陳皮的三大類作用
性(xing)味(wei):性(xing)溫,味(wei)辛、味(wei)苦。
歸經:入脾經、胃經、肺經。
理氣(qi)健(jian)脾(pi),調(diao)中(zhong),燥(zao)濕(shi),化痰(tan)。 主治(zhi) 脾(pi)胃(wei)氣(qi)滯之(zhi)脘(wan)腹(fu)脹(zhang)滿或疼痛(tong)、消化不良。濕(shi)濁阻中(zhong)之(zhi)胸悶(men)腹(fu)脹(zhang)、納呆便溏,痰(tan)濕(shi)壅肺之(zhi)咳嗽氣(qi)喘。
溫能行氣,辛能發散,苦而泄水。
故陳皮(pi)有三大類作用(yong),一是導胸(xiong)中寒邪,二破滯(zhi)氣,三益脾胃(wei)。
這三大作用(yong)中(zhong),主(zhu)(zhu)要作用(yong)是行脾胃(wei)之(zhi)氣。脾胃(wei)主(zhu)(zhu)運化水濕(shi),故脾胃(wei)之(zhi)氣行則能去濕(shi)、健(jian)脾、化痰(tan),故又可以說(shuo),陳皮溫能養脾,辛能醒脾,苦能健(jian)脾。由于陳皮主(zhu)(zhu)行脾胃(wei)之(zhi)氣,脾胃(wei)地處中(zhong)焦,中(zhong)焦之(zhi)氣通行,使三焦之(zhi)氣也隨之(zhi)涌動。三焦為(wei)(wei)決瀆(du)之(zhi)官(guan),通行水液,與(yu)濕(shi)相伴;又為(wei)(wei)藏(zang)府之(zhi)外(wai)府,上(shang)及(ji)心、肺(fei),下及(ji)肝、腎。所(suo)以陳皮的作用(yong)可寬(kuan)及(ji)所(suo)有藏(zang)府,遍及(ji)全身之(zhi)濕(shi)。
從(cong)肺而(er)言,則(ze)辛(xin)(xin)散(san)肺氣(qi)(qi),苦(ku)泄(xie)(xie)肺氣(qi)(qi),溫(wen)化(hua)寒氣(qi)(qi),能治痰多(duo)咳喘(chuan),氣(qi)(qi)壅食(shi)(shi)停(ting);從(cong)心而(er)言,則(ze)辛(xin)(xin)開心氣(qi)(qi),苦(ku)泄(xie)(xie)心火,溫(wen)化(hua)濕(shi)(shi)濁,能治胸中煩(fan)熱,口氣(qi)(qi)噦臭;從(cong)肝而(er)言,則(ze)辛(xin)(xin)散(san)肝郁(yu),苦(ku)降(jiang)肝火,溫(wen)化(hua)寒濕(shi)(shi),所以它能治肝郁(yu)有(you)熱,飲停(ting)食(shi)(shi)滯;從(cong)腎而(er)言,則(ze)辛(xin)(xin)潤腎燥,苦(ku)泄(xie)(xie)腎濕(shi)(shi),溫(wen)和腎氣(qi)(qi),所以它能治命火不足(zu),飲食(shi)(shi)不化(hua)。
當然,種種解釋都(dou)與濕和脾有關(guan),所以它的(de)藥(yao)性作用發揮余地比較大,一般理氣化痰方(fang)中(zhong)均(jun)可使用。橘皮苦能(neng)(neng)泄能(neng)(neng)燥,辛能(neng)(neng)散能(neng)(neng)和,其治百病,總是取其理氣燥濕之功。同補藥(yao)則(ze)補,同瀉藥(yao)則(ze)瀉,同升藥(yao)則(ze)升,同降(jiang)藥(yao)則(ze)降(jiang)。
如和白術同(tong)用(yong)(yong),則(ze)(ze)(ze)有補脾胃(wei)的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)人參、甘草(cao)同(tong)用(yong)(yong)則(ze)(ze)(ze)有補肺氣(qi)(qi)的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)杏仁同(tong)用(yong)(yong)則(ze)(ze)(ze)有通(tong)降大(da)腸氣(qi)(qi)秘(mi)的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)桃(tao)仁同(tong)用(yong)(yong)則(ze)(ze)(ze)有通(tong)潤大(da)腸血秘(mi)的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)半夏同(tong)用(yong)(yong)則(ze)(ze)(ze)有燥濕的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)茯苓同(tong)用(yong)(yong)則(ze)(ze)(ze)有祛濕的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)竹茹同(tong)用(yong)(yong)則(ze)(ze)(ze)有降氣(qi)(qi)止嘔的(de)作(zuo)(zuo)(zuo)用(yong)(yong),與(yu)干姜同(tong)用(yong)(yong)能(neng)溫(wen)化寒痰(tan),與(yu)黃(huang)連同(tong)用(yong)(yong)能(neng)清除(chu)熱痰(tan)或者(zhe)直接服用(yong)(yong)胃(wei)腸飲治療(liao)(liao)胃(wei)腸疾病療(liao)(liao)效更好。
橘(ju)皮(pi)去(qu)(qu)其(qi)(qi)內白者,稱(cheng)之(zhi)為(wei)橘(ju)紅(hong),其(qi)(qi)辛苦(ku)之(zhi)味較(jiao)重(zhong),故(gu)臨床(chuang)主要用(yong)(yong)在(zai)(zai)祛(qu)濕(shi)化痰(tan)上,尤其(qi)(qi)是(shi)痰(tan)多壅(yong)肺之(zhi)時(shi),如常用(yong)(yong)成(cheng)藥橘(ju)紅(hong)丸之(zhi)類。橘(ju)絡有(you)行經絡之(zhi)氣,去(qu)(qu)經絡痰(tan)濕(shi)的(de)(de)作用(yong)(yong),故(gu)臨床(chuang)上用(yong)(yong)在(zai)(zai)氣滯痰(tan)阻的(de)(de)肢(zhi)體麻木(mu)之(zhi)時(shi),多配在(zai)(zai)其(qi)(qi)它成(cheng)方之(zhi)中(zhong)(zhong)。橘(ju)核(he)有(you)散(san)結止痛去(qu)(qu)濕(shi)化痰(tan)的(de)(de)作用(yong)(yong),故(gu)在(zai)(zai)臨床(chuang)上用(yong)(yong)于(yu)疝氣疼(teng)痛、濕(shi)疒主痹(bi)腰痛等。橘(ju)葉色(se)青,有(you)條(tiao)達肝氣的(de)(de)作用(yong)(yong),故(gu)臨床(chuang)上用(yong)(yong)于(yu)脅肋疼(teng)痛,胸悶(men)乳痛之(zhi)時(shi),也多配在(zai)(zai)成(cheng)方中(zhong)(zhong)使用(yong)(yong)。
青皮(pi)(pi)(pi)和(he)陳(chen)(chen)皮(pi)(pi)(pi)一(yi)主肝脾(pi),一(yi)主脾(pi)肺,從(cong)行氣(qi)(qi)的(de)力量(liang)來說,青皮(pi)(pi)(pi)較(jiao)強,從(cong)化痰的(de)能力來說陳(chen)(chen)皮(pi)(pi)(pi)較(jiao)強,青皮(pi)(pi)(pi)破(po)氣(qi)(qi)故易(yi)(yi)傷(shang)(shang)正(zheng)氣(qi)(qi),陳(chen)(chen)皮(pi)(pi)(pi)力緩不易(yi)(yi)傷(shang)(shang)正(zheng)氣(qi)(qi)。所以青陳(chen)(chen)皮(pi)(pi)(pi)在治療(liao)氣(qi)(qi)滯痰阻的(de)疼(teng)痛(tong)時(shi)各有所長。比如左側胸痛(tong)用(yong)(yong)(yong)(yong)青皮(pi)(pi)(pi),右側胸痛(tong)用(yong)(yong)(yong)(yong)陳(chen)(chen)皮(pi)(pi)(pi);脅肋疼(teng)痛(tong)用(yong)(yong)(yong)(yong)青皮(pi)(pi)(pi),中間疼(teng)痛(tong)用(yong)(yong)(yong)(yong)陳(chen)(chen)皮(pi)(pi)(pi);乳(ru)頭(tou)疼(teng)痛(tong)用(yong)(yong)(yong)(yong)青皮(pi)(pi)(pi),乳(ru)房(fang)疼(teng)痛(tong)用(yong)(yong)(yong)(yong)陳(chen)(chen)皮(pi)(pi)(pi);下腹(fu)(fu)疼(teng)痛(tong)用(yong)(yong)(yong)(yong)青皮(pi)(pi)(pi),胸腹(fu)(fu)疼(teng)痛(tong)用(yong)(yong)(yong)(yong)陳(chen)(chen)皮(pi)(pi)(pi)。
香(xiang)(xiang)椽皮與陳(chen)皮相似(si)之(zhi)處較多,但(dan)香(xiang)(xiang)椽皮苦辛不強,甘味有(you)余,且略(lve)有(you)酸(suan)味,辛甘化(hua)陽,酸(suan)甘化(hua)陰,故香(xiang)(xiang)椽皮行氣之(zhi)中多有(you)補養(yang)作用(yong),所治范圍也主要是限于(yu)脾胃氣虛而(er)引起的腸胃消化(hua)不良等(deng)疾病。其祛濕化(hua)痰作用(yong)雖然(ran)明顯低于(yu)陳(chen)皮,但(dan)養(yang)脾行氣作用(yong)則(ze)優(you)于(yu)陳(chen)皮。
佛手片與陳(chen)皮(pi)也有相似之處,但佛手片主(zhu)(zhu)(zhu)(zhu)行肝(gan)(gan)(gan)氣,兼顧脾(pi)(pi)氣,透散(san)之力較強(qiang),所(suo)以(yi)主(zhu)(zhu)(zhu)(zhu)治(zhi)范圍主(zhu)(zhu)(zhu)(zhu)要是因肝(gan)(gan)(gan)氣郁結,肝(gan)(gan)(gan)木(mu)不(bu)(bu)能(neng)疏達(da)脾(pi)(pi)土而引起的消(xiao)化不(bu)(bu)良,其透散(san)能(neng)力優于(yu)陳(chen)皮(pi),但其去濕能(neng)力不(bu)(bu)如陳(chen)皮(pi),散(san)結化痰能(neng)力不(bu)(bu)如橘核。可(ke)以(yi)說,在臨床選(xuan)用(yong)的時候,陳(chen)皮(pi)以(yi)脾(pi)(pi)胃為(wei)主(zhu)(zhu)(zhu)(zhu),香椽皮(pi)以(yi)脾(pi)(pi)肝(gan)(gan)(gan)為(wei)主(zhu)(zhu)(zhu)(zhu),佛手片以(yi)肝(gan)(gan)(gan)脾(pi)(pi)為(wei)主(zhu)(zhu)(zhu)(zhu),有時還可(ke)以(yi)聯用(yong)。
臨床使用(yong)陳皮時,若(ruo)(ruo)治痰(tan)(tan)濕不化(hua)(hua),胸膈滿悶,咳(ke)(ke)喘痰(tan)(tan)多,痰(tan)(tan)白粘稠,可配(pei)(pei)半(ban)夏、茯(fu)苓以燥濕化(hua)(hua)痰(tan)(tan);若(ruo)(ruo)痰(tan)(tan)熱(re)咳(ke)(ke)喘,則與(yu)蛇膽(dan)、黃芩等配(pei)(pei)用(yong)以清化(hua)(hua)痰(tan)(tan)熱(re);治脘腹脹滿,食欲不振,惡心便溏,可配(pei)(pei)用(yong)白術(shu)(shu)、砂仁以健(jian)脾(pi)理(li)氣(qi);治濕困脾(pi)胃(wei),口淡納呆,可配(pei)(pei)用(yong)蒼術(shu)(shu)、厚樸以行氣(qi)燥濕;治形寒飲冷,反胃(wei)吐瀉,可配(pei)(pei)用(yong)生姜、神(shen)曲;因(yin)于(yu)寒可配(pei)(pei)干姜、肉(rou)桂;因(yin)于(yu)熱(re)可配(pei)(pei)竹茹、麥門冬;因(yin)氣(qi)滯(zhi)可配(pei)(pei)枳殼、木香;因(yin)于(yu)濕可配(pei)(pei)大腹皮、藿香;因(yin)于(yu)氣(qi)虛可配(pei)(pei)人參、甘草;因(yin)于(yu)氣(qi)滯(zhi)血秘可配(pei)(pei)杏仁、桃仁。
近代(dai)研究認為,橘皮(pi)的(de)(de)揮發油有(you)刺(ci)激性祛痰和(he)擴(kuo)張支(zhi)氣管的(de)(de)作(zuo)(zuo)用,對(dui)胃腸道平滑肌有(you)溫和(he)的(de)(de)刺(ci)激作(zuo)(zuo)用,能促進消(xiao)化液(ye)的(de)(de)分泌和(he)消(xiao)除腸道積氣。鮮品煎(jian)劑及(ji)醇(chun)提取物對(dui)心(xin)臟有(you)興(xing)奮作(zuo)(zuo)用,較大(da)劑量有(you)抑(yi)(yi)制(zhi)作(zuo)(zuo)用;有(you)輕微的(de)(de)收(shou)縮血管作(zuo)(zuo)用,靜脈(mo)注(zhu)射有(you)迅速升壓作(zuo)(zuo)用,反復給(gei)藥亦無耐藥性;甲基(ji)橙(cheng)(cheng)皮(pi)甙有(you)使冠(guan)狀動脈(mo)流(liu)量增加,冠(guan)狀動脈(mo)阻(zu)力減小,血壓降(jiang)低心(xin)率減少的(de)(de)作(zuo)(zuo)用。橙(cheng)(cheng)皮(pi)甙能降(jiang)低膽(dan)固醇(chun),抑(yi)(yi)制(zhi)試驗性潰瘍(yang)。降(jiang)低毛細血管通(tong)透性。廣陳(chen)皮(pi)有(you)抑(yi)(yi)制(zhi)葡萄球菌生(sheng)長作(zuo)(zuo)用。
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