制法 : 上為粗末。
功能主治 : 消痰逆,和胃氣。主妊(ren)娠咳嗽不(bu)止(zhi)。
用法用量 : 每服3錢匕,水1盞,加(jia)生姜3片,煎至6分,去滓(zi)溫(wen)服,不拘時候。
摘錄 : 《圣濟總錄(lu)》卷一五六
制法 : 上為末。
功能主治 : 平胃益氣(qi),寬(kuan)胸化痰(tan)。主嘔(ou)逆惡(e)心,全不(bu)美食。
用法用量 : 每(mei)服(fu)2錢,沸湯點服(fu)。
摘錄 : 《楊氏家藏方》卷二(er)十
制法 : 上為末。
功能主治 : 冷氣上攻,惡心(xin)嘔逆,不(bu)思飲食,寒痰(tan)不(bu)止。
用法用量 : 每服(fu)3錢,水1盞半(ban),加生(sheng)姜10片,煎至7分,去(qu)滓服(fu),不(bu)拘時候。
摘錄 : 《魏氏家藏方》卷二
目錄(lu)1拼音(yin)2《備急(ji)千金要方(fang)(fang)》卷(juan)(juan)十六:溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang) 2.1處(chu)方(fang)(fang)2.2制法2.3功能主(zhu)(zhu)治(zhi)2.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)2.5摘(zhai)錄(lu) 3《癥因脈治(zhi)》卷(juan)(juan)一:溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang) 3.1處(chu)方(fang)(fang)3.2功能主(zhu)(zhu)治(zhi)3.3溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)3.4摘(zhai)錄(lu) 4《直指》卷(juan)(juan)十七 4.1方(fang)(fang)名(ming)(ming)4.2組(zu)成4.3主(zhu)(zhu)治(zhi)4.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)4.5制備方(fang)(fang)法 5《千金》卷(juan)(juan)十六 5.1方(fang)(fang)名(ming)(ming)5.2組(zu)成5.3主(zhu)(zhu)治(zhi)5.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 6《白喉(hou)全生(sheng)集》 6.1方(fang)(fang)名(ming)(ming)6.2組(zu)成6.3主(zhu)(zhu)治(zhi)6.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 7《陳素庵婦科(ke)補(bu)解(jie)》卷(juan)(juan)四 7.1方(fang)(fang)名(ming)(ming)7.2組(zu)成7.3功效7.4主(zhu)(zhu)治(zhi)7.5各(ge)家論述(shu) 8《東醫寶鑒·雜(za)病篇》卷(juan)(juan)六 8.1方(fang)(fang)名(ming)(ming)8.2組(zu)成8.3主(zhu)(zhu)治(zhi)8.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)8.5制備方(fang)(fang)法 9《陳素庵婦科(ke)補(bu)解(jie)》卷(juan)(juan)五 9.1方(fang)(fang)名(ming)(ming)9.2組(zu)成9.3主(zhu)(zhu)治(zhi)9.4各(ge)家論述(shu) 10《理瀹》 10.1方(fang)(fang)名(ming)(ming)10.2組(zu)成10.3主(zhu)(zhu)治(zhi)10.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 11《誠書》卷(juan)(juan)六 11.1方(fang)(fang)名(ming)(ming)11.2組(zu)成11.3主(zhu)(zhu)治(zhi)11.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 12《嵩崖尊(zun)生(sheng)》卷(juan)(juan)九(jiu) 12.1方(fang)(fang)名(ming)(ming)12.2組(zu)成12.3主(zhu)(zhu)治(zhi)12.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 13《幼科(ke)直言》卷(juan)(juan)五 13.1方(fang)(fang)名(ming)(ming)13.2組(zu)成13.3主(zhu)(zhu)治(zhi)13.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 14《醫略(lve)六書》卷(juan)(juan)二(er)十三 14.1方(fang)(fang)名(ming)(ming)14.2組(zu)成14.3主(zhu)(zhu)治(zhi)14.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)14.5各(ge)家論述(shu) 15《會(hui)約》卷(juan)(juan)四 15.1方(fang)(fang)名(ming)(ming)15.2組(zu)成15.3主(zhu)(zhu)治(zhi)15.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)15.5加減 16《喉(hou)證指南》卷(juan)(juan)四 16.1方(fang)(fang)名(ming)(ming)16.2組(zu)成16.3主(zhu)(zhu)治(zhi)16.4溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang) 17《會(hui)約》卷(juan)(juan)八 17.1方(fang)(fang)名(ming)(ming)17.2組(zu)成17.3功效17.4主(zhu)(zhu)治(zhi)17.5溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)用(yong)(yong)(yong)法用(yong)(yong)(yong)量(liang)(liang)(liang)17.6加減 附(fu):1古籍中的(de)(de)溫(wen)(wen)(wen)(wen)(wen)(wen)(wen)(wen)胃(wei)(wei)(wei)(wei)(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang) 1拼音(yin) wēn wèi tāng
2《備急千金(jin)要方》卷十六(liu):溫胃湯
3《癥因脈治》卷一:溫(wen)胃湯
4《直指》卷十七
5《千金》卷十六
6《白喉全生集》
7《陳素庵婦科補解》卷四
8《東醫寶鑒·雜病篇》卷六
9《陳素庵婦科補解》卷五
10《理瀹》
11《誠書》卷六
12《嵩崖尊生》卷九
13《幼科直言》卷五
14《醫略六書》卷二十三
15《會約》卷四
16《喉證指南》卷四
17《會約》卷八
古籍中的溫(wen)胃湯 《癥(zheng)因脈(mo)治》:[卷一(yi)胃脘痛論]外(wai)感胃脘痛 分(fen)寒熱二(er)條。寒痛者,先(xian)用(yong)五積(ji)散(san),兼散(san)外(wai)寒;后用(yong)溫(wen)胃湯,以溫(wen)內寒。熱痛者,先(xian)用(yong)神術平胃散(san),以清外(wai)熱,...
《證(zheng)治(zhi)匯補》:[卷之(zhi)六(liu)腹(fu)脅(xie)門]心(xin)痛 心(xin)痛。痰用導(dao)痰湯(tang)。食用保和丸(wan)。熱用清中湯(tang)。寒用溫胃湯(tang)。氣用調氣湯(tang)。血用手拈(nian)散。悸(ji)用妙香散。蟲(chong)用萬應...
《景岳(yue)全書》:[卷之五(wu)十八宙(zhou)集(ji)·古方(fang)八陣(zhen)]熱陣(zhen) 中湯治同前。即(ji)前治中湯加丁(ding)香、去半(ban)夏。《良方(fang)》溫胃湯治憂(you)思結聚,脾肺氣凝,元(yuan)陽受損,大腸與胃氣不平...
《先(xian)哲醫(yi)話》:[卷上]荻(di)野臺洲 實也,宜生姜瀉心湯、大(da)半夏(xia)湯。自中焦膨脹者,宜溫胃湯類。自下(xia)焦脹起者,宜壯(zhuang)原湯加木(mu)鱉(bie)子。此病以手鼓(gu)...
《白喉全生集》:白喉寒證漸重治法(fa)
目(mu)錄(lu)1拼(pin)音(yin)2英文參考3概述4《金匱要略(lve)方(fang)(fang)(fang)論(lun)》方(fang)(fang)(fang)之半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang) 4.1半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang)的(de)(de)別名(ming)4.2處(chu)方(fang)(fang)(fang)4.3半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang)的(de)(de)用(yong)(yong)(yong)法(fa)用(yong)(yong)(yong)量4.4功(gong)(gong)能(neng)主治4.5方(fang)(fang)(fang)解(jie)4.6運用(yong)(yong)(yong)4.7現代(dai)適應證 4.7.1癔癥(zheng)4.7.2胃腸神經官能(neng)癥(zheng)4.7.3慢性支氣(qi)管炎(yan)4.7.4慢性咽炎(yan)4.7.5食(shi)道痙攣4.7.6其他 4.8半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang)的(de)(de)藥理(li)作用(yong)(yong)(yong) 4.8.1對(dui)神經、內分泌系統(tong)功(gong)(gong)能(neng)的(de)(de)影(ying)響(xiang)4.8.2對(dui)消化系統(tong)功(gong)(gong)能(neng)的(de)(de)影(ying)響(xiang)4.8.3對(dui)呼吸系統(tong)功(gong)(gong)能(neng)的(de)(de)影(ying)響(xiang)4.8.4對(dui)心臟(zang)、血管及血液流變學的(de)(de)影(ying)響(xiang)4.8.5抗病原微生物作用(yong)(yong)(yong)4.8.6對(dui)腫瘤的(de)(de)影(ying)響(xiang)4.8.7對(dui)免疫功(gong)(gong)能(neng)的(de)(de)影(ying)響(xiang)及抗炎(yan)作用(yong)(yong)(yong) 4.9各家(jia)論(lun)述4.10歌訣4.11出處(chu) 5《蘭室秘藏(zang)》卷上方(fang)(fang)(fang)之半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang) 5.1處(chu)方(fang)(fang)(fang)5.2功(gong)(gong)能(neng)主治5.3半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang)的(de)(de)用(yong)(yong)(yong)法(fa)用(yong)(yong)(yong)量5.4運用(yong)(yong)(yong)5.5摘錄(lu) 6《直(zhi)指附(fu)遺》卷七方(fang)(fang)(fang)之半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang) 6.1處(chu)方(fang)(fang)(fang)6.2功(gong)(gong)能(neng)主治6.3半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang)的(de)(de)用(yong)(yong)(yong)法(fa)用(yong)(yong)(yong)量6.4摘錄(lu) 7參考資料附(fu):1古籍中的(de)(de)半(ban)夏(xia)(xia)(xia)(xia)(xia)厚樸(pu)(pu)(pu)湯(tang)(tang) 1拼(pin)音(yin) bàn xià hòu pǔ tāng
2英文參考 Banxia Houpo Tang [21世紀雙語科技(ji)詞典]
Pinelliae and Magnoliae Officinalis Decoction [湘(xiang)雅醫學專(zhuan)業詞典]
banxia houpu decoction [中醫藥(yao)學名(ming)(ming)詞(ci)(ci)審(shen)定(ding)委員會.中醫藥(yao)學名(ming)(ming)詞(ci)(ci)(2004)]
3概(gai)述 半(ban)夏厚樸湯同名方(fang)劑約有三首,其(qi)中《金(jin)匱(kui)要略方(fang)論》方(fang)記(ji)載者為常(chang)用方(fang),其(qi)組成為半(ban)夏12g、厚樸9g、茯(fu)苓12g、生姜15g、蘇葉6g,具有行(xing)氣(qi)散結,降逆化痰(tan)之功效,主治由情志不暢,肝氣(qi)郁結,肺胃(wei)宣降失常(chang),導致濕(shi)郁為痰(tan),痰(tan)氣(qi)互結咽喉(hou)而導致的梅核氣(qi)證。現代常(chang)用于咽異感癥、癔病、焦(jiao)慮性神經癥、抑郁癥、頑固性失眠、慢(man)性咽喉(hou)炎、慢(man)性支氣(qi)管(guan)炎、慢(man)性胃(wei)炎、食(shi)管(guan)痙(jing)攣、化療(liao)(liao)或放療(liao)(liao)所致惡(e)心嘔吐,以及(ji)反流性食(shi)管(guan)炎、結腸(chang)肝(脾(pi))曲(qu)綜合征(zheng)、精神分裂癥、美(mei)尼爾病、腦震蕩后遺癥、甲狀腺腺瘤、頸前血管(guan)瘤、環狀骨膜炎、閉經、嬰幼兒秋季腹瀉、新生兒幽門痙(jing)攣等(deng)屬氣(qi)滯痰(tan)阻(zu)者。
4《金(jin)匱要略方(fang)論》方(fang)之半夏厚樸湯 實(shi)驗研究本方(fang)可抑制喉反射,并有(you)鎮靜和抗過敏作(zuo)用(yong)[1]。該方(fang)劑對(dui)神(shen)經、內分泌及免疫系統的(de)積(ji)極影(ying)響必(bi)定對(dui)癔癥、胃神(shen)經官能癥、食道痙攣等神(shen)經、內分泌調節(jie)障礙性疾(ji)病(bing)有(you)積(ji)極的(de)治療意義,其抗菌、抗炎以(yi)及免疫增強作(zuo)用(yong),必(bi)定對(dui)慢性咽(yan)炎、慢性支氣管(guan)炎起到治療作(zuo)用(yong)[2]。同時(shi)還發現該方(fang)劑對(dui)腫瘤及心(xin)臟、血(xue)管(guan)、血(xue)液流變學也有(you)十分積(ji)極的(de)影(ying)響,臨床可以(yi)大膽試(shi)用(yong)于上述疾(ji)病(bing)而見氣滯痰(tan)阻者[2]。
半夏(xia)12g、厚樸9g、茯苓(ling)12g、生姜(jiang)15g、蘇葉(xie)6g[3]
半夏一(yi)升,厚樸三(san)兩(liang)(liang),茯苓(ling)四兩(liang)(liang),生姜五(wu)兩(liang)(liang),干蘇葉(xie)二兩(liang)(liang)[4]。
每日(ri)1劑,水煎分(fen)4次服,白天服3次,夜間(jian)服1次[5]。
以水(shui)七升(sheng),煮取四升(sheng),分溫四服(fu),日三夜一服(fu)[4]
《金(jin)匱(kui)要略方論》方之(zhi)半夏厚樸湯具有行氣(qi)(qi)開郁,降逆化痰之(zhi)功效[3]。主(zhu)婦人咽中(zhong)如有炙臠;喜、怒(nu)、悲、思(si),憂、恐、驚(jing)之(zhi)氣(qi)(qi)結成痰涎,狀如破絮(xu),或(huo)(huo)(huo)如梅核,在咽喉之(zhi)間,咯不(bu)出(chu),咽不(bu)下,此七氣(qi)(qi)所(suo)為也(ye);或(huo)(huo)(huo)中(zhong)脘(wan)痞滿,氣(qi)(qi)不(bu)舒快,或(huo)(huo)(huo)痰涎壅盛,上氣(qi)(qi)喘急,或(huo)(huo)(huo)因痰飲中(zhong)結,嘔逆惡心(xin)[3]。舌(she)苔白(bai)潤或(huo)(huo)(huo)白(bai)滑,脈弦(xian)緩(huan)或(huo)(huo)(huo)弦(xian)滑[3]。
梅核氣(qi)(qi)(qi)證(zheng)多由情志(zhi)不暢,肝(gan)氣(qi)(qi)(qi)郁結(jie),肺胃宣(xuan)(xuan)降(jiang)失常(chang),導(dao)致濕郁為痰(tan)(tan),痰(tan)(tan)氣(qi)(qi)(qi)互結(jie)咽喉而成[3]。治(zhi)(zhi)當行(xing)氣(qi)(qi)(qi)與(yu)化痰(tan)(tan)兼顧(gu)[3]。方中半(ban)夏、厚樸(pu)均(jun)為苦辛(xin)溫(wen)燥(zao)之品[3]。前者屬祛痰(tan)(tan)藥(yao)(yao)(yao),功擅化痰(tan)(tan)散結(jie),降(jiang)逆和胃;后者屬理氣(qi)(qi)(qi)藥(yao)(yao)(yao),長于(yu)行(xing)氣(qi)(qi)(qi)開郁,下氣(qi)(qi)(qi)除(chu)滿[3]。兩(liang)者相配,痰(tan)(tan)氣(qi)(qi)(qi)并(bing)治(zhi)(zhi),共(gong)為君藥(yao)(yao)(yao)[3]。臣以茯苓滲濕健(jian)脾化痰(tan)(tan);蘇葉除(chu)可(ke)宣(xuan)(xuan)肺外,尚能引藥(yao)(yao)(yao)上行(xing)以達病所,是臣藥(yao)(yao)(yao)又兼使藥(yao)(yao)(yao)之職[3]。佐以生姜之辛(xin)溫(wen)散結(jie),和胃止嘔。諸藥(yao)(yao)(yao)合而成方,散結(jie)行(xing)氣(qi)(qi)(qi),降(jiang)逆化痰(tan)(tan),故(gu)為治(zhi)(zhi)療(liao)痰(tan)(tan)氣(qi)(qi)(qi)互結(jie)之梅核氣(qi)(qi)(qi)的常(chang)用良方[3]。另驚悸(ji)、癲癇、痰(tan)(tan)嗽(sou)、婦女妊娠惡心嘔吐等,屬于(yu)氣(qi)(qi)(qi)郁痰(tan)(tan)滯者,也有一(yi)定療(liao)效[3]。
本方(fang)主治梅核氣(qi)(qi)(qi)(qi)(qi)(qi)系由(you)痰(tan)氣(qi)(qi)(qi)(qi)(qi)(qi)互(hu)(hu)結(jie)(jie)咽喉(hou),肺(fei)胃宣(xuan)降(jiang)失常(chang)所致[5]。每因情志不(bu)暢,肝(gan)氣(qi)(qi)(qi)(qi)(qi)(qi)郁(yu)結(jie)(jie),肺(fei)胃失于宣(xuan)降(jiang),聚(ju)津(jin)為(wei)(wei)痰(tan),痰(tan)氣(qi)(qi)(qi)(qi)(qi)(qi)交阻(zu),互(hu)(hu)結(jie)(jie)咽喉(hou),故咽如(ru)物阻(zu),咯(ge)吐不(bu)出(chu),吞咽不(bu)下,胸膈滿悶等[5]。氣(qi)(qi)(qi)(qi)(qi)(qi)不(bu)行則郁(yu)難(nan)開(kai),痰(tan)不(bu)化(hua)則結(jie)(jie)難(nan)散(san)(san),而且痰(tan)凝可(ke)(ke)加(jia)重(zhong)氣(qi)(qi)(qi)(qi)(qi)(qi)滯,氣(qi)(qi)(qi)(qi)(qi)(qi)滯又可(ke)(ke)促進痰(tan)結(jie)(jie)[5]。治宜兩者兼顧,法當行氣(qi)(qi)(qi)(qi)(qi)(qi)解郁(yu),化(hua)痰(tan)散(san)(san)結(jie)(jie)[5]。方(fang)中半(ban)夏(xia)(xia)苦辛溫(wen)燥(zao),化(hua)痰(tan)散(san)(san)結(jie)(jie),降(jiang)逆(ni)和胃為(wei)(wei)君[5]。厚樸苦辛而溫(wen),行氣(qi)(qi)(qi)(qi)(qi)(qi)開(kai)郁(yu),下氣(qi)(qi)(qi)(qi)(qi)(qi)除滿,助(zhu)半(ban)夏(xia)(xia)以(yi)散(san)(san)結(jie)(jie)降(jiang)逆(ni)為(wei)(wei)臣[5]。兩藥(yao)為(wei)(wei)伍(wu),一行氣(qi)(qi)(qi)(qi)(qi)(qi)滯,一化(hua)痰(tan)結(jie)(jie)[5]。茯(fu)苓甘淡滲濕健脾,助(zhu)半(ban)夏(xia)(xia)以(yi)化(hua)痰(tan);生姜辛散(san)(san)溫(wen)行,助(zhu)半(ban)夏(xia)(xia)和胃而止嘔,共(gong)為(wei)(wei)佐藥(yao)[5]。蘇葉芳香疏散(san)(san),宣(xuan)肺(fei)疏肝(gan),助(zhu)厚樸行氣(qi)(qi)(qi)(qi)(qi)(qi)寬胸,宣(xuan)通郁(yu)結(jie)(jie)之(zhi)氣(qi)(qi)(qi)(qi)(qi)(qi),為(wei)(wei)使藥(yao)[5]。綜觀全方(fang),是辛苦合用,辛可(ke)(ke)行氣(qi)(qi)(qi)(qi)(qi)(qi)散(san)(san)結(jie)(jie),苦能燥(zao)濕降(jiang)逆(ni),共(gong)奏(zou)行氣(qi)(qi)(qi)(qi)(qi)(qi)散(san)(san)結(jie)(jie),降(jiang)逆(ni)化(hua)痰(tan)之(zhi)功[5]。
2.加減法(fa):若氣郁(yu)較甚者,酌加香附(fu)、郁(yu)金等以增強行氣解郁(yu)之(zhi)功;脅肋(lei)疼(teng)痛者,酌加川楝(lian)子、延胡索以疏肝(gan)止(zhi)痛;咽痛者,酌加玄參、桔梗(geng)以利(li)咽;痰氣郁(yu)結(jie)化熱,心煩失眠者,酌加梔子、黃(huang)芩、連翹以清熱除煩[3]。
3.使用(yong)注意:本方藥物(wu)多(duo)為苦(ku)辛溫燥之品(pin),易于傷(shang)陰(yin)助熱,故陰(yin)虛(xu)津虧或火(huo)旺者不宜使用(yong)[3]。
4.梅核(he)氣(qi)(qi):張某,女,52歲(sui)、半年來咽(yan)部(bu)似有(you)所塞,猶如梅核(he),如絮如膜。咽(yan)不下,咯(ge)不出(chu),腹(fu)部(bu)作(zuo)脹,有(you)氣(qi)(qi)攻沖,大便秘結,得矢氣(qi)(qi)則舒,苔(tai)薄膩,脈(mo)沉弦(xian)。氣(qi)(qi)機失暢,痰凝氣(qi)(qi)滯,化痰導滯為主,半夏厚樸湯加(jia)枳實9g、姜(jiang)竹茹9g、萊菔子9g、全瓜蔞(lou)12g、生甘草1.5g,2劑后咽(yan)部(bu)阻塞感消失,精神(shen)好轉。
5.胃(wei)脘(wan)痛:謝(xie)某(mou),男(nan),21歲,脘(wan)痛牽引(yin)兩脅,胸(xiong)悶噯氣(qi)(qi)頻(pin)頻(pin),納谷乏味,口滲清涎,脈象弦滑,舌苔薄膩。病起肝郁氣(qi)(qi)滯(zhi),痰濕內阻,胃(wei)失和降,擬(ni)半夏(xia)厚樸湯損益(yi),姜半夏(xia)1錢(qian)(qian)(qian)半、制厚樸6分(fen)、云茯(fu)苓(ling)4錢(qian)(qian)(qian)、蘇葉(xie)1錢(qian)(qian)(qian)半、大麥芽4錢(qian)(qian)(qian)、炒(chao)枳(zhi)殼(ke)1錢(qian)(qian)(qian)半、新會皮1錢(qian)(qian)(qian)半、粉甘(gan)草8分(fen)。服上方2劑(ji)后,脘(wan)痛大減(jian),惟(wei)負重(zhong)力屏氣(qi)(qi)后又致胸(xiong)悶且痛,原方加竹(zhu)茹(ru)3錢(qian)(qian)(qian),紅(hong)棗4枚,2劑(ji)后愈(yu)。
6.眩(xuan)暈(yun):徐某,男,46歲,頭(tou)暈(yun),目(mu)眩(xuan),耳鳴,作泛嘔吐2天,視物旋轉(zhuan),頭(tou)不(bu)能(neng)轉(zhuan)側,動(dong)則(ze)眩(xuan)暈(yun)更甚(shen),不(bu)思食(shi),食(shi)入作泛嘔吐。西醫診斷為(wei)美尼爾氏(shi)綜合癥(zheng)。中醫會診,除(chu)上述癥(zheng)狀外(wai),觀形體稍胖,閉目(mu)怕睜,時有干惡,苔(tai)白膩,舌質稍胖淡,脈弦滑。擬下氣(qi)消痰,降逆和胃,佐(zuo)平(ping)肝熄風。取半(ban)夏厚(hou)(hou)樸湯(tang)加減:制(zhi)半(ban)夏10g、川厚(hou)(hou)樸10g、云茯苓10g,老蘇梗10g、珍珠母(先煎)30g、雙鉤藤(teng)(后入)15g、代赭石(shi)(先煎)15g、廣皮5g、炒蒼術10g、建澤瀉(xie)10g,5劑(ji)。服3劑(ji)后,自(zi)覺眩(xuan)暈(yun)好轉(zhuan),能(neng)進些飲食(shi),5劑(ji)畢,行動(dong)自(zi)如。
適(shi)應證:癔癥、胃神經官(guan)能癥、慢性咽炎、慢性支氣(qi)管(guan)炎、食道痙(jing)攣等屬氣(qi)滯痰阻者,均(jun)可用(yong)之。
4.7.1癔癥(zheng)(zheng) 癔癥(zheng)(zheng)病(bing)因(yin)(yin)機理至(zhi)今不清(qing)楚,應屬神(shen)經(jing)(jing)官能(neng)癥(zheng)(zheng)的一種,其(qi)發(fa)作(zuo)常(chang)與外(wai)界精(jing)神(shen) *** 有(you)關。多(duo)見(jian)于青年女性,每次發(fa)作(zuo)多(duo)有(you)外(wai)界因(yin)(yin)素 *** 誘發(fa),病(bing)人(ren)(ren)多(duo)在人(ren)(ren)多(duo)場(chang)合下發(fa)作(zuo),每次誘因(yin)(yin)及發(fa)作(zuo)形(xing)式大(da)(da)概相同,發(fa)作(zuo)形(xing)式多(duo)樣,暗示(shi)(shi)可(ke)使(shi)其(qi)終止或發(fa)作(zuo)。常(chang)見(jian)的有(you):①癔癥(zheng)(zheng)性抽(chou)(chou)搐(chu),肢體抽(chou)(chou)搐(chu)無(wu)規律,持續(xu)時間較長(chang),發(fa)作(zuo)時瞳(tong)孔、呼(hu)吸無(wu)改變(bian)(bian),暗示(shi)(shi)方法可(ke)使(shi)之加(jia)重或終止,腦電圖(tu)等檢(jian)查(cha)多(duo)無(wu)異常(chang)改變(bian)(bian)。②歇(xie)斯底里,該類型患者多(duo)有(you)相當特別的癔癥(zheng)(zheng)性性格,有(you)高度(du)的情(qing)感性,暗示(shi)(shi)性很強(qiang),自我為(wei)中心(xin),好(hao)幻(huan)想。表(biao)現(xian)(xian)為(wei):a.精(jing)神(shen)障礙(ai),以蒙眬狀態多(duo)見(jian);另(ling)外(wai)還有(you)情(qing)感暴(bao)發(fa),可(ke)因(yin)(yin)微(wei)細原因(yin)(yin)大(da)(da)發(fa)雷(lei)霆,大(da)(da)吵大(da)(da)鬧,捶胸(xiong)頓足,撕毀衣物,隨后經(jing)(jing)安(an)慰又可(ke)破涕為(wei)笑;也可(ke)表(biao)現(xian)(xian)為(wei)麻痹和木僵狀態。b.運動障礙(ai),亢進時如癲癇大(da)(da)發(fa)作(zuo),減低時表(biao)現(xian)(xian)為(wei)癱瘓(huan)或表(biao)現(xian)(xian)為(wei)失音。c.感覺障礙(ai)如失明、失聽等。d.自主神(shen)經(jing)(jing)功能(neng)紊亂如嘔吐(tu)、噯氣、呃逆、呼(hu)吸困難等。
4.7.2胃腸神經(jing)官(guan)能癥(zheng) 胃腸神經(jing)官(guan)能癥(zheng)并不是(shi)胃腸的器質性疾病(bing)(bing),而是(shi)由于患者神經(jing)精神緊張(zhang)、焦慮、恐(kong)懼、疑病(bing)(bing)或(huo)癔癥(zheng)等所致,其臨床表現為(wei)腹(fu)痛、腹(fu)瀉,而每(mei)次發(fa)病(bing)(bing)均與精神因素密切相關。
4.7.3慢性(xing)支氣(qi)(qi)管炎 支氣(qi)(qi)管炎患者(zhe)連(lian)(lian)續(xu)咳嗽、咳痰3個月以上(shang),或(huo)每年咳嗽2個月以上(shang),連(lian)(lian)續(xu)超過(guo)兩(liang)年并除外心肺(fei)(fei)和其(qi)(qi)(qi)他疾(ji)病(bing)(bing)(bing)者(zhe)為慢性(xing)支氣(qi)(qi)管炎。其(qi)(qi)(qi)病(bing)(bing)(bing)因(yin)主要(yao)是機體(ti)(ti)和呼吸道局部抵抗力降低,外因(yin)常(chang)(chang)常(chang)(chang)是細(xi)(xi)菌(jun)(jun)等(deng)(deng)微(wei)生(sheng)物感染(ran)、有害氣(qi)(qi)體(ti)(ti)、塵(chen)埃吸入、過(guo)冷(leng)過(guo)熱(re)、空(kong)氣(qi)(qi)干燥(zao)等(deng)(deng),常(chang)(chang)見(jian)感染(ran)微(wei)生(sheng)物是腺病(bing)(bing)(bing)毒、流感病(bing)(bing)(bing)毒、呼吸道合(he)胞病(bing)(bing)(bing)毒、鼻病(bing)(bing)(bing)毒、單純(chun)皰疹(zhen)病(bing)(bing)(bing)毒等(deng)(deng);常(chang)(chang)見(jian)細(xi)(xi)菌(jun)(jun)為流感嗜血桿菌(jun)(jun)、肺(fei)(fei)炎鏈球菌(jun)(jun)、衣原體(ti)(ti)、支原體(ti)(ti)等(deng)(deng),也有在病(bing)(bing)(bing)毒感染(ran)基礎上(shang)繼發(fa)細(xi)(xi)菌(jun)(jun)感染(ran)者(zhe)。同時吸入職業性(xing)粉塵(chen)及(ji)(ji)化學物質如花粉、粉塵(chen)或(huo)空(kong)氣(qi)(qi)污(wu)染(ran)大氣(qi)(qi)中的有毒氣(qi)(qi)體(ti)(ti),或(huo)蛋白酶(mei)-抗胰蛋白酶(mei)失衡(heng)等(deng)(deng)細(xi)(xi)菌(jun)(jun)蛋白質的過(guo)敏以及(ji)(ji)體(ti)(ti)內(nei)的因(yin)素等(deng)(deng)也是常(chang)(chang)見(jian)的病(bing)(bing)(bing)因(yin)。病(bing)(bing)(bing)原微(wei)生(sheng)物在呼吸道生(sheng)長繁(fan)殖及(ji)(ji)其(qi)(qi)(qi)代謝產物、毒素等(deng)(deng)作用對支氣(qi)(qi)管黏(nian)膜破(po)壞(huai),從而引起支氣(qi)(qi)管黏(nian)膜充血、水腫,上(shang)皮細(xi)(xi)胞破(po)壞(huai)、滲出和單核細(xi)(xi)胞浸潤等(deng)(deng),慢性(xing)期(qi)主要(yao)是支氣(qi)(qi)管壁(bi)的慢性(xing)非特異性(xing)炎癥。臨(lin)床上(shang)主要(yao)以慢性(xing)咳嗽、咳痰,兩(liang)肺(fei)(fei)支氣(qi)(qi)管內(nei)可聞及(ji)(ji)干濕噦音為主要(yao)表現。
4.7.4慢性(xing)(xing)咽(yan)炎(yan) 咽(yan)炎(yan)分急(ji)性(xing)(xing)與(yu)慢性(xing)(xing)兩(liang)種,急(ji)性(xing)(xing)喉(hou)炎(yan)多見于感冒之后,多由細菌(jun)、病毒等微生物感染致(zhi)喉(hou)黏膜急(ji)性(xing)(xing)卡他性(xing)(xing)炎(yan)癥;同(tong)時用聲(sheng)過(guo)度(du)或(huo)吸入有(you)害氣(qi)體(ti)(ti)、粉塵(chen)、煙(yan)酒過(guo)度(du)等也(ye)可引起,臨(lin)床(chuang)上主要表(biao)現為聲(sheng)嘶(si)、咳嗽、咳痰及(ji)喉(hou)痛。慢性(xing)(xing)喉(hou)炎(yan)是(shi)指(zhi)喉(hou)部(bu)慢性(xing)(xing)非特異性(xing)(xing)炎(yan)癥,臨(lin)床(chuang)上分單純性(xing)(xing)、肥厚性(xing)(xing)和萎(wei)縮性(xing)(xing)喉(hou)炎(yan)3種病理類型。常見原因是(shi)用聲(sheng)過(guo)度(du);長期吸入有(you)害氣(qi)體(ti)(ti)或(huo)粉塵(chen);急(ji)性(xing)(xing)喉(hou)炎(yan)長期反復發作(zuo)或(huo)遷延不愈;下呼(hu)吸道(dao)慢性(xing)(xing)炎(yan)癥長期咳嗽 *** 所(suo)致(zhi)。臨(lin)床(chuang)主要表(biao)現為長期的(de)(de)反復的(de)(de)或(huo)時輕時重(zhong)的(de)(de)聲(sheng)嘶(si)。喉(hou)部(bu)不適、干燥感,說(shuo)話多了(le)喉(hou)痛,有(you)的(de)(de)患者喉(hou)部(bu)有(you)黏痰。
4.7.5食道(dao)痙(jing)攣 食道(dao)痙(jing)攣是(shi)由(you)精(jing)神因素或其他物理(li)化學因素導致(zhi)神經功(gong)能調節障(zhang)礙使食道(dao)平滑肌興奮性增高(gao)所致(zhi),臨床表現咽下的食物通(tong)過障(zhang)礙感等。
4.7.6其他(ta) 常用于焦慮(lv)性神經癥、抑郁癥、頑固性失眠、化療(liao)(liao)或放療(liao)(liao)所致惡(e)心嘔(ou)吐(tu),以(yi)及反(fan)流性食管(guan)炎、結腸肝(gan)(脾)曲綜合征(zheng)、精神分裂癥、美(mei)尼爾(er)病(bing)、腦震蕩后遺(yi)癥、甲狀(zhuang)(zhuang)腺(xian)腺(xian)瘤、頸前血管(guan)瘤、環狀(zhuang)(zhuang)骨膜炎、閉(bi)經、嬰幼(you)兒(er)秋季腹瀉、新生(sheng)兒(er)幽門痙攣等屬(shu)氣(qi)滯痰(tan)阻者[3]。
4.8.1對(dui)神(shen)(shen)經、內分(fen)泌系(xi)(xi)統(tong)功能(neng)的(de)(de)(de)(de)影響(xiang) 君藥半(ban)夏煎劑具(ju)有(you)(you)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)性鎮咳、鎮吐、鎮靜作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),并能(neng)增(zeng)強戊巴(ba)比妥鈉的(de)(de)(de)(de)催眠作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong);半(ban)夏煎劑對(dui)腎(shen)上(shang)腺皮質功能(neng)有(you)(you)輕度 *** 作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),可使血(xue)中(zhong)(zhong)(zhong)皮質酮(tong)水(shui)平升高;半(ban)夏中(zhong)(zhong)(zhong)的(de)(de)(de)(de)葡(pu)萄糖醛酸(suan)衍生(sheng)(sheng)物(wu)(wu)對(dui)士的(de)(de)(de)(de)寧和(he)乙酰(xian)膽堿有(you)(you)解(jie)毒作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),同(tong)時(shi)半(ban)夏凝(ning)集素可弱化(hua)運(yun)動(dong)(dong)神(shen)(shen)經末梢的(de)(de)(de)(de)乙酰(xian)膽堿量(liang)子(zi)的(de)(de)(de)(de)釋放。厚(hou)(hou)樸中(zhong)(zhong)(zhong)所(suo)含厚(hou)(hou)樸酚和(he)和(he)厚(hou)(hou)樸酚具(ju)有(you)(you)明顯(xian)而持(chi)久的(de)(de)(de)(de)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)抑(yi)(yi)制(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),較大量(liang)可使動(dong)(dong)物(wu)(wu)的(de)(de)(de)(de)任何(he)反(fan)射消(xiao)失;近年研究證實(shi)厚(hou)(hou)樸酚的(de)(de)(de)(de)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)抑(yi)(yi)制(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)機制(zhi)(zhi)是(shi)通過抑(yi)(yi)制(zhi)(zhi)多(duo)突觸反(fan)射而引(yin)起(qi)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)性肌肉(rou)松弛作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),它是(shi)抑(yi)(yi)制(zhi)(zhi)脊(ji)髓興(xing)奮性傳導物(wu)(wu)質的(de)(de)(de)(de)前體谷氨(an)酸(suan)的(de)(de)(de)(de)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)而產(chan)生(sheng)(sheng)脊(ji)髓抑(yi)(yi)制(zhi)(zhi)的(de)(de)(de)(de);厚(hou)(hou)樸提取物(wu)(wu)能(neng)明顯(xian)抑(yi)(yi)制(zhi)(zhi)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)多(duo)巴(ba)胺系(xi)(xi)統(tong)的(de)(de)(de)(de)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),明顯(xian)抑(yi)(yi)制(zhi)(zhi)腦(nao)(nao)干網狀激(ji)活(huo)(huo)系(xi)(xi)統(tong)及丘腦(nao)(nao)下部激(ji)活(huo)(huo)系(xi)(xi)統(tong),還(huan)有(you)(you)顯(xian)著(zhu)的(de)(de)(de)(de)鎮痛作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)。茯(fu)苓(ling)(ling)所(suo)含羧甲基茯(fu)苓(ling)(ling)多(duo)糖可使肝勻漿中(zhong)(zhong)(zhong)細胞色素P450含量(liang)減少,增(zeng)強柳賁妥鈉的(de)(de)(de)(de)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)抑(yi)(yi)制(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),臨(lin)床單用(yong)(yong)(yong)(yong)茯(fu)苓(ling)(ling)60g水(shui)煎服,對(dui)慢性精神(shen)(shen)分(fen)裂癥(zheng)治療有(you)(you)效(xiao)。生(sheng)(sheng)姜具(ju)有(you)(you)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)性鎮吐、鎮痛作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),生(sheng)(sheng)姜油、姜辣醇、姜辣烯酮(tong)具(ju)有(you)(you)解(jie)熱、抗(kang)驚厥作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),同(tong)時(shi)對(dui)血(xue)管(guan)運(yun)動(dong)(dong)中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)、呼吸中(zhong)(zhong)(zhong)樞(shu)(shu)(shu)均有(you)(you)興(xing)奮作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)。蘇葉(xie)所(suo)含蒔蘿芹菜腦(nao)(nao)可延長巴(ba)比妥鹽的(de)(de)(de)(de)睡眠時(shi)間,其活(huo)(huo)性幾(ji)乎與鹽酸(suan)氯丙嗪相當(dang);蘇葉(xie)醛則具(ju)有(you)(you)顯(xian)著(zhu)的(de)(de)(de)(de)鎮痛作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong);蘇葉(xie)水(shui)提物(wu)(wu)對(dui)貓切斷離心性回(hui)路側的(de)(de)(de)(de)上(shang)喉頭神(shen)(shen)經電 *** 有(you)(you)抑(yi)(yi)制(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong),同(tong)時(shi)對(dui)神(shen)(shen)經細胞膜動(dong)(dong)作(zuo)(zuo)(zuo)(zuo)電位(wei)有(you)(you)抑(yi)(yi)制(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)。
由此可見該(gai)方劑對(dui)中(zhong)樞神經(jing)(jing)有(you)強大的鎮靜、鎮痛、鎮咳、鎮吐(tu)作用,對(dui)周圍神經(jing)(jing)及肌肉運動(dong)也有(you)明顯的抑(yi)制作用,故對(dui)胃(wei)神經(jing)(jing)官能癥、癔(yi)癥、食管痙(jing)攣以及中(zhong)醫所謂的“梅核氣”應有(you)一定治療作用。
4.8.2對(dui)(dui)消化(hua)系統功能的(de)(de)(de)影響 半夏(xia)可(ke)抑(yi)制胃(wei)液(ye)分泌(mi)和(he)胃(wei)蛋白酶活(huo)性(xing),降(jiang)(jiang)低胃(wei)液(ye)的(de)(de)(de)游離酸(suan)度和(he)總酸(suan)度,保(bao)護急(ji)性(xing)胃(wei)損(sun)傷(shang)并(bing)促(cu)(cu)進胃(wei)黏膜(mo)的(de)(de)(de)修復;同時(shi)半夏(xia)有(you)(you)(you)阿(a)托品樣作(zuo)用(yong)(yong)(yong),抑(yi)制各(ge)種腺體的(de)(de)(de)分泌(mi),抑(yi)制乙酰膽堿、組胺等(deng)所(suo)致腸(chang)道(dao)收縮;半夏(xia)水煎(jian)劑(ji)既有(you)(you)(you)催吐作(zuo)用(yong)(yong)(yong),又有(you)(you)(you)瀉下(xia)作(zuo)用(yong)(yong)(yong),能增(zeng)加腸(chang)輸(shu)送能力,因此對(dui)(dui)腸(chang)道(dao)功能有(you)(you)(you)雙相調(diao)節作(zuo)用(yong)(yong)(yong)。厚(hou)樸(pu)中所(suo)含(han)厚(hou)樸(pu)酚不僅有(you)(you)(you)持久的(de)(de)(de)中樞抑(yi)制作(zuo)用(yong)(yong)(yong)和(he)活(huo)化(hua)防(fang)御因子、抑(yi)制胃(wei)酸(suan)分泌(mi)的(de)(de)(de)作(zuo)用(yong)(yong)(yong)而(er)具有(you)(you)(you)明(ming)顯的(de)(de)(de)抗(kang)應(ying)激性(xing)胃(wei)潰瘍(yang)、預(yu)防(fang)出血、防(fang)止損(sun)傷(shang)作(zuo)用(yong)(yong)(yong),而(er)且還對(dui)(dui)組胺所(suo)致十二(er)指(zhi)腸(chang)痙攣有(you)(you)(you)一(yi)(yi)(yi)定(ding)抑(yi)制作(zuo)用(yong)(yong)(yong);厚(hou)樸(pu)煎(jian)劑(ji)在一(yi)(yi)(yi)定(ding)劑(ji)量范圍內對(dui)(dui)腸(chang)管產生(sheng)興奮作(zuo)用(yong)(yong)(yong),但加大劑(ji)量則產生(sheng)抑(yi)制作(zuo)用(yong)(yong)(yong);厚(hou)樸(pu)酚是抗(kang)肝(gan)(gan)(gan)(gan)炎病(bing)毒的(de)(de)(de)有(you)(you)(you)效成分,可(ke)明(ming)顯防(fang)止肝(gan)(gan)(gan)(gan)纖(xian)(xian)維化(hua)及肝(gan)(gan)(gan)(gan)硬化(hua)的(de)(de)(de)形(xing)成,可(ke)提高免疫性(xing)肝(gan)(gan)(gan)(gan)纖(xian)(xian)維化(hua)血漿中SOD活(huo)性(xing),降(jiang)(jiang)低LPO含(han)量,減輕(qing)肝(gan)(gan)(gan)(gan)細胞壞死,對(dui)(dui)病(bing)毒性(xing)肝(gan)(gan)(gan)(gan)炎有(you)(you)(you)一(yi)(yi)(yi)定(ding)保(bao)護作(zuo)用(yong)(yong)(yong)。茯苓(ling)(ling)所(suo)含(han)新型(xing)羧(suo)甲基茯苓(ling)(ling)多糖對(dui)(dui)肝(gan)(gan)(gan)(gan)臟有(you)(you)(you)保(bao)護作(zuo)用(yong)(yong)(yong),抑(yi)制肝(gan)(gan)(gan)(gan)損(sun)傷(shang),降(jiang)(jiang)低ALT,可(ke)明(ming)顯加速(su)肝(gan)(gan)(gan)(gan)組織(zhi)再生(sheng),使(shi)肝(gan)(gan)(gan)(gan)重量明(ming)顯增(zeng)加;茯苓(ling)(ling)醇能降(jiang)(jiang)低肝(gan)(gan)(gan)(gan)內膠(jiao)原含(han)量,促(cu)(cu)進膠(jiao)原蛋白降(jiang)(jiang)解,促(cu)(cu)進肝(gan)(gan)(gan)(gan)內纖(xian)(xian)維組織(zhi)重吸收,防(fang)止和(he)治(zhi)(zhi)療(liao)肝(gan)(gan)(gan)(gan)硬化(hua);茯苓(ling)(ling)浸劑(ji)可(ke)松弛腸(chang)道(dao)平(ping)滑肌,降(jiang)(jiang)低胃(wei)液(ye)酸(suan)度,防(fang)治(zhi)(zhi)胃(wei)潰瘍(yang)。生(sheng)姜能促(cu)(cu)進消化(hua)液(ye)分泌(mi),增(zeng)加食欲,生(sheng)姜煎(jian)劑(ji)可(ke)促(cu)(cu)進胃(wei)黏膜(mo)合成和(he)釋(shi)放內源(yuan)性(xing)PG,對(dui)(dui)胃(wei)黏膜(mo)有(you)(you)(you)保(bao)護作(zuo)用(yong)(yong)(yong),同時(shi)有(you)(you)(you)保(bao)肝(gan)(gan)(gan)(gan)利膽作(zuo)用(yong)(yong)(yong)。蘇葉煎(jian)劑(ji)可(ke)促(cu)(cu)進消化(hua)液(ye)分泌(mi),促(cu)(cu)進腸(chang)蠕動,對(dui)(dui)小腸(chang)絨毛的(de)(de)(de)損(sun)傷(shang)有(you)(you)(you)改善作(zuo)用(yong)(yong)(yong)。
由此(ci)可(ke)見該方劑(ji)對(dui)胃黏膜有保護和抗潰(kui)瘍(yang)作用(yong),對(dui)胃腸平(ping)滑肌(ji)呈抑制(zhi)和興奮雙(shuang)重作用(yong)。
4.8.3對呼(hu)吸系統功能(neng)的影響(xiang) 君藥(yao)半夏不僅對咳(ke)嗽中(zhong)樞(shu)有(you)鎮靜(jing)作(zuo)用(yong)(yong),同時(shi)可解除支氣(qi)(qi)管(guan)(guan)(guan)痙攣,并使(shi)支氣(qi)(qi)管(guan)(guan)(guan)分泌物減少而有(you)鎮咳(ke)祛痰作(zuo)用(yong)(yong)。厚樸煎劑低濃(nong)度(du)時(shi)對支氣(qi)(qi)管(guan)(guan)(guan)呈興奮(fen)(fen)作(zuo)用(yong)(yong),高(gao)濃(nong)度(du)時(shi)則轉為抑制(zhi)。生(sheng)姜能(neng)興奮(fen)(fen)呼(hu)吸中(zhong)樞(shu)。蘇葉(xie)所含β丁(ding)香烯(xi)對氣(qi)(qi)管(guan)(guan)(guan)有(you)松(song)弛作(zuo)用(yong)(yong),并有(you)明(ming)顯的鎮咳(ke)作(zuo)用(yong)(yong),其所含沉(chen)香醇則有(you)平喘作(zuo)用(yong)(yong)。值得(de)注(zhu)意的是(shi)半夏制(zhi)劑在硅沉(chen)著肺治療(liao)時(shi)全肺膠原(yuan)蛋白量降(jiang)低,病理改變減輕,預防給藥(yao)的療(liao)效與克矽(xi)平相(xiang)似(si),這可能(neng)是(shi)該方劑用(yong)(yong)于慢(man)性咽炎(yan)、慢(man)性支氣(qi)(qi)管(guan)(guan)(guan)炎(yan)的主(zhu)要(yao)機理之一。
4.8.4對心(xin)(xin)臟、血(xue)管(guan)及血(xue)液流變學的(de)影響(xiang) 半夏煎(jian)劑能(neng)(neng)擴(kuo)張冠狀(zhuang)動脈(mo),增(zeng)加(jia)冠脈(mo)血(xue)流,同時(shi)有(you)抗心(xin)(xin)律失常(chang)作(zuo)(zuo)(zuo)用,臨床用于治療冠心(xin)(xin)病(bing)、心(xin)(xin)絞(jiao)痛常(chang)與天(tian)南(nan)星配伍。厚樸(pu)(pu)所含(han)木(mu)蘭箭毒及厚樸(pu)(pu)堿(jian)均有(you)降(jiang)壓(ya)作(zuo)(zuo)(zuo)用;厚樸(pu)(pu)酚和(he)和(he)厚樸(pu)(pu)酚均能(neng)(neng)抑(yi)(yi)制血(xue)栓(shuan)素的(de)B2(TXB2)的(de)生(sheng)成,以及抑(yi)(yi)制細胞(bao)(bao)內鈣轉運,從而(er)(er)具有(you)抗血(xue)小(xiao)板(ban)(ban)(ban)聚集(ji)作(zuo)(zuo)(zuo)用。茯苓(ling)(ling)具有(you)強大的(de)利尿作(zuo)(zuo)(zuo)用,從而(er)(er)可(ke)減(jian)(jian)輕心(xin)(xin)臟前負荷,同時(shi)茯苓(ling)(ling)的(de)各(ge)種提取物(wu)均能(neng)(neng)使心(xin)(xin)肌收(shou)縮(suo)力加(jia)強,心(xin)(xin)率增(zeng)快。生(sheng)姜可(ke)興奮心(xin)(xin)血(xue)管(guan)中樞(shu)和(he)心(xin)(xin)臟,增(zeng)加(jia)心(xin)(xin)肌收(shou)縮(suo)力,對血(xue)壓(ya)可(ke)產生(sheng)一過性(xing)降(jiang)壓(ya)、明(ming)顯升高、持續性(xing)降(jiang)壓(ya)三相性(xing)作(zuo)(zuo)(zuo)用。蘇葉水煎(jian)劑可(ke)以通過收(shou)縮(suo)毛(mao)細血(xue)管(guan)擴(kuo)約肌而(er)(er)有(you)止血(xue)作(zuo)(zuo)(zuo)用,同時(shi)能(neng)(neng)抑(yi)(yi)制膠原和(he)ADP引起的(de)血(xue)小(xiao)板(ban)(ban)(ban)聚集(ji),抑(yi)(yi)制血(xue)小(xiao)板(ban)(ban)(ban)活(huo)化,減(jian)(jian)少凝血(xue)因(yin)子(zi)的(de)釋放;使血(xue)漿中TXB2下降(jiang)、血(xue)小(xiao)板(ban)(ban)(ban)合成和(he)釋放TXA2減(jian)(jian)少,從而(er)(er)拮抗血(xue)小(xiao)板(ban)(ban)(ban)聚集(ji);蘇葉還能(neng)(neng)降(jiang)低全(quan)血(xue)黏(nian)度和(he)血(xue)細胞(bao)(bao)壓(ya)積,從而(er)(er)具有(you)抗凝作(zuo)(zuo)(zuo)用。
4.8.5抗(kang)(kang)病(bing)原微(wei)生(sheng)物作(zuo)(zuo)(zuo)用(yong)(yong)(yong) 厚樸煎(jian)劑有(you)(you)(you)廣譜抗(kang)(kang)菌(jun)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),其對(dui)(dui)(dui)革蘭氏陽性(xing)(xing)(xing)菌(jun)、耐酸性(xing)(xing)(xing)菌(jun)、肺炎(yan)球(qiu)(qiu)(qiu)菌(jun)、白(bai)喉(hou)桿(gan)菌(jun)、溶血性(xing)(xing)(xing)鏈球(qiu)(qiu)(qiu)菌(jun)、枯(ku)草(cao)桿(gan)菌(jun)、金(jin)(jin)黃(huang)(huang)色(se)葡(pu)萄(tao)球(qiu)(qiu)(qiu)菌(jun)、痢疾(ji)桿(gan)菌(jun)及常見的(de)(de)致(zhi)病(bing)性(xing)(xing)(xing)皮(pi)(pi)膚(fu)真(zhen)菌(jun)均有(you)(you)(you)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),同時(shi)對(dui)(dui)(dui)炭疽桿(gan)菌(jun)、變(bian)異鏈球(qiu)(qiu)(qiu)菌(jun)等(deng)(deng)(deng)致(zhi)齲菌(jun)也有(you)(you)(you)強(qiang)大(da)(da)的(de)(de)抗(kang)(kang)菌(jun)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),對(dui)(dui)(dui)病(bing)毒(du)有(you)(you)(you)顯著的(de)(de)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)。雖然半(ban)夏(xia)在文獻中無抗(kang)(kang)病(bing)原微(wei)生(sheng)物的(de)(de)記載,但用(yong)(yong)(yong)半(ban)夏(xia)粉涂(tu)宮頸糜爛處總有(you)(you)(you)效率達97%,鮮半(ban)夏(xia)外(wai)涂(tu)尋(xun)常疣治愈(yu)率達96.74%,說(shuo)明半(ban)夏(xia)也含有(you)(you)(you)抗(kang)(kang)菌(jun)和抗(kang)(kang)病(bing)毒(du)成分;最近實驗(yan)證明半(ban)夏(xia)有(you)(you)(you)抗(kang)(kang)真(zhen)菌(jun)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)。茯苓(ling)煎(jian)劑對(dui)(dui)(dui)大(da)(da)腸(chang)桿(gan)菌(jun)、金(jin)(jin)黃(huang)(huang)色(se)葡(pu)萄(tao)球(qiu)(qiu)(qiu)菌(jun)、變(bian)形(xing)(xing)桿(gan)菌(jun)有(you)(you)(you)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),對(dui)(dui)(dui)鉤端(duan)螺(luo)旋體(ti)有(you)(you)(you)抑(yi)殺作(zuo)(zuo)(zuo)用(yong)(yong)(yong)。生(sheng)姜對(dui)(dui)(dui)傷(shang)寒桿(gan)菌(jun)、霍亂(luan)弧菌(jun)、金(jin)(jin)黃(huang)(huang)色(se)葡(pu)萄(tao)球(qiu)(qiu)(qiu)菌(jun)、白(bai)色(se)葡(pu)萄(tao)球(qiu)(qiu)(qiu)菌(jun)、痢疾(ji)桿(gan)菌(jun)、銅綠假單胞桿(gan)菌(jun)、沙門菌(jun)、肺炎(yan)鏈球(qiu)(qiu)(qiu)菌(jun)等(deng)(deng)(deng)均有(you)(you)(you)顯著的(de)(de)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),對(dui)(dui)(dui)大(da)(da)部分皮(pi)(pi)膚(fu)真(zhen)菌(jun)如(ru)堇(jin)色(se)毛癬菌(jun)等(deng)(deng)(deng)也有(you)(you)(you)抑(yi)殺作(zuo)(zuo)(zuo)用(yong)(yong)(yong),對(dui)(dui)(dui)乙肝病(bing)毒(du)及 *** 滴蟲有(you)(you)(you)不同程度的(de)(de)抑(yi)殺作(zuo)(zuo)(zuo)用(yong)(yong)(yong)。蘇葉水煎(jian)劑對(dui)(dui)(dui)金(jin)(jin)黃(huang)(huang)色(se)葡(pu)萄(tao)球(qiu)(qiu)(qiu)菌(jun)、傷(shang)寒桿(gan)菌(jun)、大(da)(da)腸(chang)桿(gan)菌(jun)、痢疾(ji)桿(gan)菌(jun)等(deng)(deng)(deng)均有(you)(you)(you)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong),對(dui)(dui)(dui)大(da)(da)部分真(zhen)菌(jun)如(ru)白(bai)色(se)念珠(zhu)菌(jun)、新(xin)形(xing)(xing)隱球(qiu)(qiu)(qiu)菌(jun)也有(you)(you)(you)抑(yi)制(zhi)作(zuo)(zuo)(zuo)用(yong)(yong)(yong)。
4.8.6對腫(zhong)瘤(liu)(liu)(liu)的影響 半夏(xia)通(tong)過活(huo)化(hua)多形(xing)核(he)白(bai)細(xi)(xi)胞(bao),導致腫(zhong)瘤(liu)(liu)(liu)細(xi)(xi)胞(bao)破(po)壞(huai),其對實驗性(xing)(xing)腫(zhong)瘤(liu)(liu)(liu)(S180、HcA、U14)和HeLa細(xi)(xi)胞(bao)均有(you)(you)明(ming)(ming)顯(xian)的抑(yi)制(zhi)作用(yong),對肝癌(ai)、慢(man)性(xing)(xing)白(bai)血(xue)病細(xi)(xi)胞(bao)(K652)、宮頸(jing)癌(ai)等均有(you)(you)一(yi)定的抗(kang)腫(zhong)瘤(liu)(liu)(liu)活(huo)性(xing)(xing)。臣藥厚(hou)樸也有(you)(you)一(yi)定抗(kang)腫(zhong)瘤(liu)(liu)(liu)作用(yong),尤其能抑(yi)制(zhi)皮膚癌(ai)生長。厚(hou)樸中(zhong)所(suo)含(han)木(mu)蘭(lan)醇(chun)有(you)(you)明(ming)(ming)顯(xian)的抗(kang)腫(zhong)瘤(liu)(liu)(liu)活(huo)性(xing)(xing)。茯苓(ling)(ling)所(suo)含(han)茯苓(ling)(ling)多糖和茯苓(ling)(ling)素(su)均有(you)(you)明(ming)(ming)顯(xian)的抗(kang)腫(zhong)瘤(liu)(liu)(liu)作用(yong),茯苓(ling)(ling)是通(tong)過直(zhi)接細(xi)(xi)胞(bao)毒作用(yong)抗(kang)腫(zhong)瘤(liu)(liu)(liu)的,茯苓(ling)(ling)多糖及茯苓(ling)(ling)素(su)可直(zhi)接抑(yi)制(zhi)腫(zhong)瘤(liu)(liu)(liu)細(xi)(xi)胞(bao)DNA合成;茯苓(ling)(ling)素(su)能與腫(zhong)瘤(liu)(liu)(liu)細(xi)(xi)胞(bao)膜上(shang)核(he)苷轉運(yun)(yun)蛋白(bai)結(jie)合,抑(yi)制(zhi)核(he)苷轉運(yun)(yun),高(gao)(gao)濃度時則(ze)使細(xi)(xi)胞(bao)破(po)壞(huai),另一(yi)方面通(tong)過增強機體免(mian)疫功能激活(huo)監督系統,提高(gao)(gao)臣噬細(xi)(xi)胞(bao)產(chan)生TNF的能力,從而共(gong)同抑(yi)制(zhi)腫(zhong)瘤(liu)(liu)(liu)的生長,其對腹水癌(ai)、宮頸(jing)癌(ai)、白(bai)血(xue)病均有(you)(you)一(yi)定的拮抗(kang)作用(yong)。厚(hou)樸中(zhong)所(suo)含(han)木(mu)蘭(lan)醇(chun)有(you)(you)明(ming)(ming)顯(xian)的抗(kang)腫(zhong)瘤(liu)(liu)(liu)活(huo)性(xing)(xing)。
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4.8.7對(dui)免(mian)(mian)疫功(gong)能的(de)影響及(ji)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong) 半夏對(dui)腎上腺皮(pi)質功(gong)能有(you)(you)輕度的(de) *** 作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),可(ke)(ke)使(shi)(shi)(shi)血中(zhong)皮(pi)質酮(tong)水平上升(sheng),皮(pi)質酮(tong)有(you)(you)強(qiang)大的(de)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),又(you)可(ke)(ke)調節(jie)全身神(shen)經、內分泌(mi)平衡(heng),半夏多(duo)糖(tang)有(you)(you)較強(qiang)的(de)網狀內皮(pi)系統激活(huo)活(huo)性(xing)。厚樸(pu)可(ke)(ke)提高(gao)機體細(xi)胞(bao)免(mian)(mian)疫功(gong)能,并(bing)有(you)(you)抗過敏作(zuo)(zuo)(zuo)(zuo)用(yong)(yong);能提高(gao)免(mian)(mian)疫性(xing)肝纖維化(hua)血漿SOD活(huo)性(xing),降低(di)(di)LPO含量(liang)(liang)及(ji)生(sheng)物(wu)效(xiao)應;厚樸(pu)還(huan)能降低(di)(di)炎(yan)(yan)(yan)(yan)癥區(qu)毛細(xi)血管通(tong)透(tou)性(xing),抑(yi)制(zhi)(zhi)(zhi)白細(xi)胞(bao)游走,抑(yi)制(zhi)(zhi)(zhi)纖維組織增(zeng)生(sheng),從而(er)具(ju)有(you)(you)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)。茯(fu)苓(ling)所含新型羧(suo)甲(jia)基(ji)茯(fu)苓(ling)多(duo)糖(tang)不僅有(you)(you)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),而(er)且(qie)可(ke)(ke)改善炎(yan)(yan)(yan)(yan)癥時的(de)全身癥狀,更重要的(de)是茯(fu)苓(ling)多(duo)糖(tang)具(ju)有(you)(you)增(zeng)強(qiang)免(mian)(mian)疫功(gong)能的(de)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong);茯(fu)苓(ling)多(duo)糖(tang)和(he)羥(qian)乙基(ji)茯(fu)苓(ling)多(duo)糖(tang)可(ke)(ke)使(shi)(shi)(shi)淋(lin)(lin)巴(ba)細(xi)胞(bao)毒性(xing)增(zeng)加20~28倍,作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)隨(sui)劑量(liang)(liang)增(zeng)加而(er)增(zeng)加;同時還(huan)能提高(gao)淋(lin)(lin)巴(ba)細(xi)胞(bao)轉化(hua)率,使(shi)(shi)(shi)免(mian)(mian)疫球蛋白的(de)IgG含量(liang)(liang)顯(xian)著上升(sheng);羧(suo)甲(jia)基(ji)茯(fu)苓(ling)多(duo)糖(tang)對(dui)脾臟T細(xi)胞(bao)生(sheng)長因(yin)子(zi)(zi)(zi)有(you)(you)增(zeng)強(qiang)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),使(shi)(shi)(shi)巨(ju)噬細(xi)胞(bao)吞(tun)(tun)噬率及(ji)吞(tun)(tun)噬指數(shu)明顯(xian)升(sheng)高(gao),使(shi)(shi)(shi)胸腺、脾臟、淋(lin)(lin)巴(ba)結重量(liang)(liang)明顯(xian)增(zeng)加;茯(fu)苓(ling)素對(dui)巨(ju)噬細(xi)胞(bao)功(gong)能有(you)(you)促進作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),但對(dui)淋(lin)(lin)巴(ba)細(xi)胞(bao)轉化(hua)和(he)抗體產(chan)生(sheng)有(you)(you)抑(yi)制(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)。生(sheng)姜也(ye)能促進免(mian)(mian)疫功(gong)能并(bing)有(you)(you)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),還(huan)有(you)(you)抗5HT作(zuo)(zuo)(zuo)(zuo)用(yong)(yong),對(dui)炎(yan)(yan)(yan)(yan)癥的(de)早(zao)期、晚期均有(you)(you)明顯(xian)的(de)抑(yi)制(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong);鮮生(sheng)姜提取物(wu)同時可(ke)(ke)清除超氧(yang)(yang)陰離(li)子(zi)(zi)(zi)、羥(qian)自(zi)由基(ji),抑(yi)制(zhi)(zhi)(zhi)肝脂(zhi)質過氧(yang)(yang)化(hua),抑(yi)制(zhi)(zhi)(zhi)H2O2所致溶血、腫(zhong)瘤壞(huai)死因(yin)子(zi)(zi)(zi)(TNF)過量(liang)(liang)生(sheng)成是其(qi)抑(yi)制(zhi)(zhi)(zhi)慢性(xing)炎(yan)(yan)(yan)(yan)癥的(de)有(you)(you)效(xiao)措施。蘇葉能明顯(xian)抑(yi)制(zhi)(zhi)(zhi)腫(zhong)瘤壞(huai)死因(yin)子(zi)(zi)(zi)的(de)生(sheng)成,因(yin)而(er)具(ju)有(you)(you)抗炎(yan)(yan)(yan)(yan)作(zuo)(zuo)(zuo)(zuo)用(yong)(yong)。
2.《金匱方歌(ge)括》:方中半夏降逆(ni)氣(qi),厚樸解結氣(qi),茯苓消痰;尤妙以(yi)生姜通神明(ming),助(zhu)正祛邪;以(yi)紫蘇之辛香(xiang),散(san)(san)其郁(yu)(yu)氣(qi)。郁(yu)(yu)散(san)(san)氣(qi)行,而凝結焉有不(bu)化哉。
5《蘭室秘藏》卷上方之半夏厚樸湯
6《直指附遺》卷七方之半夏厚樸湯
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