大黄常见药对的临床应用

大黄,始载于《神农本草经》,为蓼科多年生草本掌叶大黄、唐古特大黄或药用大黄的干燥根及根茎。弘景日：“大黄,其色也。”又因其攻积导滞之力锐不可挡,古人誉之为“将军”。性味苦寒,归脾、胃、大肠、肝、心包经。具有攻下积滞、清热解毒、凉血止血、利胆退黄、活血化瘀等功效,临床常用于胃肠积滞,大便秘结;热毒疮疡、丹毒及烧烫伤;血热妄行之出血;瘀血各证;黄疸;淋证等。     

小议大黄在方剂中的配伍应用

大黄味苦，性寒，具有攻下积滞、清热解毒、凉血止血、利胆退黄、活血化瘀等功效，常与他药配伍应用，治疗肠胃积滞、大便秘结、黄疸、热毒疮疡、丹毒及血热妄行之出血等病症。笔者现以功效为纲，以大黄与多种药物的配伍为目，总结如下。     

中药

30.大黄具有哪些功效和适应症? 大黄功效:泻下攻积,清热泻火,解毒,活血祛瘀。适应症:(1)肠道积滞,大便秘结,大黄为治疗积滞便秘的要药,因其苦寒泄热,故热结便秘尤为适宜,配伍温阳药,可治寒积便秘。(2)血热吐衄,目赤肿痛,痈肿疔疮,大黄为清火解毒,凉血消肿之佳品。(3)瘀血经闭,产后瘀阻,症瘕积聚,跌打损伤,大黄行瘀破积,活血通经,适用于瘀血阻滞引起的多种病症,为治疗瘀血证的常用药。(4)湿热泻痢,黄疸水肿,痰热癫癎。 31.大黄、芒硝功能主治的异同点是什么? 大黄、芒硝均能峻下热结,清火消肿,同可用     

中药大黄用途探讨

1药材来源 ①掌叶大黄Rhenum palmatum L又名北大黄、天水大黄、葵叶大黄;②唐古特大黄R.tangutieum Maxim.ex Reg又名鸡爪大黄;③药用大黄R.officnaleBaill又名南大黄.药用干燥根及根茎. 性能 苦,寒.归脾、胃、大肠、肝、心包经. 功效 泻下攻积,清热泻火,凉血解毒,逐瘀通经. 应用 ①积滞便秘.本品有较强的泻下作用,能荡涤肠胃,推陈致新,为治疗便秘之要药.又因其苦寒沉降,善能泄热,故实热便秘尤为适宜.②血热吐衄,目赤咽肿.本品苦降,能使上炎之火下泄,又具清热泻火,凉血止血之功.③热毒疮疡,烧烫伤.本品内服外用均可.内服能清热解毒,并借其泻下通便作用,使热毒下泄.④瘀血证.本品有较好的活血逐瘀通经作用,其既可下瘀血,又清瘀热,为治疗瘀血证的常用药物.⑤湿热痢疾、黄疸、淋证.本品具有泻下通便,导湿热外出之功,故可用治湿热蕴结之证.     

大黄治疗胃肠病的临床应用

大黄味苦性寒 ,既可清肠通便 ,又能泻火解毒 ,还有逐瘀通经之作用。其力猛善走 ,直达下焦 ,荡涤胃肠积滞 ,清泻血分实热 ,多用于胃肠宿食燥粪 ,腹胀便难 ;湿热下痢里急后重 ;实热不退神昏谵语 ;火盛迫血而致吐血 ;或痈肿疮毒、牙龈肿痛及湿热黄疸等证。还可与热药同用以下寒食积滞。利用其入血降泄之功、活血行瘀之能 ,可治疗妇女瘀血经闭、瘕积聚、产后瘀阻及跌打损伤、瘀血肿痛等证。现代药理研究 ,大黄含大黄泻素和大黄鞣酸 ,能刺激肠壁 ,改善肠蠕动 ,使分泌增加 ,肠内容物易于排出。笔者多年来治疗胃肠病以大黄为主 ,增强胃动力 ,促进…     

试论仲景运用大黄

<正> 仲景运用大黄严谨、灵活、广泛。《伤寒》及《金匮》中运用大黄约120多条,方35首。大黄苦寒泄降,有泄实热、破积滞、行瘀血、荡涤胃肠、去陈生新、凉血止血、清热利湿等功效。配伍组方,治疗肠胃积滞,大便燥结,火热亢盛,迫血上滥,瘀血腹痛、经闭,黄疸,症瘕积聚、痰饮、下痢、腹水、肠痈、热痞、呕吐等证。如: 1.泻火(热)荡涤通便:大黄配芒硝,用于胃肠实热积滞,腹账满拒按,便燥不通的阳明腑实证。如大、小调胃承气汤证,大陷胸汤证。以大黄酒洗为君,配芒硝泻热润燥,则泻热荡涤力宏,有润中推下之功。2.攻积导滞、消痞陈满:大黄配枳、朴治阳明腑实,兼痞满重证。如大、小承气汤证,厚朴三物汤证,麻子仁丸证。取大黄泻热攻积,配枳朴行气散结、消痞除满。吴鞠通云:“枳实开幽门之不通,厚     

古代大黄的几种特殊应用

大黄具有“泻下攻积,清热泻火,解毒,活血祛淤”的功效,常用于肠道积滞,大便秘结,血热妄行之血证,淤血,热毒疮疡等症(五版《中药学》教材)。然古代大黄的应用不仅局限于以上几个方面,尚有降逆止呕、理(?)、利小便等特殊功效,兹浅论如次。     

大黄及其混淆品的经验鉴别

大黄以形大色黄而得名,是我国著名特产药材之一,功能泻实热,破积滞,行瘀血。主治大便燥结、腹痛胀满、热毒痈疮、妇人经闭、瘀血停滞、湿热黄疸、目赤口疮等症。早在公元前114年,我国大黄即向欧洲出口,颇负盛誉。     

单味大黄治疗重症肝炎疗效观察

大黄是我国传统中药材之一 ,属攻下药 ,历代有黄良、将军之称。处方用名有生军、生川军、生锦纹、生大黄、制军、制大黄、熟军等。功能下肠胃积滞 ,泻血分实热 ,下瘀血 ,破症瘕。往常多用于大便秘结 ,热毒疮疖 ,瘀血凝滞 ,跌打损伤。近几年来随着祖国医药的挖掘发展 ,发现大黄治疗上消化道出血、肾功能衰竭、急性胰腺炎、烧伤及急慢性肝炎等多种疾病有独特功效。尤其是重症肝炎持续高胆红素血症 ,在西药治疗难以奏效情况下使用单味生大黄煎服 ,疗效甚为满意。现将 2 0 0 0年以来使用大剂量大黄煎服治疗的 1 3例重症肝炎的结果报告如下 ;1　…     

大黄——攻积泻下之王

【歌诀】荡涤肠胃王大黄,攻积泻下解毒藏。火燥便秘痈肿疮,破积行瘀虚勿尝。【释义】大黄号称将军之药,其性沉而不浮,走而不守,下走胃与大肠,涤荡有形之积滞,大泻无形之实热。因其苦降,能使上炎之火下泻,有清热泻火,凉血止血之功,用于治疗血热妄行之吐血、衄血、咯血等。     

The Evolutional Development of Traditional Chinese Medicine (TCM) Outside China Mainland: Challenges,Training, Practice, Research, and Future Development

This overview has provided an account of evolutional changes of an experience-based traditional medical practice of traditional Chinese medicine (TCM) towards modernisation to keep up with recent advances in analytical and biomedical sciences, and information technology, which may help readers to understand why applying biomedical research methodology to TCM modernisation, while maintaining the experience-based concepts, principles and heritage of TCM’s personalised health and medical approaches in balancing body’s functions with physical and mental harmony when facing environmental changes, can contribute to gain global appreciation and acceptance of TCM in healthcare. It is envisaged that such future development and integration with biomedicine-based main-stream medicine (MSM) in practice will provide valuable medical care in the development of future personalised health and medicine as well as TCM product development.     

Antimicrobial, anti-inflammatory, antiparasitic, and cytotoxic activities of Galium mexicanum

Ethnopharmacological relevance

To study the potential benefit of the traditional Mexican medicinal plant Galium mexicanum Kunth (Rubiaceae). Hexane, chloroform, and methanol extracts as well as various fractions from these extracts were tested to determine antibacterial, antifungal, antiparasitic or anti-inflammatory activities in vitro.

Materials and methods

Aerial parts of the plant were extracted with various solvents and fractionated accordingly. Their antibacterial and antifungal activities were assessed on nine bacterial and four fungal strains. Leishmania donovani was used as a protozoan strain for antiparasitic activity. The anti-inflammatory activity of the compounds was investigated by measuring the secretion of interleukin-6 when macrophages were exposed to lipopolysaccharide.

Results

Various extracts and fractions obtained from this plant exhibit antibacterial, antifungal, antiparasitic, and anti-inflammatory activities. Of special interest was the hexane fraction HE 14b, which show antibacterial (ranging between 67 and 666 μg/ml) and antifungal (at concentrations of 333 μg/ml) activities. Also the hexane fraction HE 5 exhibited antiparasitic activity (at concentrations of 260 μg/ml), whereas the methanol fraction ME 13-15 showed a potent anti-inflammatory activity when compared to dexamethasone. Chemical analyses of the chloroform extract show the presence of triterpenes, saponins, flavonoids, sesquiterpene lactones, and glucosides, but no tannins were detected in the assayed extract.

Conclusions

The benefit of Galium mexicanum as a traditional medicinal plant was confirmed using antibacterial and antifungal assays in vitro. We also report for the first time, and to the best of our knowledge, antiparasitic and anti-inflammatory activities of this plant.     

血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义

目的：探讨血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义。方法：采用酶联免疫吸附法（ELISA法）检测130例恶性消化道肿瘤患者（食管癌32例、胃癌34例、胰腺癌30例、大肠癌34例）血清CEA、CA-125、CA-153、CA-199、CA242水平。结果：表明上述四种消化道肿瘤的血清CEA、CA-125、CA-153、CA-199、CA242与对照组比较结果统计学上均有显著性差异（P〈0．01）。除胰腺癌之外，其余3种消化道肿瘤五项肿瘤标记物联合检测的阳性率均显著高于单一标志物检测（P〈0．05），分别为食管癌62．5％、胃癌85．2％、大肠癌82．3％。结论：血清CEA、CA-125、CA-153、CA-199、CA242联合检测可以显著提高消化道恶性肿瘤诊断的敏感性。     

分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性多中心临床研究

目的探讨分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性。方法采用随机对照、多中心平行试验的设计方法,将240例复杂性肛瘘患者随机分为2组:试验组120例采用分段开窗旷置结合切扩挂线置管引流术治疗,对照组120例采用切开挂线术治疗,比较2组肛门直肠结构和功能改善情况。结果术后试验组肛门失禁和肛门狭窄、移位、变形等发生率低;肛管直肠压力、直肠容量感觉功能和直肠肛管反射强度降低幅度对照组明显大于试验组。结论分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘可控性与安全性好,值得作为肛瘘手术的新规范化术式在临床中推广应用。     

A traditional Chinese herbal preparation, Er-Zhi-Wan, prevent ovariectomy-induced osteoporosis in rats

Ethnopharmacological relevance

Er-Zhi-Wan (EZW), a classic Chinese formulation, which contains Fructus Ligustri Lucidi (FLL) and Herba Ecliptae (HE). EZW is widely used to prevent and treat various kidney diseases for its actions of nourishing the kidney and strengthening tendon and bone. Although recent reports indicate that EZW restrains osteoclastic bone resorption, its effects on the protection against define OVX-induced bone loss in mature rats have not been systematically investigated.

Materials and methods

Sixty 3-month-old female Sprague-Dawley rats were randomly assigned into sham-operated group (Sham) and five OVX subgroups, OVX with vehicle (OVX); OVX with Estradiol Valerate (EV, 0.4 mg/kg body weight/day); OVX with EZW of graded doses (9.0, 4.5, or 2.25 g/kg/day). Daily oral administration of EV and EZW on 5th week for 26 weeks. Bone turnover markers (Serum alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), osteocalcin (OCN), deoxypyridinoline (DPD)), other parameters, including serum calcium (S-Ca), serum phosphorus (S-P), urine calcium (U-Ca), phosphorus (U-P), and bone mineral density (BMD) of the femur, 4th lumbar vertebra and tibia, bone biomechanical properties and trabecular microarchitecture parameters were measured.

Results

Administration of EZW could significantly prevent ovariectomy-induced bone loss, biomechanical reduction, deterioration of trabecular microarchitecture and the body weight gain without affecting the weight of the uterus, and increased S-Ca, S-P levels, decreased level of bone turnover markers and U-Ca, U-P levels in ovariectomized rats.

Conclusion

The present study indicated that EZW had a definite antiosteoporotic effect without hyperplastic effect on uterus, and it might be a potential alternative medicine for treatment of postmenopausal osteoporosis.     

方剂剂量与君臣佐使关系初探

以2 022个方剂为研究对象, 围绕其中中药剂量及君臣信息, 计算中药的相对剂量, 并进行方剂内的中药相对剂量排名, 利用相关关系分析方法, 进行"中药相对剂量排名"与"君臣佐使情况"之间的相关关系假设检验。探讨中药剂量与中药"君、臣、佐、使"之间的关系。中药相对剂量排名与君、臣地位存在相关关系, 且为负相关。中药相对剂量排名与佐、使地位不存在相关关系。某味中药在处方中如果相对剂量高, 越有可能成为该方的主要药物, 而某味中药是否为该方的佐药或使药与相对剂量无关。     

蒿芩麻杏石甘汤治疗肺炎支原体感染所致儿童急性支气管炎和轻症肺炎23例

目的:观察蒿芩麻杏石甘汤治疗肺炎支原体感染所致儿童急性支气管炎和轻症肺炎的临床疗效。方法:选取肺炎支原体感染所致急性支气管炎和轻症肺炎患儿44例,随机分为治疗组23例和对照组21例。治疗组给予蒿芩麻杏石甘汤治疗,对照组给予阿奇霉素治疗。结果:治疗组愈显率优于对照组(P0.05);治疗组治疗后临床症状体征评分优于对照组(P0.05)。结论:蒿芩麻杏石甘汤治疗儿童肺炎支原体感染所致急性支气管炎和轻症肺炎疗效确切。     

Ethnopharmacological survey of medicinal plants used by traditional health practitioners in Thanchi,Bandarban Hill Tracts,Bangladesh

Ethnopharmacological relevance

There is very limited information regarding plants used by traditional healers in Bandarban Hill Tracts (BHT), Bangladesh for treating general as well as complex ailments. Current study provides significant ethnopharmacological information, both qualitative and quantitative on medical plants in BHT. Aim of the study This study aimed to collect, analyze and evaluate the rich ethnopharmacologic knowledge on medicinal plants in Thanchi, BHT and attempted to identify the important species used in traditional medicine. Further analysis was done by comparison of the traditional medicinal use of the plants with the available scientific literature data.

Materials and methods

The field survey was carried out in a period of several years in Thanchi upazilla of Bandarban districts, Bangladesh. A total of 53 Traditional Health Practitioners (THPs) were interviewed through open-ended and semi structured questionnaire. The collected data were analyzed qualitatively and quantitatively. This ethnomedicinal knowledge was compared against the available scientific literature for reports of related uses and studies of phytochemical compounds responsible for respective ailments.

Results

A total of 84 species of plants, mostly herbs, belonging to 42 families were identified for the treatment of 70 types of ailments. These ailments were categorized into 16 categories. Leaves were the most frequently used plant parts and juice is the mode of preparation of major portions of the plant species. The most common mode of administration was oral ingestion and topical application. Informant consensus factor (F_ic) values of the present study reflected the high agreement in the use of plants in the treatment of digestive system and respiratory system disorders among the informants. Diseases of the digestive system had highest use-reports and 3 species of plants, namely Centella asiatica (L.) Urban. (dysentery), Justicia gendarussa L. (asthma) and Ocimum tenuiflorum L. (coughing) had the highest fidelity level (FL) of 100%. Clerodendrum viscosum Vent., Achyranthes aspera L and Justicia gendarussa L. showed the highest relative importance (RI) value of 1.86. According to use value (UV) the most important species were Ocimum tenuiflorum L. (2.24) and Achyranthes aspera L. (2.15).

Conclusion

Priority should be given for further phytochemical investigation to plants that scored highest FL, F_ic, UV or RI values, as such values could be considered as good indicator of prospective plants for discovering new drugs. Since knowledge regarding traditional medicine being vulnerable day by day so traditional medicine in school curricula should be incorporated so that younger people could appreciate its usefulness. Also counseling of THPs and gardening of medicinal plants should be taken into consideration immediately in order to smooth continuance and extension of traditional medical knowledge and practice for ensuring safe and effective therapy.     

Sedative, vasorelaxant, and cytotoxic effects of convolvulin from Ipomoea tyrianthina

Aim of the study

Ipomoea tyrianthina has been used in Mexican traditional medicine as a mild purgative, for the treatment of nervous disorders, and against tumors. In this study, the effect of convolvulin (an ether-insoluble resin glycoside) from the root of Ipomoea tyrianthina on: Central Nervous System; as spasmolytic and vasodilator; cytotoxic against cancer cell lines is evaluated.

Materials and methods

Convolvulin isolated from the root of Ipomoea tyrianthina (IT-EM) was tested on pentylentetrazole induced seizures, pentobarbital-induced hypnosis, release of GABA and glutamic acid, isolated rat aorta and ileum rings, and against Caco-2 and KB cell lines.

Results

IT-EM increased the hypnotic effect induced by pentobarbital and the release of GABA in brain cortex of mice, but did not protect mice against pentylenetetrazole-induced convulsions. IT-EM produced a significant vasodilator effect in concentration- and endothelium-dependent manners on isolated rat aorta, but did not inhibit significantly contractions on rat ileum, colon, and jejune rings. IT-EM showed cytotoxic activity against nasopharyngeal carcinoma KB cell line.

Conclusions

Convolvulin (IT-EM) from Ipomoea tyrianthina has sedative effect, vasorelaxant effect in concentration- and endothelium-dependent manners, and cytotoxic activity against nasopharyngeal carcinoma KB cell line.