逐瘀汤为代表方，方中桔梗、牛膝为代表引经药，以血瘀证大鼠模型为研究载体，运用液质联用的检测方法，观察桔梗或/和牛膝对血府逐瘀汤中有效物质在脑、心、肺、肝中分布的影响，以及对血浆蛋白结合率、受体数量的影响，并通过PK-PD研究进行药物分布的差异与药效学效应变化一致性的验证。本课题研究结果对揭示引经药的作用机制，阐明“引经”作用的科学内涵，拓展方剂配伍理论的研究思路和方法具有重要意义。

"Medicinal Guide", also known as "Guiding Action", is the compatibility form of prescription compatibility theory extremely rich in traditional Chinese medicine characteristics. Guiding-herb are extensively used clinically, but its mechanism is lack of systematic research. Based on the preliminary research, this topic proposes the research hypothesis from the distribution level of pharmacokinetics：the guiding-herb affects the distribution of the drugs in the prescription, and it is one of the mechanisms for its "Medicinal Guide"effect. In the present study, Xuefu Zhuyu Tang is used as the representative prescriptions, the radix platycodonis and radix cyathulae are the representative guiding-herbs, the rat model of blood stasis syndrome was used as the research carrier to detect the influence of radix platycodonis or/and radix cyathulae on the distribution of active substances in Xuefu Zhuyu Tang in brain, heart, lung and liver by using liquid chromatography-mass spectrometry (HPLC-MS), and their impacts on plasma protein binding rate and the number of receptors, as well as validate the consistency between the difference of herbs’ distribution and the change of pharmacodynamic effect via PK-PD study. The research results of the present study are of great significance to reveal the mechanism of guiding-herb, to clarify the scientific connotation of the role of the "Medicinal Guide", and to expand the research ideas and methods of the prescription compatibility theory.