處方 : 青皮(pi)1錢(qian)(qian),陳(chen)皮(pi)1錢(qian)(qian),人參(can)1錢(qian)(qian),白術1錢(qian)(qian)(炒(chao)),炮姜1錢(qian)(qian),甘(gan)草(炙)1錢(qian)(qian),木香7分(fen)。
功能主治 : 寒氣攻心,嘔逆,心腹絞痛(tong),或泄(xie)瀉,四肢厥冷,或疝氣攻筑,小(xiao)腹疼痛(tong)。
用法用量 : 加(jia)生姜3片(pian),水煎服(fu)。
摘錄 : 《赤水玄珠》卷二
補中益氣湯,出自李東垣《脾胃論》。東垣立此方以補氣升陽,甘溫除熱,主治氣虛發熱證,但后世多用于治療脾胃氣虛證及氣虛下陷證。以下是我為你精心整理的補中益氣湯藥方介紹,希望你喜歡。
補中益氣湯處方
黃芪 18克;炙甘草 9克;人參 6克;當歸 3克;橘皮 6克;升麻 6克;柴胡 6克;白術 9克
補中益氣湯方解
本方治證系因飲食勞倦,損傷脾胃,以致脾胃氣虛、清陽下陷所致。脾胃為營衛氣血生化之源,脾胃氣虛,納運乏力,故飲食減少、少氣懶言、大便稀薄;脾主升清,脾虛則清陽不升,中氣下陷,故見脫肛、子宮下垂等;清陽陷于下焦,郁遏不達則發熱,因非實火,故其熱不甚,病程較長。時發時止、手心熱甚于手背,與外感發熱之熱甚不休、手背熱甚于手心者不同。氣虛腠理不固,陰液外泄則自汗。治宜補益脾胃中氣,升陽舉陷。方中重用黃芪,味甘微溫,入牌、肺經,補中益氣,升陽固表,為君藥。配伍人參、炙甘草、白術補氣健脾為臣,與黃芪合用,以增強其補益中氣之功。血為氣之母,氣虛時久,營血亦虧,故用當歸養血和營,協人參、黃芪以補氣養血;陳皮理氣和胃,使諸藥補而不滯,共為佐藥。并以少量升麻、柴胡升陽舉陷,協助君藥以升提下陷之中氣,《本草綱目》謂:“升麻引陽明清氣上升,柴胡引少陽清氣上行,此乃稟賦虛弱,元氣虛餒,及勞役饑飽,生冷內傷,脾胃引經最要藥也”,共為佐使。炙甘草調和諸藥,亦為使藥。諸藥合用,使氣虛得補,氣陷得升則諸癥自愈。氣虛發熱者,亦借甘溫益氣而除之。關于用本方治療氣虛發熱的理論依據,李東垣說:“是熱也,非表傷寒邪皮毛間發熱也,乃腎間脾胃下流之濕氣悶塞其下,致陰火上沖,作蒸蒸燥熱。”又說:“既脾胃虛衰,元氣不足,而心火獨盛。心火者,陰火也,起于下焦,其系系于心,心不主令,相火代之;相火,下焦包絡之火,元氣之賊也。火與元氣不兩立,一勝則一負。”(《內外傷辨惑論》卷中)可見這種發熱在李東垣看來,就是“陰火”。其實質主要是脾胃元氣虛餒,升降失常,清陽下陷,脾濕下流,下焦陽氣郁而生熱上沖,加之化源不足,“中焦取汁”不足以化赤生血,則心血不足以養心而致心火獨亢而出現的熱象。治療這種發熱,“惟當以甘溫之劑,補其中,升其陽,甘寒以瀉其火則愈。”“蓋溫能除大熱,大忌苦寒之藥瀉胃土耳!今立補中益氣湯。”(《內外傷辨惑論》)綜上李氏創立“溫能除大熱”的理論,對區別外感與內傷發熱的辨證、病機、治則、治法以及使用的宜忌等均有闡發,對深入理解本方意義和指導臨床運用均有稗益。
補中益氣湯文獻
方論羅美《古今名醫方論》卷1:“凡脾胃一虛,肺氣先絕,故用黃芪護皮毛而閉胰理,不令自汗;元氣不足,懶言氣喘,人參以補之;炙甘草之甘以瀉心火而除煩,補脾胃而生氣。此三味,除煩熱之圣藥也。佐白術以健脾;當歸以和血;氣亂于胸,清濁相干,用陳皮以理之,且以散諸甘藥之滯;胃中清氣下沉,用升麻、柴胡氣之輕而味之薄者,引胃氣以上騰,復其本位,便能升浮以行生長之令矣。補中之劑,得發表之品而中自安;益氣之劑,賴清氣之品而氣益倍,此用藥有相須之妙也。”《內外傷辨惑論》卷中:“氣高而喘,身熱而煩,其脈洪大而頭痛,或渴不止,其皮膚不任風寒而生寒熱。”
補中益氣湯加減方法
1.血不足-加當歸。
2.精神短少-加人參、五味子。
3.肺熱咳嗽-去人參。
4.嗌干-加葛根。
5.頭痛-加蔓荊子,痛甚加川芎。
6.腦痛-加?本、細辛。
7.風濕相搏,一身盡痛-加羌活、防風。
8.有痰-加半夏、生姜。
9.胃寒氣滯-加青皮、蔻仁、木香、益智仁。
10.腹脹-加白芍、甘草。
11.熱痛-加黃連。
12.能食而心下痞-加黃連。
13.咽痛-加桔梗。
14.有寒-加肉桂。
15.濕勝-加蒼術。
16.陰火-加黃柏、加熟地、山藥。
17.陰虛-去升麻,加熟地、山茱、山藥。
18.大便秘-加酒煨大黃。
19.欬嗽:春加旋覆、款冬,夏加麥冬、五味,秋加麻黃、黃芩,冬加不去根節麻黃,天寒加干姜。
20.泄瀉-去當歸,加茯苓、蒼術、益智。
補中益氣湯藥理作用
1.益氣健脾
李燕舞等研究發現,大黃致脾虛模型大鼠胃壁細胞電鏡下可見明顯擴張的分泌小管,小管內可見增長密集的微絨毛,囊泡狀結構少見,未見線粒體結構異常,提示脾虛大鼠胃壁細胞超微結構呈應激狀態,補中益氣湯對其超微結構的異常改變有恢復作用。
許琦等和鄭小偉等研究提示,脾虛大鼠胃壁細胞胃泌素受體的結合位點數顯著減少,導致脾虛大鼠胃黏膜的防御性下降,對攻擊因子的敏感性增強,同時可見胃黏膜組織一氧化氮含量降低,補中益氣湯可以升高脾虛大鼠胃泌素受體的結合位點數,升高胃黏膜組織中一氧化氮的含量,升高脾虛大鼠胃泌素含量。
研究還發現,大黃致脾虛模型大鼠壁細胞內鈣調素(calmodulin,CaM)、鈣/鈣調素依賴蛋白激酶Ⅱ(Ca2+/calmodulindependentproteinkinaseⅡ,Ca2+/CaM?PKⅡ)活性明顯升高,提示脾虛大鼠壁細胞處于高應激狀態;補中益氣湯可以降低大鼠壁細胞內CaM及Ca2+/CaM?PKII活性,降低壁細胞內的Ca2+含量,增加壁細胞內三磷酸肌醇(inositoltrisphosphate,IP3)含量,提示補中益氣湯調理脾虛證的部分機制可能是通過受體及受體后細胞內信號傳導來實現的。以上研究提示補中益氣湯益氣健脾的作用機制可能涉及改善消化道組織結構及影響消化道信號轉導等方面。
2.甘溫除熱
張恩戶等和趙勤等以“生化乏源”法復制家兔脾虛模型,給予脾虛家兔和正常家兔同一外源性致熱源致熱,以觀察不同機體狀態下對同一致病因素刺激的應答反應,結果提示脾氣虛家兔致熱后發熱潛伏期與熱程均較長,發熱后期熱度稽留不退,反映了正氣無力驅邪,邪毒盤踞的熱病后期病理狀態。補中益氣湯對實驗性家兔脾虛發熱有較明顯的解熱作用,表現在能抑制體溫升高,緩解熱勢,縮短熱程。從補中益氣湯對正常致熱家兔和脾氣虛致熱家兔體溫的影響來看,補中益氣湯對二者均有降低體溫的作用,但就影響二者發熱的熱程、熱勢和發熱峰值來看,其對脾氣虛家兔的發熱有較明顯的作用,提示補中益氣湯對“氣虛邪侵”的發熱有較好的解熱作用。其解熱機制可能與降低腦脊液前列腺素E2(prostaglandinE2,PGE2)和丘腦下部視前區組織環磷酸腺苷(cyclicadenosinemonophosphate,cAMP)含量有關。
3.保護臟器功能
Chen等以卵清蛋白致敏Nc/Jic小鼠建立免疫性肝病模型,發現補中益氣湯治療后鼠肝組織病理明顯改善,血清丙氨酸氨基轉移酶顯著降低,肝中白細胞介素4(interleukin?4,IL4)、IL?6、CD4明顯下降,提示補中益氣湯可以改善免疫性肝損傷。Ochi等報道,補中益氣湯可以抑制豬血清導致的羥脯氨酸升高,減少Ⅳ型膠原在肝內沉積,抑制血清或肝脯氨酰?4?羥化酶活性,抑制纖維發生細胞因子如轉化生長因子β(transforminggrowthfactorβ,TGF?β)和IL?13的產生,提示補中益氣湯可以改善肝纖維化。
劉良徛等以補中益氣湯治療慢性阻塞性肺疾病,結果提示補中益氣湯治療組顯控率為73.3%,治療后肺功能明顯改善,提示補中益氣湯可降低氣道高反應性,減小氣道阻力,改善肺通氣,從而改善急性加重期患者的肺功能。Tajima等發現,補中益氣湯可以顯著降低博來霉素誘導肺損傷鼠的死亡率,降低肺羥脯氨酸、液體含量,降低肺組織細胞浸潤,緩解肺纖維化,改善肺組織結構,調節肺IL?5和干擾素γ,提示補中益氣湯可能通過調節Th1/Th2比值來改善肺纖維化。Tajima等還在脂多糖誘導急性肺損傷模型中發現,補中益氣湯可以降低支氣管肺泡液中總細胞、中性粒細胞以及巨噬細胞數量;升高血清角質細胞誘導因子(keratinocytechemoattractant,KC);組織學檢查可以見到肺組織白細胞浸潤減少,提示補中益氣湯具有一定程度的保肺功能。
Kim等研究證實,補中益氣湯具有放射保護作用,可以保護γ射線對腸道、造血器官的損傷,方中人參、當歸、升麻、柴胡是其介導放射保護的主要組分,但其強度均不如補中益氣湯全方。
以上研究提示補中益氣湯具有多種正常組織保護功能,包括肝、肺、骨髓、胃腸道等,其機制可能與免疫部分相關。
4.改善骨代謝
林堅濤等在環磷酰胺致小鼠骨質疏松模型中發現,模型組骨生物力學指標最大載荷、彈性載荷及剛度系數均減少,補中益氣湯治療后各系數明顯改善,其強度與葡萄糖酸鈣相當,提示補中益氣湯能對抗環磷酰胺導致的骨質量下降,預防骨質疏松。Sakamoto等發現,補中益氣湯可以提高促性腺激素釋放激素激動劑布舍瑞林(buserelinacetate)導致的骨密度降低,提高血雌二醇水平,提示補中益氣湯可以用于卵巢化學去勢所致的骨代謝異常。Sassa等發現,補中益氣湯可以抑制卵巢切除導致的骨密度降低,提升血雌二醇和孕激素水平,提示補中益氣湯可以抑制卵巢激素降低導致的骨丟失。Song等研究也證實補中益氣湯可以提高微重力環境下大鼠雌二醇水平,降低堿性磷酸酶,降低血鈣/磷比值以及尿鈣排除,提示補中益氣湯可以改善骨代謝。
5.抗不育
Yoshida等證實,補中益氣湯可以提高精液濃度、數量、密度及其活動能力;用于精子減少性不育臨床有效率可達51.1%,受孕率達20%。隨后Sudo等研究發現,補中益氣湯可以有效提高阿霉素所致的生精缺陷,包括睪丸重量下降和生精管數量減少等。Amano等證實,補中益氣湯在體外可以有效提高精子的運動能力,但不影響精子的熒光參數。Onishi等發現,補中益氣湯可以明顯提高精液可溶性Fas,降低精液IL?6水平,但不改變IL?8的水平。Furuya等基于傳統辨證將補中益氣湯用于自發性男性不育,發現補中益氣湯可以有效提升精子數量和運動能力,升高精液可溶性Fas水平,并指出中藥應用需辨證論治。
6.抗前列腺增生
廖澤云等應用去勢大鼠皮下注射丙酸睪丸酮誘導前列腺增生,研究發現,用補中益氣湯后大鼠前列腺上皮細胞萎縮,腺泡表面皺襞消失,腺腔光滑,腺上皮多為單層扁平上皮,細胞核小而圓,居中,腺體間質少,分布稀疏,基底平滑肌較少;前列腺的濕重、前列腺指數和血清酸性磷酸酶均顯著低于模型組,提示補中益氣湯可明顯抑制大鼠血清酸性磷酸酶活性,抑制大鼠前列腺增生,臨床上可以利用補中益氣湯治療良性前列腺增生癥。
7.其他
Wang等以(yi)流(liu)產布氏桿(gan)菌(jun)(Brucellaabortus)造(zao)成小(xiao)鼠(shu)(shu)(shu)(shu)疲勞綜(zong)合征模(mo)(mo)型(xing)(xing),補(bu)中(zhong)益(yi)氣(qi)湯可(ke)以(yi)提(ti)高模(mo)(mo)型(xing)(xing)鼠(shu)(shu)(shu)(shu)每天(tian)活動能力(li),增(zeng)加(jia)模(mo)(mo)型(xing)(xing)鼠(shu)(shu)(shu)(shu)體質(zhi)量(liang)及體質(zhi)量(liang)/脾(pi)質(zhi)量(liang)的比(bi)值(zhi),抑制脾(pi)IL?10表達。Shih等在(zai)正常小(xiao)鼠(shu)(shu)(shu)(shu)與(yu)衰老(lao)加(jia)速小(xiao)鼠(shu)(shu)(shu)(shu)模(mo)(mo)型(xing)(xing)的研究中(zhong)發現,補(bu)中(zhong)益(yi)氣(qi)湯可(ke)以(yi)劑(ji)量(liang)依賴(lai)性提(ti)高小(xiao)鼠(shu)(shu)(shu)(shu)的運動耐力(li)、神經肌(ji)肉協調能力(li)以(yi)及學習記憶(yi)能力(li),并能提(ti)高肌(ji)肉組織中(zhong)的多巴胺、去甲腎上腺素水(shui)平,提(ti)示補(bu)中(zhong)益(yi)氣(qi)湯具有一(yi)定程度的抗衰老(lao)作用。
目錄(lu)1拼音2英(ying)文(wen)參考3概述4《內(nei)外(wai)傷辨惑論(lun)》卷中方(fang)之厚(hou)樸(pu)溫(wen)(wen)(wen)中湯 4.1處(chu)(chu)方(fang)4.2功(gong)能(neng)(neng)主治4.3厚(hou)樸(pu)溫(wen)(wen)(wen)中湯的(de)(de)(de)(de)用(yong)(yong)(yong)法(fa)(fa)用(yong)(yong)(yong)量4.4方(fang)解4.5臨床運用(yong)(yong)(yong) 4.5.1加減法(fa)(fa) 4.6現代適(shi)應證 4.6.1慢(man)性胃炎4.6.2胃及十二(er)指腸潰瘍4.6.3慢(man)性腸炎4.6.4白帶 4.7厚(hou)樸(pu)溫(wen)(wen)(wen)中湯的(de)(de)(de)(de)藥理作用(yong)(yong)(yong) 4.7.1對(dui)(dui)胃腸功(gong)能(neng)(neng)的(de)(de)(de)(de)影(ying)響(xiang)4.7.2抗病原微生(sheng)物作用(yong)(yong)(yong)4.7.3對(dui)(dui)神經(jing)、內(nei)分泌(mi)系統(tong)功(gong)能(neng)(neng)的(de)(de)(de)(de)影(ying)響(xiang)4.7.4對(dui)(dui)心臟、血(xue)管、血(xue)液流變學的(de)(de)(de)(de)影(ying)響(xiang)4.7.5抗炎、抗氧化(hua)作用(yong)(yong)(yong)4.7.6對(dui)(dui)免疫功(gong)能(neng)(neng)的(de)(de)(de)(de)影(ying)響(xiang) 4.8各家論(lun)述4.9附注4.10出處(chu)(chu) 5《明醫(yi)指掌》卷五方(fang)之厚(hou)樸(pu)溫(wen)(wen)(wen)中湯 5.1處(chu)(chu)方(fang)5.2制(zhi)法(fa)(fa)5.3功(gong)能(neng)(neng)主治5.4厚(hou)樸(pu)溫(wen)(wen)(wen)中湯的(de)(de)(de)(de)用(yong)(yong)(yong)法(fa)(fa)用(yong)(yong)(yong)量5.5出處(chu)(chu) 6《醫(yi)學傳燈》卷上方(fang)之厚(hou)樸(pu)溫(wen)(wen)(wen)中湯 6.1方(fang)名(ming)6.2組(zu)成6.3厚(hou)樸(pu)溫(wen)(wen)(wen)中湯的(de)(de)(de)(de)用(yong)(yong)(yong)法(fa)(fa)用(yong)(yong)(yong)量6.4主治6.5出處(chu)(chu) 7參考資料(liao) 1拼音 hòu pǔ wēn zhōng tāng
2英(ying)文(wen)參考 houpu wenzhong decoction [中醫藥(yao)學名詞(ci)審定委員會.中醫藥(yao)學名詞(ci)(2004)]
Houpo Wenzhong Tang [21世紀雙語科技(ji)詞(ci)典]
Matgnoliae Officinalis Decoction for Warming Middle Energizer [湘雅醫學專業詞典]
Magnoliae Officinalis Decoction for Warming Middle Energizer [湘雅醫學專業詞典]
3概述 厚(hou)樸溫(wen)(wen)中湯同名方劑約有三首,其(qi)中記載(zai)于《內(nei)外傷(shang)辨惑論》卷上者為(wei)常用方,其(qi)組成為(wei)厚(hou)樸9g、陳皮9g、甘草(炙(zhi))5g、茯苓(ling)5g、草豆蔻仁5g、木香(xiang)5g、干姜2g。具(ju)有行氣(qi)溫(wen)(wen)中,燥濕除(chu)滿之功效。主治寒濕氣(qi)滯(zhi)證(zheng)。[1]
4《內外傷辨惑論》卷(juan)中方之厚樸(pu)溫中湯 厚樸(pu)溫中湯中部分(fen)藥味具有(you)強(qiang)大的廣譜抗(kang)病(bing)原微(wei)生(sheng)物作(zuo)用(yong)(yong),又具有(you)抗(kang)炎(yan)、抗(kang)氧化作(zuo)用(yong)(yong),同時對(dui)胃腸道功能(neng)具有(you)積(ji)極(ji)調節作(zuo)用(yong)(yong),對(dui)胃黏膜有(you)保護及(ji)抗(kang)潰瘍作(zuo)用(yong)(yong),因而對(dui)慢性胃炎(yan)、慢性腸炎(yan)、胃潰瘍及(ji)帶(dai)下有(you)一定(ding)治(zhi)療(liao)(liao)作(zuo)用(yong)(yong),但治(zhi)療(liao)(liao)上(shang)述疾病(bing)應配合現代醫(yi)學(xue)治(zhi)療(liao)(liao);同時該方劑對(dui)心血(xue)管及(ji)血(xue)液流變學(xue)和(he)神經、內分(fen)泌功能(neng)也有(you)積(ji)極(ji)的調節作(zuo)用(yong)(yong)。[1]
厚(hou)樸(姜(jiang)制)、橘皮(pi)(pi)(去(qu)白)各一兩,干姜(jiang)七(qi)分,茯苓(去(qu)皮(pi)(pi))、草豆蔻仁、木香、炙甘草各五錢(qian)[3]。
厚樸(姜(jiang)制)橘(ju)皮(pi)(去白)各30克(ke) 甘草(cao)(炙(zhi))草(cao)豆蔻仁 茯苓(ling)(去皮(pi))木香各15克(ke) 干姜(jiang)2.1克(ke)
厚樸(姜(jiang)(jiang)制)1兩,橘皮(去白(bai))1兩,甘(gan)草(炙)5錢(qian),草豆蔻仁(ren)5錢(qian),茯苓(去皮)5錢(qian),木香(xiang)5錢(qian),干(gan)姜(jiang)(jiang)7分。
厚樸9g、陳皮9g、甘(gan)草(炙)5g、茯苓5g、草豆(dou)蔻仁5g、木香5g、干姜2g[4]
厚樸溫(wen)中湯具有行氣(qi)溫(wen)中,燥濕(shi)除(chu)滿的功(gong)效。主治寒(han)濕(shi)氣(qi)滯(zhi)證。脘腹脹(zhang)滿或疼痛,不思飲食,舌(she)苔白膩,脈沉弦。[4]
厚(hou)樸溫中湯(tang)具有功能溫中化濕,行氣除(chu)滿的功效[3]。治脾胃寒濕氣滯,脘腹(fu)脹滿,不思飲食或客寒犯胃,時(shi)作疼痛[3]。
為粗末,每服五錢(qian)匕,加生姜(jiang)三片,水煎,去(qu)滓(zi),食前服[3]。
上為粗散。每服(fu)15克(ke),用水300毫升,加生姜3片(pian),煎至150毫升,去滓,空腹(fu)時溫服(fu)。
上為粗散。每服(fu)5錢(qian)匕,水2盞(zhan),加生(sheng)姜3片,煎至1盞(zhan),去滓,食(shi)前溫服(fu)。
每(mei)日(ri)1劑,水煎,分3次飯前(qian)服。忌(ji)一切冷物。[4]
方中(zhong)厚樸(pu)芳香苦溫(wen),下(xia)氣化濕(shi)除滿為(wei)君藥;草(cao)蔻(kou)、干姜、陳皮(pi)、木香合用,溫(wen)中(zhong)散寒(han),行(xing)氣寬中(zhong),以助(zhu)化濕(shi),可使(shi)(shi)脾(pi)胃之(zhi)樞機運轉,共為(wei)臣藥;更佐(zuo)茯(fu)苓滲濕(shi)健(jian)脾(pi);炙甘草(cao)、生姜和(he)中(zhong)而調諸(zhu)(zhu)藥為(wei)使(shi)(shi)[3]。諸(zhu)(zhu)藥合用,共奏溫(wen)中(zhong)行(xing)氣之(zhi)功,使(shi)(shi)寒(han)濕(shi)得去,氣滯得行(xing),則(ze)痞滿脹痛自除[3]。
4.5.1加減法 若兼(jian)身重肢浮(fu)者(zhe),可(ke)加大腹皮以下氣利水;痛(tong)者(zhe),加肉桂(gui)、良(liang)姜以溫中散寒(han)[5]。
近代常用于急性胃(wei)(wei)炎(yan)、慢性胃(wei)(wei)炎(yan)、胃(wei)(wei)腸功能紊(wen)亂等(deng)[3]。
4.6.1慢(man)性(xing)(xing)(xing)胃(wei)炎 慢(man)性(xing)(xing)(xing)胃(wei)炎又分慢(man)性(xing)(xing)(xing)淺表性(xing)(xing)(xing)胃(wei)炎及慢(man)性(xing)(xing)(xing)萎縮性(xing)(xing)(xing)胃(wei)炎,其發病原(yuan)因(yin)(yin)有3:①幽門(men)螺(luo)旋(xuan)桿菌感(gan)染是主(zhu)要(yao)原(yuan)因(yin)(yin),該菌有鞭毛,對(dui)胃(wei)黏膜(mo)穿過能力強,分泌空泡(pao)毒素A,引起強烈炎癥反(fan)應(ying);該菌細(xi)胞壁(bi)作為抗(kang)原(yuan)誘導免疫反(fan)應(ying),從而(er)共同引起胃(wei)黏膜(mo)慢(man)性(xing)(xing)(xing)炎癥。②飲食和環境因(yin)(yin)素如高鹽飲食及缺(que)乏(fa)水果蔬菜等增加了胃(wei)炎的(de)易感(gan)性(xing)(xing)(xing)。③自(zi)身(shen)免疫,患者血中(zhong)存(cun)在壁(bi)細(xi)胞抗(kang)體,攻擊(ji)壁(bi)細(xi)胞,導致胃(wei)黏膜(mo)病變(bian)。④其他(ta)因(yin)(yin)素如含膽汁及胰(yi)液(ye)的(de)十二指腸液(ye)反(fan)流入胃(wei)、酗酒(jiu)、某些食物 *** 等或(huo)單獨或(huo)與幽門(men)螺(luo)旋(xuan)桿菌協同導致胃(wei)黏膜(mo)病變(bian)。慢(man)性(xing)(xing)(xing)胃(wei)炎主(zhu)要(yao)病理改變(bian)是炎癥、萎縮和腸化生(sheng)。臨床(chuang)主(zhu)要(yao)表現為上(shang)腹(fu)痛、腹(fu)脹等消化道癥狀。[5]
4.6.2胃(wei)及十二指(zhi)腸潰(kui)(kui)瘍(yang) 胃(wei)及十二指(zhi)腸潰(kui)(kui)瘍(yang)通(tong)稱(cheng)為消化性潰(kui)(kui)瘍(yang),其(qi)最常(chang)見的原因是幽門(men)螺(luo)旋桿菌感(gan)染及服用非甾(zai)體類(lei)抗(kang)炎藥,二者(zhe)均(jun)會導致胃(wei)、十二指(zhi)腸黏(nian)(nian)膜(mo)屏障(zhang)破壞,在正常(chang)黏(nian)(nian)膜(mo)損(sun)害(hai)防御和(he)修復(fu)過程中(zhong),胃(wei)酸(suan)及胃(wei)蛋白酶分(fen)泌增加,是損(sun)害(hai)發生(sheng)的直接(jie)因素,從(cong)而(er)發生(sheng)潰(kui)(kui)瘍(yang),其(qi)主要病理改變是十二指(zhi)腸球部、胃(wei)角或(huo)胃(wei)小彎處出現(xian)(xian)圓(yuan)形或(huo)橢圓(yuan)形潰(kui)(kui)瘍(yang),邊緣光整(zheng),底部潔(jie)凈(jing),由肉芽(ya)組織構成,上(shang)面覆蓋灰白色或(huo)灰黃色纖維滲出物;活(huo)動(dong)性潰(kui)(kui)瘍(yang)周圍(wei)黏(nian)(nian)膜(mo)常(chang)有炎性水腫,潰(kui)(kui)瘍(yang)淺者(zhe)累及黏(nian)(nian)膜(mo)肌層(ceng),深者(zhe)可達(da)漿(jiang)膜(mo)層(ceng),血管潰(kui)(kui)破時引起出血,穿(chuan)破漿(jiang)膜(mo)層(ceng)引起穿(chuan)孔(kong)。臨床上(shang)主要表現(xian)(xian)為腹鈍痛(tong)、灼痛(tong)、脹痛(tong)等(deng),尤(you)以空腹時為著;周期性發作,秋冬季為多(duo),發作具有節律性,查體可見上(shang)腹部局部輕壓痛(tong)。[5]
4.6.3慢(man)(man)(man)性(xing)(xing)(xing)(xing)腸(chang)(chang)(chang)(chang)炎(yan)(yan) 慢(man)(man)(man)性(xing)(xing)(xing)(xing)腸(chang)(chang)(chang)(chang)炎(yan)(yan)實(shi)質上(shang)是(shi)(shi)指(zhi)(zhi)慢(man)(man)(man)性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)病(bing),既包(bao)括感染(ran)性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)也包(bao)括非感染(ran)性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)。所(suo)謂慢(man)(man)(man)性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)是(shi)(shi)指(zhi)(zhi)排便(bian)(bian)次數>3次/d,糞便(bian)(bian)量(liang)增加(jia)>200g/d,糞質稀(xi)薄,含水量(liang)>85%,腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)超過(guo)(guo)(guo)4周。其常(chang)見病(bing)因為:①胃腸(chang)(chang)(chang)(chang)道疾病(bing),如胃癌(ai)、胃炎(yan)(yan)、慢(man)(man)(man)性(xing)(xing)(xing)(xing)痢疾、腸(chang)(chang)(chang)(chang)結核、腸(chang)(chang)(chang)(chang)道菌群失調癥、潰瘍性(xing)(xing)(xing)(xing)結腸(chang)(chang)(chang)(chang)炎(yan)(yan)、阿米巴結腸(chang)(chang)(chang)(chang)炎(yan)(yan)、結腸(chang)(chang)(chang)(chang)血吸蟲病(bing),及(ji)其他腸(chang)(chang)(chang)(chang)道慢(man)(man)(man)性(xing)(xing)(xing)(xing)感染(ran)性(xing)(xing)(xing)(xing)疾病(bing)、原發性(xing)(xing)(xing)(xing)小腸(chang)(chang)(chang)(chang)吸收不良綜合(he)征等多種疾病(bing)。②肝膽胰腺疾病(bing),如慢(man)(man)(man)性(xing)(xing)(xing)(xing)肝炎(yan)(yan)、肝硬化、慢(man)(man)(man)性(xing)(xing)(xing)(xing)胰腺炎(yan)(yan)、膽管癌(ai)等。③全身性(xing)(xing)(xing)(xing)疾病(bing),如甲狀腺機(ji)(ji)(ji)能亢(kang)進(jin)、糖尿病(bing)、尿毒癥、風濕性(xing)(xing)(xing)(xing)免疫性(xing)(xing)(xing)(xing)疾病(bing)、動(dong)脈(mo)粥樣硬化、食物過(guo)(guo)(guo)敏等多種疾病(bing)。其常(chang)見機(ji)(ji)(ji)理(li)為:①滲(shen)透性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie),是(shi)(shi)由(you)于(yu)腸(chang)(chang)(chang)(chang)腔含有大(da)量(liang)不被吸收的(de)溶質使腸(chang)(chang)(chang)(chang)腔滲(shen)透壓增高,大(da)量(liang)液體進(jin)入腸(chang)(chang)(chang)(chang)腔引(yin)起(qi)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)。②分泌性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie),是(shi)(shi)指(zhi)(zhi)腸(chang)(chang)(chang)(chang)黏(nian)膜上(shang)皮(pi)細胞電解(jie)質轉運(yun)機(ji)(ji)(ji)制障礙導致腸(chang)(chang)(chang)(chang)道電解(jie)質、水分分泌過(guo)(guo)(guo)多或(huo)吸收障礙所(suo)致,或(huo)先天性(xing)(xing)(xing)(xing)腸(chang)(chang)(chang)(chang)黏(nian)膜離子吸收缺陷(xian)所(suo)致腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie);或(huo)廣(guang)泛的(de)腸(chang)(chang)(chang)(chang)黏(nian)膜病(bing)變(bian)最終導致腸(chang)(chang)(chang)(chang)上(shang)皮(pi)細胞水、電解(jie)質分泌增多和吸收減少。③滲(shen)出性(xing)(xing)(xing)(xing)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie),是(shi)(shi)指(zhi)(zhi)腸(chang)(chang)(chang)(chang)黏(nian)膜的(de)完整性(xing)(xing)(xing)(xing)因炎(yan)(yan)癥、潰瘍等病(bing)變(bian)而受到破壞(huai),造成大(da)量(liang)滲(shen)出而引(yin)起(qi)腹(fu)(fu)(fu)瀉(xie)(xie)(xie)(xie)。④腸(chang)(chang)(chang)(chang)運(yun)動(dong)功能異常(chang),腸(chang)(chang)(chang)(chang)蠕(ru)動(dong)過(guo)(guo)(guo)快,以致腸(chang)(chang)(chang)(chang)腔內水分和電解(jie)質與腸(chang)(chang)(chang)(chang)黏(nian)膜接觸時間過(guo)(guo)(guo)短,影響其吸收所(suo)致。所(suo)謂慢(man)(man)(man)性(xing)(xing)(xing)(xing)腸(chang)(chang)(chang)(chang)炎(yan)(yan)這4種機(ji)(ji)(ji)制大(da)都同時或(huo)先后存在(zai)。[5]
4.6.4白(bai)(bai)帶(dai) 白(bai)(bai)帶(dai)是一組疾(ji)(ji)病的共同癥(zheng)狀(zhuang),臨(lin)床(chuang)上多見于 *** 炎、子宮頸(jing)炎、盆(pen)腔炎、婦(fu)科腫(zhong)瘤等(deng)(deng)疾(ji)(ji)病,前三者大(da)多見于細菌、病毒、滴蟲等(deng)(deng)微生(sheng)物感(gan)染,感(gan)染局部(bu)組織充血、紅腫(zhong)、有膿性(xing)分泌(mi)(mi)(mi)物附著(zhu),臨(lin)床(chuang)表現(xian)為 *** 口有膿性(xing)分泌(mi)(mi)(mi)物流出,常伴泌(mi)(mi)(mi)尿(niao)道癥(zheng)狀(zhuang)。后(hou)者種類(lei)繁(fan)多,病因也復雜,臨(lin)床(chuang)除(chu)白(bai)(bai)帶(dai)增多外(wai),常伴月經異常和下腹部(bu)腫(zhong)塊。[5]
4.7.1對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)腸(chang)(chang)(chang)(chang)(chang)功(gong)能(neng)(neng)的(de)影響(xiang) 君(jun)藥(yao)厚(hou)(hou)樸所(suo)含(han)厚(hou)(hou)樸酚(fen)(fen)通(tong)過(guo)對(dui)(dui)(dui)中(zhong)樞的(de)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)能(neng)(neng)活(huo)化(hua)(hua)(hua)(hua)(hua)防(fang)(fang)(fang)御因子,預(yu)防(fang)(fang)(fang)出(chu)血,抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)組(zu)胺所(suo)致十二(er)指(zhi)腸(chang)(chang)(chang)(chang)(chang)痙(jing)(jing)(jing)攣(luan);厚(hou)(hou)樸能(neng)(neng)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)酸分(fen)(fen)(fen)泌(mi)(mi)過(guo)多(duo),從而保(bao)(bao)護(hu)胃(wei)(wei)(wei)(wei)(wei)損(sun)傷,抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)潰(kui)(kui)(kui)(kui)瘍(yang)發生(sheng);對(dui)(dui)(dui)腸(chang)(chang)(chang)(chang)(chang)管小(xiao)劑(ji)(ji)量(liang)興奮,大劑(ji)(ji)量(liang)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi),而以抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)為(wei)主;厚(hou)(hou)樸酚(fen)(fen)為(wei)抗(kang)(kang)肝(gan)(gan)(gan)(gan)炎病毒的(de)有(you)(you)(you)(you)(you)效成(cheng)分(fen)(fen)(fen),能(neng)(neng)提高(gao)(gao)免疫(yi)性(xing)肝(gan)(gan)(gan)(gan)纖維(wei)(wei)化(hua)(hua)(hua)(hua)(hua)血漿SOD活(huo)性(xing),降(jiang)(jiang)低LPO含(han)量(liang),減(jian)(jian)輕肝(gan)(gan)(gan)(gan)細(xi)胞(bao)(bao)(bao)(bao)變性(xing)和(he)壞死(si),防(fang)(fang)(fang)止(zhi)(zhi)肝(gan)(gan)(gan)(gan)纖維(wei)(wei)化(hua)(hua)(hua)(hua)(hua)及(ji)(ji)抗(kang)(kang)肝(gan)(gan)(gan)(gan)硬化(hua)(hua)(hua)(hua)(hua)。臣藥(yao)草豆蔻對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)腸(chang)(chang)(chang)(chang)(chang)平滑(hua)肌有(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)有(you)(you)(you)(you)(you)保(bao)(bao)護(hu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),可(ke)(ke)使(shi)胃(wei)(wei)(wei)(wei)(wei)蛋白酶活(huo)性(xing)增高(gao)(gao),其(qi)煎(jian)劑(ji)(ji)可(ke)(ke)增加(jia)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)血流及(ji)(ji)血清胃(wei)(wei)(wei)(wei)(wei)泌(mi)(mi)素水平,增加(jia)胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)分(fen)(fen)(fen)泌(mi)(mi)量(liang),使(shi)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)SOD活(huo)性(xing)升高(gao)(gao),MDA含(han)量(liang)降(jiang)(jiang)低,并有(you)(you)(you)(you)(you)止(zhi)(zhi)吐(tu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)。佐(zuo)藥(yao)陳(chen)皮(pi)(pi)含(han)有(you)(you)(you)(you)(you)多(duo)種(zhong)成(cheng)分(fen)(fen)(fen),對(dui)(dui)(dui)消化(hua)(hua)(hua)(hua)(hua)道有(you)(you)(you)(you)(you)多(duo)種(zhong)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),且因消化(hua)(hua)(hua)(hua)(hua)道機能(neng)(neng)狀態而異;陳(chen)皮(pi)(pi)所(suo)含(han)橙(cheng)皮(pi)(pi)苷可(ke)(ke)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)分(fen)(fen)(fen)泌(mi)(mi),具(ju)(ju)(ju)有(you)(you)(you)(you)(you)抗(kang)(kang)潰(kui)(kui)(kui)(kui)瘍(yang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);對(dui)(dui)(dui)腸(chang)(chang)(chang)(chang)(chang)道平滑(hua)肌呈(cheng)雙(shuang)相作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),即先有(you)(you)(you)(you)(you)短暫興奮,然后抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)之;甲基(ji)橙(cheng)皮(pi)(pi)苷對(dui)(dui)(dui)腸(chang)(chang)(chang)(chang)(chang)管運動(dong)也有(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)乙(yi)酰膽堿(jian)所(suo)致腸(chang)(chang)(chang)(chang)(chang)痙(jing)(jing)(jing)攣(luan)有(you)(you)(you)(you)(you)微弱的(de)解(jie)(jie)痙(jing)(jing)(jing)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);川陳(chen)皮(pi)(pi)素也能(neng)(neng)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)小(xiao)腸(chang)(chang)(chang)(chang)(chang)運動(dong);同時(shi)(shi)陳(chen)皮(pi)(pi)煎(jian)劑(ji)(ji)能(neng)(neng)提高(gao)(gao)淀(dian)粉酶的(de)活(huo)性(xing),陳(chen)皮(pi)(pi)所(suo)含(han)萘異硫氰酸酯(ANIT)可(ke)(ke)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肝(gan)(gan)(gan)(gan)細(xi)胞(bao)(bao)(bao)(bao)變性(xing)壞死(si),降(jiang)(jiang)低ALT,其(qi)所(suo)含(han)甲基(ji)橙(cheng)皮(pi)(pi)苷可(ke)(ke)促(cu)(cu)進膽汁(zhi)及(ji)(ji)膽汁(zhi)內(nei)固(gu)體(ti)排出(chu),橘(ju)油(you)(you)具(ju)(ju)(ju)有(you)(you)(you)(you)(you)極強的(de)溶解(jie)(jie)膽固(gu)醇(chun)(chun)結(jie)石作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)。干姜(jiang)(jiang)有(you)(you)(you)(you)(you)健胃(wei)(wei)(wei)(wei)(wei)止(zhi)(zhi)吐(tu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),其(qi)甲醇(chun)(chun)提取(qu)物(wu)(wu)不(bu)僅(jin)有(you)(you)(you)(you)(you)明(ming)(ming)顯(xian)(xian)(xian)止(zhi)(zhi)吐(tu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),而且能(neng)(neng)明(ming)(ming)顯(xian)(xian)(xian)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)分(fen)(fen)(fen)泌(mi)(mi),降(jiang)(jiang)低胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)酸度(du)(du),具(ju)(ju)(ju)有(you)(you)(you)(you)(you)抗(kang)(kang)潰(kui)(kui)(kui)(kui)瘍(yang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);且低濃度(du)(du)使(shi)腸(chang)(chang)(chang)(chang)(chang)管收(shou)縮(suo),高(gao)(gao)濃度(du)(du)使(shi)其(qi)弛(chi)緩;干姜(jiang)(jiang)揮(hui)發油(you)(you)能(neng)(neng)非競爭(zheng)性(xing)地拮抗(kang)(kang)乙(yi)酰膽堿(jian)、組(zu)胺等對(dui)(dui)(dui)腸(chang)(chang)(chang)(chang)(chang)管的(de)收(shou)縮(suo);生(sheng)姜(jiang)(jiang)浸(jin)膏、姜(jiang)(jiang)辣(la)酮(tong)、姜(jiang)(jiang)辣(la)烯(xi)酮(tong)均有(you)(you)(you)(you)(you)止(zhi)(zhi)吐(tu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),且對(dui)(dui)(dui)肝(gan)(gan)(gan)(gan)損(sun)傷有(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),生(sheng)姜(jiang)(jiang)油(you)(you)對(dui)(dui)(dui)肝(gan)(gan)(gan)(gan)損(sun)傷有(you)(you)(you)(you)(you)預(yu)防(fang)(fang)(fang)和(he)治療作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),生(sheng)姜(jiang)(jiang)丙酮(tong)提取(qu)物(wu)(wu)有(you)(you)(you)(you)(you)顯(xian)(xian)(xian)著利(li)膽作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);生(sheng)姜(jiang)(jiang)煎(jian)劑(ji)(ji)能(neng)(neng)促(cu)(cu)進合(he)成(cheng)和(he)釋放(fang)具(ju)(ju)(ju)有(you)(you)(you)(you)(you)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)保(bao)(bao)護(hu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)的(de)內(nei)源性(xing)PG,對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)潰(kui)(kui)(kui)(kui)瘍(yang)有(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);生(sheng)姜(jiang)(jiang)能(neng)(neng)弱化(hua)(hua)(hua)(hua)(hua)蛋白酶作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)胰酶則有(you)(you)(you)(you)(you)顯(xian)(xian)(xian)著抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),能(neng)(neng)明(ming)(ming)顯(xian)(xian)(xian)降(jiang)(jiang)低其(qi)對(dui)(dui)(dui)淀(dian)粉、脂肪的(de)消化(hua)(hua)(hua)(hua)(hua)功(gong)能(neng)(neng)。茯(fu)苓可(ke)(ke)使(shi)胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)酸度(du)(du)降(jiang)(jiang)低,對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)潰(kui)(kui)(kui)(kui)瘍(yang)有(you)(you)(you)(you)(you)防(fang)(fang)(fang)治作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),同時(shi)(shi)對(dui)(dui)(dui)腸(chang)(chang)(chang)(chang)(chang)肌有(you)(you)(you)(you)(you)直接松(song)弛(chi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),使(shi)腸(chang)(chang)(chang)(chang)(chang)肌收(shou)縮(suo)振(zhen)幅(fu)(fu)減(jian)(jian)少、張力(li)下降(jiang)(jiang),可(ke)(ke)使(shi)肝(gan)(gan)(gan)(gan)臟(zang)膠(jiao)原蛋白降(jiang)(jiang)解(jie)(jie),促(cu)(cu)進肝(gan)(gan)(gan)(gan)內(nei)纖維(wei)(wei)重(zhong)吸收(shou),防(fang)(fang)(fang)止(zhi)(zhi)肝(gan)(gan)(gan)(gan)硬化(hua)(hua)(hua)(hua)(hua)。木(mu)香(xiang)揮(hui)發油(you)(you)可(ke)(ke)使(shi)胃(wei)(wei)(wei)(wei)(wei)血管舒張、血流增加(jia),促(cu)(cu)進胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)分(fen)(fen)(fen)泌(mi)(mi),對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)腸(chang)(chang)(chang)(chang)(chang)道平滑(hua)肌呈(cheng)興奮和(he)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)雙(shuang)相作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);木(mu)香(xiang)提取(qu)液(ye)(ye)(ye)使(shi)腸(chang)(chang)(chang)(chang)(chang)蠕(ru)動(dong)幅(fu)(fu)度(du)(du)及(ji)(ji)張力(li)顯(xian)(xian)(xian)著增強,但對(dui)(dui)(dui)乙(yi)酰膽堿(jian)、組(zu)胺、BaCl2引起的(de)腸(chang)(chang)(chang)(chang)(chang)痙(jing)(jing)(jing)攣(luan)又有(you)(you)(you)(you)(you)對(dui)(dui)(dui)抗(kang)(kang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),還有(you)(you)(you)(you)(you)利(li)膽作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)。使(shi)藥(yao)甘(gan)(gan)草及(ji)(ji)所(suo)含(han)FM100等黃酮(tong)類化(hua)(hua)(hua)(hua)(hua)合(he)物(wu)(wu)具(ju)(ju)(ju)有(you)(you)(you)(you)(you)罌(ying)粟堿(jian)樣特異性(xing)解(jie)(jie)痙(jing)(jing)(jing)能(neng)(neng)力(li),對(dui)(dui)(dui)胃(wei)(wei)(wei)(wei)(wei)腸(chang)(chang)(chang)(chang)(chang)道平滑(hua)肌運動(dong)有(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong),直接作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)于胃(wei)(wei)(wei)(wei)(wei)壁細(xi)胞(bao)(bao)(bao)(bao)而抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)酸分(fen)(fen)(fen)泌(mi)(mi),直接吸附胃(wei)(wei)(wei)(wei)(wei)酸,降(jiang)(jiang)低胃(wei)(wei)(wei)(wei)(wei)液(ye)(ye)(ye)酸度(du)(du), *** 胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)分(fen)(fen)(fen)泌(mi)(mi)具(ju)(ju)(ju)有(you)(you)(you)(you)(you)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)保(bao)(bao)護(hu)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)的(de)內(nei)源性(xing)PG及(ji)(ji)己(ji)糖胺,并促(cu)(cu)進胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)上皮(pi)(pi)細(xi)胞(bao)(bao)(bao)(bao)再生(sheng),可(ke)(ke)促(cu)(cu)進潰(kui)(kui)(kui)(kui)瘍(yang)修復(fu),具(ju)(ju)(ju)有(you)(you)(you)(you)(you)抗(kang)(kang)潰(kui)(kui)(kui)(kui)瘍(yang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);甘(gan)(gan)草鋅可(ke)(ke)促(cu)(cu)進成(cheng)纖維(wei)(wei)細(xi)胞(bao)(bao)(bao)(bao)合(he)成(cheng)纖維(wei)(wei)和(he)基(ji)質(zhi),也具(ju)(ju)(ju)有(you)(you)(you)(you)(you)抗(kang)(kang)潰(kui)(kui)(kui)(kui)瘍(yang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong);甘(gan)(gan)草次酸能(neng)(neng)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)內(nei)磷(lin)酸二(er)酯酶活(huo)性(xing),增高(gao)(gao)幽門(men)及(ji)(ji)賁門(men)黏(nian)膜(mo)(mo)的(de)cAMP含(han)量(liang),從而抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)酸分(fen)(fen)(fen)泌(mi)(mi);甘(gan)(gan)草次酸不(bu)僅(jin)可(ke)(ke)抑(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)(wei)(wei)酸分(fen)(fen)(fen)泌(mi)(mi),而且可(ke)(ke)促(cu)(cu)進潰(kui)(kui)(kui)(kui)瘍(yang)的(de)愈合(he);生(sheng)胃(wei)(wei)(wei)(wei)(wei)酮(tong)能(neng)(neng)與胃(wei)(wei)(wei)(wei)(wei)蛋白酶結(jie)合(he)而降(jiang)(jiang)低其(qi)活(huo)性(xing),促(cu)(cu)進胃(wei)(wei)(wei)(wei)(wei)黏(nian)膜(mo)(mo)的(de)分(fen)(fen)(fen)泌(mi)(mi),使(shi)胃(wei)(wei)(wei)(wei)(wei)上皮(pi)(pi)細(xi)胞(bao)(bao)(bao)(bao)的(de)生(sheng)存(cun)時(shi)(shi)間延(yan)長(chang)。
由此可見該方劑各味(wei)藥(yao)對(dui)慢性胃炎(yan)、胃潰瘍,以及腸炎(yan)有治療(liao)作(zuo)用。
4.7.2抗(kang)病(bing)(bing)(bing)(bing)原(yuan)微生物(wu)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong) 君藥厚(hou)樸(pu)煎劑(ji)具有(you)廣(guang)(guang)譜(pu)抗(kang)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),其對(dui)(dui)(dui)(dui)革蘭氏(shi)陽性(xing)(xing)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、耐酸(suan)性(xing)(xing)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、肺(fei)炎球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、白(bai)喉桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、溶(rong)血性(xing)(xing)鏈(lian)(lian)球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、枯草(cao)桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、金(jin)黃(huang)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、痢疾桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)及(ji)常見(jian)的(de)致(zhi)病(bing)(bing)(bing)(bing)性(xing)(xing)皮膚(fu)真菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)(dui)炭(tan)疽桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)及(ji)變異(yi)鏈(lian)(lian)球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(致(zhi)齲菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun))有(you)明(ming)顯(xian)(xian)的(de)抗(kang)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),且對(dui)(dui)(dui)(dui)部(bu)分病(bing)(bing)(bing)(bing)毒有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)。佐藥陳皮能抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)及(ji)霉菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)生長,其所含橘(ju)皮油可殺(sha)死(si)蟲螨。木香(xiang)對(dui)(dui)(dui)(dui)傷(shang)寒桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、痢疾桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、大(da)腸(chang)桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、鏈(lian)(lian)球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、金(jin)黃(huang)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)及(ji)白(bai)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、許蘭黃(huang)癬菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)等10余種真菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)。干(gan)姜有(you)顯(xian)(xian)著的(de)滅(mie)螺和抗(kang)血吸(xi)蟲作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)。生姜提取(qu)物(wu)對(dui)(dui)(dui)(dui)金(jin)黃(huang)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、傷(shang)寒桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、痢疾桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、銅綠假(jia)單(dan)胞桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)顯(xian)(xian)著抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)(dui)霍(huo)亂弧菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、沙(sha)門菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、鏈(lian)(lian)球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)和肺(fei)炎鏈(lian)(lian)球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)也有(you)顯(xian)(xian)著抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),尚能抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)HBV及(ji) *** 滴蟲。茯苓煎劑(ji)對(dui)(dui)(dui)(dui)金(jin)黃(huang)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、大(da)腸(chang)桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、變形桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),并能殺(sha)死(si)鉤端螺旋體。甘(gan)(gan)草(cao)對(dui)(dui)(dui)(dui)結核桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、大(da)腸(chang)桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、金(jin)黃(huang)色(se)葡(pu)萄球(qiu)(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)、阿米巴原(yuan)蟲及(ji)滴蟲均(jun)有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),同時具有(you)廣(guang)(guang)譜(pu)抗(kang)病(bing)(bing)(bing)(bing)毒作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),特別是(shi)對(dui)(dui)(dui)(dui)艾滋病(bing)(bing)(bing)(bing)毒、單(dan)純皰疹(zhen)病(bing)(bing)(bing)(bing)毒、水痘(dou)-帶狀(zhuang)皰疹(zhen)病(bing)(bing)(bing)(bing)毒有(you)確(que)切抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong);甘(gan)(gan)草(cao)對(dui)(dui)(dui)(dui)幽門螺旋桿(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)(jun)有(you)較強抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong),甘(gan)(gan)草(cao)多(duo)糖對(dui)(dui)(dui)(dui)水皰口炎病(bing)(bing)(bing)(bing)毒、Ⅰ型皰疹(zhen)病(bing)(bing)(bing)(bing)毒均(jun)有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong);甘(gan)(gan)草(cao)酸(suan)對(dui)(dui)(dui)(dui)合胞病(bing)(bing)(bing)(bing)毒、腺病(bing)(bing)(bing)(bing)毒、柯薩(sa)奇(qi)病(bing)(bing)(bing)(bing)毒抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)較強,甘(gan)(gan)草(cao)酸(suan)單(dan)胺還能抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)HIV;甘(gan)(gan)草(cao)甜素(su)除對(dui)(dui)(dui)(dui)上(shang)述病(bing)(bing)(bing)(bing)毒有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)外(wai),還對(dui)(dui)(dui)(dui)肝炎病(bing)(bing)(bing)(bing)毒有(you)抑(yi)(yi)制(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)。
4.7.3對神經、內分泌系(xi)(xi)(xi)統(tong)功能(neng)的影響 君(jun)藥厚樸(pu)(pu)含有(you)厚樸(pu)(pu)酚,能(neng)抑制(zhi)腦(nao)干網狀(zhuang)激活系(xi)(xi)(xi)統(tong)及丘腦(nao)下(xia)部激活系(xi)(xi)(xi)統(tong),使腦(nao)內5羥色胺及其(qi)代謝產物(wu)含量增加,從(cong)而(er)對中(zhong)樞(shu)有(you)明顯而(er)持久(jiu)的抑制(zhi)作(zuo)用(yong);同時厚樸(pu)(pu)提取物(wu)尚(shang)可(ke)顯著影響中(zhong)樞(shu)多巴胺系(xi)(xi)(xi)統(tong)的作(zuo)用(yong)。干姜不僅有(you)中(zhong)樞(shu)性鎮痛(tong)、鎮靜作(zuo)用(yong),而(er)且能(neng)增強(qiang)腎上(shang)腺(xian)(xian)皮質(zhi)功能(neng)。茯(fu)苓(ling)不僅有(you)中(zhong)樞(shu)性鎮靜作(zuo)用(yong),同時其(qi)所含茯(fu)苓(ling)素還能(neng)激活Na+K+ATP酶和細胞(bao)中(zhong)總ATP酶,從(cong)而(er)促進機體(ti)的水鹽代謝。使藥甘草所含FM100有(you)鎮靜、鎮痛(tong)作(zuo)用(yong),而(er)且有(you)抗驚厥作(zuo)用(yong),還可(ke)通(tong)過興奮下(xia)丘腦(nao)-腺(xian)(xian)垂體(ti)-腎上(shang)腺(xian)(xian)皮質(zhi)軸(zhou)而(er)促進腎上(shang)腺(xian)(xian)皮質(zhi)激素的合成與釋(shi)放,從(cong)而(er)提高機體(ti)內分泌調節能(neng)力,起到“扶正固(gu)本(ben)”的治(zhi)療作(zuo)用(yong)。
4.7.4對(dui)心(xin)(xin)臟(zang)、血(xue)(xue)(xue)(xue)管(guan)、血(xue)(xue)(xue)(xue)液(ye)流變學的(de)(de)(de)影響 君(jun)藥(yao)(yao)厚(hou)樸所含(han)木蘭(lan)箭毒堿或厚(hou)樸堿均(jun)有(you)降(jiang)血(xue)(xue)(xue)(xue)壓(ya)作(zuo)(zuo)(zuo)用(yong);厚(hou)樸酚(fen)與(yu)和厚(hou)樸酚(fen)通過(guo)抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)栓素的(de)(de)(de)生(sheng)(sheng)成以及(ji)抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)細(xi)胞內(nei)鈣轉運(yun)而(er)具有(you)抗血(xue)(xue)(xue)(xue)小板(ban)聚(ju)集(ji)作(zuo)(zuo)(zuo)用(yong);和厚(hou)樸酚(fen)在Ca2+存在下(xia)能與(yu)鈣調素結合(he),拮抗其對(dui)靶酶-磷酸二(er)酯酶的(de)(de)(de)激活,從(cong)而(er)引起cAMP提(ti)高,對(dui)冠心(xin)(xin)病、動(dong)脈粥(zhou)樣硬化有(you)益。佐(zuo)(zuo)藥(yao)(yao)陳皮(pi)所含(han)橙(cheng)皮(pi)苷(gan)(gan)及(ji)橙(cheng)皮(pi)苷(gan)(gan)甲基查耳酮(tong)均(jun)有(you)不同程度的(de)(de)(de)擴(kuo)張(zhang)冠脈、增加冠脈血(xue)(xue)(xue)(xue)流作(zuo)(zuo)(zuo)用(yong);橙(cheng)皮(pi)苷(gan)(gan)還能增加心(xin)(xin)肌收(shou)(shou)縮力和心(xin)(xin)搏出(chu)量,陳皮(pi)煎劑(ji)也有(you)上述作(zuo)(zuo)(zuo)用(yong)。木香(xiang)揮發(fa)油及(ji)其總(zong)內(nei)酯能明(ming)顯擴(kuo)血(xue)(xue)(xue)(xue)管(guan),因而(er)有(you)持(chi)久的(de)(de)(de)降(jiang)血(xue)(xue)(xue)(xue)壓(ya)作(zuo)(zuo)(zuo)用(yong)。其水(shui)溶性(xing)(xing)部(bu)分能抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)小板(ban)聚(ju)集(ji),對(dui)聚(ju)集(ji)的(de)(de)(de)血(xue)(xue)(xue)(xue)小板(ban)也有(you)解(jie)聚(ju)作(zuo)(zuo)(zuo)用(yong)。干姜(jiang)(jiang)的(de)(de)(de)乙醇(chun)提(ti)取(qu)(qu)液(ye)能直接興奮(fen)心(xin)(xin)臟(zang)及(ji)血(xue)(xue)(xue)(xue)管(guan)運(yun)動(dong)中(zhong)樞,干姜(jiang)(jiang)水(shui)提(ti)物(wu)能明(ming)顯抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)TXB2及(ji)PGS合(he)成,從(cong)而(er)抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)小板(ban)聚(ju)集(ji),延(yan)長(chang)血(xue)(xue)(xue)(xue)栓形成的(de)(de)(de)時(shi)(shi)間(jian)。生(sheng)(sheng)姜(jiang)(jiang)所含(han)6姜(jiang)(jiang)辣醇(chun)、8姜(jiang)(jiang)辣醇(chun)、10姜(jiang)(jiang)辣醇(chun)均(jun)為強(qiang)心(xin)(xin)藥(yao)(yao),能增強(qiang)心(xin)(xin)肌收(shou)(shou)縮力,對(dui)血(xue)(xue)(xue)(xue)壓(ya)產生(sheng)(sheng)一過(guo)性(xing)(xing)下(xia)降(jiang)、明(ming)顯上升和持(chi)續性(xing)(xing)降(jiang)壓(ya)三(san)相性(xing)(xing)作(zuo)(zuo)(zuo)用(yong),影響花生(sheng)(sheng)四烯酸代謝(xie),抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)TXB2及(ji)PGS合(he)成,減(jian)少(shao)6酮(tong)PGF1αTXB2、PGI2合(he)成,從(cong)而(er)抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)小板(ban)聚(ju)集(ji)。茯苓(ling)各種提(ti)取(qu)(qu)物(wu)均(jun)能使(shi)心(xin)(xin)肌收(shou)(shou)縮力加強(qiang)、心(xin)(xin)率加快,同時(shi)(shi)其強(qiang)大的(de)(de)(de)利尿作(zuo)(zuo)(zuo)用(yong)可有(you)利地(di)減(jian)輕心(xin)(xin)臟(zang)前負(fu)荷。木香(xiang)揮發(fa)油有(you)明(ming)顯的(de)(de)(de)血(xue)(xue)(xue)(xue)管(guan)擴(kuo)張(zhang)作(zuo)(zuo)(zuo)用(yong)。佐(zuo)(zuo)藥(yao)(yao)甘草提(ti)取(qu)(qu)物(wu)有(you)抗心(xin)(xin)律失常(chang)、降(jiang)血(xue)(xue)(xue)(xue)脂、抑(yi)(yi)(yi)制(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)小板(ban)聚(ju)集(ji)、抗動(dong)脈硬化作(zuo)(zuo)(zuo)用(yong)。
4.7.5抗(kang)炎(yan)(yan)、抗(kang)氧化(hua)作(zuo)(zuo)用(yong)(yong)(yong)(yong) 君(jun)藥(yao)(yao)厚樸能提(ti)高(gao)血(xue)漿(jiang)SOD活性(xing)(xing),降(jiang)(jiang)低(di)LPO含(han)(han)量的(de)(de)生(sheng)(sheng)物(wu)效應,具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)(you)抗(kang)氧化(hua)損(sun)傷作(zuo)(zuo)用(yong)(yong)(yong)(yong);同時厚樸可降(jiang)(jiang)低(di)炎(yan)(yan)癥(zheng)(zheng)區毛(mao)細(xi)(xi)(xi)(xi)血(xue)管的(de)(de)通透(tou)(tou)性(xing)(xing),抑(yi)制(zhi)(zhi)白(bai)細(xi)(xi)(xi)(xi)胞游出,抑(yi)制(zhi)(zhi)纖維組(zu)(zu)織增生(sheng)(sheng)而具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)(you)抗(kang)炎(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。佐(zuo)藥(yao)(yao)陳(chen)皮中(zhong)所(suo)含(han)(han)類(lei)黃(huang)酮(tong)類(lei)化(hua)合物(wu)有(you)(you)(you)(you)(you)(you)(you)很(hen)(hen)強的(de)(de)抑(yi)制(zhi)(zhi)人體嗜(shi)堿性(xing)(xing)白(bai)細(xi)(xi)(xi)(xi)胞釋(shi)放(fang)組(zu)(zu)胺和中(zhong)性(xing)(xing)粒(li)細(xi)(xi)(xi)(xi)胞釋(shi)放(fang)β尿甘酸化(hua)物(wu)酶(mei)的(de)(de)活性(xing)(xing),從(cong)而具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)(you)抗(kang)炎(yan)(yan)、抗(kang)過(guo)敏作(zuo)(zuo)用(yong)(yong)(yong)(yong);橙(cheng)皮苷(gan)及(ji)甲基橙(cheng)皮苷(gan)均(jun)能降(jiang)(jiang)低(di)毛(mao)細(xi)(xi)(xi)(xi)血(xue)管通透(tou)(tou)性(xing)(xing),防止微血(xue)管出血(xue),橙(cheng)皮苷(gan)對(dui)(dui)炎(yan)(yan)性(xing)(xing)肉芽腫也有(you)(you)(you)(you)(you)(you)(you)抑(yi)制(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。木(mu)香75%乙(yi)醇提(ti)取物(wu)對(dui)(dui)炎(yan)(yan)性(xing)(xing)毛(mao)細(xi)(xi)(xi)(xi)血(xue)管通透(tou)(tou)性(xing)(xing)增高(gao)、水腫有(you)(you)(you)(you)(you)(you)(you)抑(yi)制(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong),其所(suo)含(han)(han)倍萜烯內酯(zhi)對(dui)(dui)炎(yan)(yan)性(xing)(xing)肉芽腫有(you)(you)(you)(you)(you)(you)(you)抑(yi)制(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。干(gan)姜(jiang)也具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)(you)抗(kang)炎(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong),對(dui)(dui)炎(yan)(yan)癥(zheng)(zheng)的(de)(de)早(zao)期(qi)、晚期(qi)均(jun)有(you)(you)(you)(you)(you)(you)(you)明顯(xian)抑(yi)制(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong),干(gan)姜(jiang)提(ti)取物(wu)能清除超(chao)氧陰(yin)離子及(ji)羥自(zi)由(you)基,抑(yi)制(zhi)(zhi)H2O2所(suo)致溶(rong)血(xue),抑(yi)制(zhi)(zhi)肝脂質過(guo)氧化(hua),降(jiang)(jiang)低(di)MDA含(han)(han)量。使(shi)藥(yao)(yao)甘草對(dui)(dui)下丘腦-腺(xian)垂體-腎(shen)上腺(xian)皮質有(you)(you)(you)(you)(you)(you)(you)興奮作(zuo)(zuo)用(yong)(yong)(yong)(yong),可使(shi)皮質激素釋(shi)放(fang)增多(duo)而起到強大的(de)(de)抗(kang)炎(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。茯(fu)苓所(suo)含(han)(han)新(xin)型羧(suo)甲基茯(fu)苓多(duo)糖有(you)(you)(you)(you)(you)(you)(you)很(hen)(hen)強的(de)(de)抗(kang)炎(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong),并能改善炎(yan)(yan)癥(zheng)(zheng)的(de)(de)全(quan)身癥(zheng)(zheng)狀。使(shi)藥(yao)(yao)甘草具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)(you)保泰松及(ji)氫化(hua)可的(de)(de)松樣(yang)抗(kang)炎(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong),對(dui)(dui)炎(yan)(yan)癥(zheng)(zheng)的(de)(de)Ⅰ、Ⅱ、Ⅲ期(qi)都有(you)(you)(you)(you)(you)(you)(you)抑(yi)制(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong),還能抑(yi)制(zhi)(zhi)變態反應性(xing)(xing)炎(yan)(yan)癥(zheng)(zheng)如Arthus現象及(ji)Schwartzman反應,同時還有(you)(you)(you)(you)(you)(you)(you)抗(kang)氧化(hua)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。
4.7.6對(dui)(dui)免(mian)疫功(gong)能(neng)的(de)(de)影響 佐藥(yao)陳皮(pi)水煎(jian)劑對(dui)(dui)血(xue)(xue)清(qing)溶(rong)菌酶(mei)含量(liang)、血(xue)(xue)清(qing)血(xue)(xue)凝(ning)抗(kang)(kang)(kang)(kang)體(ti)(ti)滴度、心臟血(xue)(xue)T淋巴(ba)細(xi)(xi)胞(bao)(bao)E玫瑰花環形成率(lv)均有(you)(you)(you)顯(xian)著增(zeng)(zeng)強作用,但對(dui)(dui)T淋巴(ba)細(xi)(xi)胞(bao)(bao)轉化(hua)率(lv)卻(que)有(you)(you)(you)抑(yi)(yi)制(zhi)(zhi)(zhi)作用。木香甲醇提取物對(dui)(dui)巨(ju)噬細(xi)(xi)胞(bao)(bao)中NO合成及TNFα有(you)(you)(you)抑(yi)(yi)制(zhi)(zhi)(zhi)作用。干(gan)姜(jiang)有(you)(you)(you)抗(kang)(kang)(kang)(kang)5HT作用,能(neng)明(ming)顯(xian)改善免(mian)疫功(gong)能(neng),升高臟器指數,提高巨(ju)噬細(xi)(xi)胞(bao)(bao)吞(tun)(tun)噬功(gong)能(neng)。茯(fu)苓(ling)多糖具有(you)(you)(you)顯(xian)著增(zeng)(zeng)強機體(ti)(ti)免(mian)疫功(gong)能(neng)的(de)(de)作用,能(neng)增(zeng)(zeng)強免(mian)疫器官胸腺、脾(pi)(pi)臟、淋巴(ba)結的(de)(de)重量(liang),增(zeng)(zeng)強巨(ju)噬細(xi)(xi)胞(bao)(bao)吞(tun)(tun)噬功(gong)能(neng),拮抗(kang)(kang)(kang)(kang)可(ke)(ke)的(de)(de)松(song)對(dui)(dui)其(qi)的(de)(de)抑(yi)(yi)制(zhi)(zhi)(zhi)作用,對(dui)(dui)抗(kang)(kang)(kang)(kang)60Co照射引起(qi)的(de)(de)外周血(xue)(xue)WBC減少,增(zeng)(zeng)強ANAE陽性(xing)(xing)淋巴(ba)細(xi)(xi)胞(bao)(bao)數;對(dui)(dui)特異(yi)性(xing)(xing)免(mian)疫功(gong)能(neng)可(ke)(ke)使PHA誘發的(de)(de)淋巴(ba)細(xi)(xi)胞(bao)(bao)轉化(hua)率(lv)升高,使脾(pi)(pi)臟抗(kang)(kang)(kang)(kang)體(ti)(ti)分(fen)泌細(xi)(xi)胞(bao)(bao)數明(ming)顯(xian)增(zeng)(zeng)加;茯(fu)苓(ling)素(su)可(ke)(ke)增(zeng)(zeng)強巨(ju)噬細(xi)(xi)胞(bao)(bao)吞(tun)(tun)噬功(gong)能(neng),但對(dui)(dui)抗(kang)(kang)(kang)(kang)體(ti)(ti)生(sheng)成及淋巴(ba)細(xi)(xi)胞(bao)(bao)轉化(hua)有(you)(you)(you)抑(yi)(yi)制(zhi)(zhi)(zhi)作用;甘(gan)(gan)草(cao)(cao)(cao)所含甘(gan)(gan)草(cao)(cao)(cao)多糖可(ke)(ke)提高網狀內皮(pi)系統和單核細(xi)(xi)胞(bao)(bao)吞(tun)(tun)噬功(gong)能(neng),甘(gan)(gan)草(cao)(cao)(cao)次酸可(ke)(ke)升高淋巴(ba)細(xi)(xi)胞(bao)(bao)比(bi)率(lv),甘(gan)(gan)草(cao)(cao)(cao)甜素(su)可(ke)(ke)抑(yi)(yi)制(zhi)(zhi)(zhi)肥大細(xi)(xi)胞(bao)(bao)釋放(fang)組胺,并(bing)增(zeng)(zeng)強ConA誘導的(de)(de)淋巴(ba)細(xi)(xi)胞(bao)(bao)分(fen)泌IL2的(de)(de)能(neng)力;甘(gan)(gan)草(cao)(cao)(cao)Lx可(ke)(ke)降低抗(kang)(kang)(kang)(kang)原量(liang),抑(yi)(yi)制(zhi)(zhi)(zhi)抗(kang)(kang)(kang)(kang)體(ti)(ti)生(sheng)成,防(fang)治青霉素(su)過敏(min)性(xing)(xing)休(xiu)克;β甘(gan)(gan)草(cao)(cao)(cao)次酸是人體(ti)(ti)補體(ti)(ti)經典(dian)途徑的(de)(de)抑(yi)(yi)制(zhi)(zhi)(zhi)劑。
5《明醫指掌》卷五方之厚樸溫中湯
人體體表面積計算器BMI指數計算及評價女性安全期計算器預產期計算器孕期體重增長正常值孕期用藥安全性分級(FDA)五行八字成人血壓評價體溫水平評價糖尿病飲食建議臨床生化常用單位換算基礎代謝率計算補鈉計算器補鐵計算器處方常用拉丁文縮寫速查藥代動力學常用符號速查有效血漿滲透壓計算器乙醇攝入量計算器
醫(yi)學百(bai)科,馬上計算!
6《醫學傳燈》卷上方之厚樸溫中湯
厚樸(pu)、杏(xing)仁、半夏、枳殼(ke)、桔(jie)梗、炮姜(jiang)、甘草、藿(huo)香(xiang)(xiang)、香(xiang)(xiang)茹、陳皮。
厚樸(pu)溫中(zhong)湯(tang)具有功能溫中(zhong)化濕(shi)解(jie)暑(shu)的功效[3]。治夏月(yue)中(zhong)暑(shu),多食生冷,停滯飲食,脈沉細緩者[3]。
扶正理氣湯
方劑組成及用法:川樸9g,木香9g,烏藥9g,赤芍9g,桃仁6g,芒硝6g,萊菔子9g,番瀉葉9g,水煎成500ml湯劑,分3次服用,每日1劑。
扶正理氣湯以通里攻下為主。中醫認為,腸梗阻為腸道氣機不利,氣血閉塞,疏導不暢水飲停滯。本方劑可使平滑肌舒張更完全,收縮更有力,不被腸道吸收,促進腸道蠕動,加速腸內容物排出。其作用明顯強于蓖麻油及生豆油。
小承氣湯保留灌腸加小劑量紅霉素靜滴為主治療粘連性腸梗阻
采用小承氣湯(枳實15g,厚樸15g,生大黃15g,煎水200ml)保留灌腸,每12h1次;乳糖酸紅霉素0.3g加入5%葡萄糖250ml中靜脈滴注,每日1次;根據病情予補充水、電解質,糾正酸堿失衡及對癥處理。粘連性腸梗阻,特別是廣泛性粘連者,一般選用非手術治療。又如手術后早期發生的粘連性腸梗阻,多為新形成的纖維素性粘連,日后可部分或全部吸收,一般多采用非手術治療。這類腸梗阻有反復發作,呈慢性經過的特點。
近年小劑量紅霉素治療腸梗阻較為引起關注 。紅霉素作為胃動素受體激動劑刺激胃腸道運動,改善胃竇十二指腸收縮的協調,促進固體食物(包括較大顆粒的未消化食物)的排空。國外有報道,采用紅霉素治療反射性腸梗阻和 Ogili Vie綜合征,可以使腹脹減輕,出現排氣和排大便。機理是紅霉素可以直接刺激腸蠕動,可廣泛用于胃腸道神經源性運動障礙。本研究采用乳糖酸紅霉素0.3g靜滴,qd,未見明顯副作用表現。
小承氣湯方中以大黃苦寒泄熱通便、蕩滌腸胃為主藥;積滯不去,由于氣滯不行,故輔以枳實、厚樸消痞除滿,行氣散結,三藥合用,有下熱結,通便秘的功效。對于腸胃燥實、郁滯不通者能承順胃氣下行,使塞者通,閉者暢。但大多數腸梗阻患者嘔吐較頻繁,口服中藥往往隨即吐出,難以達到治療效果。采用小承氣湯保留灌腸則能有效解決這個問題。
復方承氣湯治療粘連性腸梗阻
復方承氣湯的主要成份是大黃和芒硝。大黃具有瀉下功能,能促進腸道有序蠕動,并有抑菌、抗感染作用;芒硝具有瀉下、利尿、抗干擾等作用。
按常規方法給予禁食、禁水,持續胃腸減壓,輸液補充水分和電解質等。除上述常規處理外,從胃管內注入復方承氣湯150~200ml,每天2次,連續3天。
復方大承氣湯
處方組成:生大黃15克(后下)、芒硝9-15克(沖服)、川樸15克、枳實12克、炒萊菔子45克、桃仁12克、赤芍15克,上方加水500毫升,煎成200毫升,每日1-2劑,2次分服或由胃管注入,也可灌腸以加強通下作用
功能主治:功能通里攻下,理氣祛瘀。主治蛔蟲團性腸梗阻,單純性粘連性腸梗阻,麻痹性腸梗阻,手術后腸麻痹
臨床療效: 治療142例,106例有效,占74.6%;無效改手術36例,占25.4%
處方來源: 貴州省遵義醫學院
按語: 本組臨床療效病例系由吉林醫科大學第三臨床學院應用遵義醫學院復方大承氣湯方觀察結果。方中大黃、芒硝攻結通下;枳實行氣導滯;川樸寬中下氣;炒萊菔子消食降氣;桃仁、赤芍活血祛瘀。本方為行氣祛瘀通下之峻劑。據近年來對本方的實驗研究表明,其作用有促進胃腸蠕動,并能增加胃腸道的容積,改善腸管的血液循環,降低腸道毛細血管的通透性
防粘連湯
【方名】防粘連湯。
【組成】烏藥12克,川楝子12克,厚樸9克,元胡9克,當歸12克,赤芍9克,枳殼9克,炒萊菔子12克,大黃15克(后下),芒硝6克(沖服)。
【辨證】陽明腑實,氣機痞塞,血行瘀滯與糟粕互結。
【治法】理氣活血,通腑散結。
【用法】水煎服,每日1劑,日服2次。
【出處】嚴鳳山方。
參考網頁:/search.aspx?query=%u6cbb%u7597%u7c98%u8fde%u6027%u80a0%u6897&start=1
參考資料:
53歲的老范胃部分切除后,又不幸繼發了粘連性腸梗阻,大便和排氣十分困難。齊齊哈爾市第一醫院中醫科的醫生為他煎煮并服用理氣瀉下湯后梗阻即刻得到緩解,糞便迅速排出。
齊市第一醫院劉煒等醫生選用大黃、芒硝、川樸、枳殼、木香、萊菔子、桃仁、赤芍各一定劑量,加水1000毫升,浸泡30分鐘后煎煮40分鐘,取汁400毫升。用時先以胃管吸盡胃液,然后注入中藥湯劑200~400毫升。一般1~2小時藥效達到高峰,此時患者腹中可出現腸鳴音亢進,腹痛加重,梗阻隨即就能緩解,排出腸內容物或排氣。必要時可加肥皂水灌腸以利于腸內容物的徹底清除。目前他們采用本法已治愈粘連性腸梗阻患者近百人,輕者一次見效,重者2~4次收效。
中醫認為(wei)粘連(lian)性腸梗(geng)阻(zu)屬陽明腑實(shi)證(zheng),表現為(wei)實(shi)熱、氣滯和血瘀征象。上述方(fang)劑理氣瀉下并重,由此(ci)使粘連(lian)松解(jie)。
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