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內補當歸建中湯癥狀表現,立方意義,治療范圍

道醫 2023-06-25 18:26:35

桂枝湯證,而呈(cheng)貧血之(zhi)瘀血證者,加當歸。——《金匱(kui)附方》

【組成】當歸7克(ke),桂枝、生姜、大棗各(ge)5.5克(ke),芍藥11克(ke),甘草5.5克(ke)。以水(shui)二(er)合五勺;煎一(yi)合,去滓。一(yi)日三次,溫(wen)服。

按:原文:方(fang)后有云,若(ruo)大虛,加(jia)飴糖六(liu)(liu)兩,湯成(cheng),納(na)入(ru)于火上煖(nuan)令飴消(xiao)。若(ruo)去血過多崩傷(shang),內(nei)衄不止,加(jia)地黃六(liu)(liu)兩、阿(a)(a)膠(jiao)二兩,合(he)八味(wei),湯成(cheng),納(na)阿(a)(a)膠(jiao)。若(ruo)無(wu)當歸,以(yi)芎(xiong)代之。若(ruo)無(wu)生(sheng)姜,以(yi)干姜代之,為此方(fang)加(jia)味(wei)法(fa)及(ji)代替(ti)法(fa)。

【癥狀(zhuang)表現】原(yuan)文:產(chan)后(hou)虛羸不足(zu),腹(fu)中刺痛不止,呼吸(xi)少(shao)氣(呼吸(xi)困難之狀(zhuang)),或苦(ku)少(shao)腹(fu)中急(ji)痛,引腰背,不能飲食。

編者按:產后腹(fu)中刺痛(tong),少(shao)腹(fu)急(ji)痛(tong)之(zhi)(zhi)(zhi)證,多(duo)系(xi)瘀(yu)血(xue)(xue)(xue)積(ji)滯之(zhi)(zhi)(zhi)故,以右屬氣(qi),左屬血(xue)(xue)(xue)言之(zhi)(zhi)(zhi),當以左側腹(fu)部攣急(ji)為(wei)甚,少(shao)腹(fu)血(xue)(xue)(xue)滯,當有軟弱瘀(yu)血(xue)(xue)(xue)之(zhi)(zhi)(zhi)塊(kuai)形沉著,呈貧血(xue)(xue)(xue)虛狀(zhuang)之(zhi)(zhi)(zhi)觀,自(zi)屬顯然。

【立方意義】貧血(xue)(xue)(xue)(xue)證當補(bu)血(xue)(xue)(xue)(xue),瘀(yu)(yu)血(xue)(xue)(xue)(xue)證當行(xing)瘀(yu)(yu)。若由有瘀(yu)(yu)血(xue)(xue)(xue)(xue)之故而呈貧血(xue)(xue)(xue)(xue)之狀者(zhe),以驅瘀(yu)(yu)為主,雖然,婦人產后,瘀(yu)(yu)血(xue)(xue)(xue)(xue)之釀成,以屬于虛者(zhe)為多。本方,桂(gui)枝合芍藥,有驅瘀(yu)(yu)血(xue)(xue)(xue)(xue)之能;生(sheng)姜健胃散寒,大棗滋養和血(xue)(xue)(xue)(xue),甘(gan)草緩(huan)急止痛(tong),此桂(gui)枝湯(tang)方證也(ye),再加當歸,以通達血(xue)(xue)(xue)(xue)液(ye),既行(xing)血(xue)(xue)(xue)(xue),又補(bu)血(xue)(xue)(xue)(xue),去瘀(yu)(yu)生(sheng)新(xin),補(bu)虛緩(huan)痛(tong),為治產后虛羸(lei)瘀(yu)(yu)血(xue)(xue)(xue)(xue)作痛(tong)之妙劑。

【治療范圍】:以左側腹(fu)筋攣急(ji),少腹(fu)有軟(ruan)弱瘀(yu)血(xue)塊狀而呈貧血(xue)虛羸不足為主的。

【諸家經驗談】《漫游雜記》:一婦人經水至年(nian)五十(shi)余不(bu)斷,血下三(san)倍(bei)于常人,面目黎黑,肌膚(fu)甲(jia)錯,暈(yun)眩(xuan),日(ri)發四五次(ci),數步難行,呻吟不(bu)寐,脈沉細而腹空(kong)脹,心下暨肚腹各有一塊如石,與(yu)(yu)當歸建(jian)中湯(tang)(tang),日(ri)服二(er)帖,五十(shi)余日(ri),只覺暈(yun)眩(xuan)稍(shao)減(jian),又數日(ri),左(zuo)足(zu)發腫毒,暴熱來去三(san)五次(ci),醫與(yu)(yu)三(san)黃湯(tang)(tang),暈(yun)眩(xuan)大(da)發,卒(zu)厥欲死,仍令服當歸建(jian)中湯(tang)(tang)數百日(ri),竟得身體滋潤。徐徐以艾(ai)炷,令再服建(jian)中湯(tang)(tang)半歲,暈(yun)眩(xuan)不(bu)發,日(ri)行數百步,血減(jian)于前(qian),每日(ri)輪灸脊際(ji)。終與(yu)(yu)建(jian)中湯(tang)(tang)一年(nian)許,血來減(jian)半,皮膚(fu)生(sheng)津液,又經一年(nian),能徒步行遠路。

《類聚方廣義(yi)》:諸瘍(yang)膿潰(kui)之后,荏苒不(bu)愈(yu),虛羸(lei)煩(fan)躁,自汗(han),盜汗(han),稀(xi)膿不(bu)出,新(xin)肉不(bu)長,若惡寒下痢(li),四肢厥冷者,加附(fu)子。

【諸家緒論】《外臺》引《必效》,黃芪建中湯加當歸(gui)、人參,治虛(xu)勞,下(xia)焦冷,不(bu)甚渴,小便數。若(ruo)失精,加龍骨、白斂。

編者按:黃(huang)芪(qi)、當(dang)歸二味合(he)用(yong),后世(shi)方稱(cheng)為補血湯(tang),合(he)加于(yu)小建中湯(tang),稱(cheng)為歸芪(qi)建中湯(tang)。

簡侯(hou):曾治一腹(fu)痛經久之男子(zi),手(shou)足不(bu)溫,見風毛戴(dai),夜或自汗,面(mian)色無華,行動少力,脈(mo)兩(liang)手(shou)沉遲,咽口皆感干燥,間(jian)發(fa)干咳,醫治無顯效。自訴時有氣(qi)塊發(fa)現(xian)作痛,按之似有似無。大便溏(tang),或間(jian)日一次,食欲不(bu)振,為擬歸芪建中(zhong)湯(tang)加飴(yi)糖、地黃(huang),服(fu)二十(shi)余帖(tie)而愈。

【憑證(zheng)使用(yong)】虛(xu)弱者之(zhi)腹痛,自汗,盜汗,貧(pin)血,暈眩,慢性潰瘍(yang)病,婦女月經病等。

補中益氣湯(tang)藥方介紹(shao)?

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,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,乃腎間脾胃下流之溼氣悶塞其下,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,脾溼下流,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,其面板不任風寒而生寒熱。”

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.風溼相搏,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.溼勝-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***calmo *** n,CaM***、鈣/鈣調素依賴蛋白激酶Ⅱ***Ca2+/calmo *** ndependentproteinkinaseⅡ,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訊號傳導來實現的。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訊號轉導等方面。

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 *** 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 *** 濃度、數量、密度及其活動能力;用于 *** 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 *** 的運動能力,但不影響 *** 的熒光引數。Onishi等發現,補中益氣湯可以明顯提高 *** 可溶性Fas,降低 *** 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 *** 數量和運動能力,升高 *** 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;前列腺的溼重、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等以流產布氏桿菌***Brucellaabortus***造成小鼠疲勞綜合征模型,補中益氣湯可以提高模型鼠每天活動能力,增加模型鼠體質量及體質量/脾質量的比值,抑制脾IL?10表達。Shih等在正常小鼠與衰老加速小鼠模型的研究中發現,補中益氣湯可以劑量依賴性提高小鼠的運動耐力、神經肌肉協調能力以及學習記憶能力,并能提高肌肉組織中的多巴胺、去甲腎上腺素水平,提示補中益氣湯具有一定程度的抗衰老作用。

目(mu)前的(de)研究(jiu)(jiu)證(zheng)實,補(bu)中益氣湯具(ju)有(you)廣泛的(de)藥(yao)理作用,除傳統的(de)益氣健脾、甘溫除熱等(deng)作用外,至(zhi)少(shao)還(huan)包括保護(hu)臟器功能(neng)***肝、肺(fei)、消化道、骨髓等(deng)***、抗(kang)不(bu)育、抗(kang)前列腺(xian)增生、抗(kang)疲勞(lao)、抗(kang)衰老以及改善骨代謝等(deng)藥(yao)理作用;這些研究(jiu)(jiu)為臨床擴大補(bu)中益氣湯的(de)應用范圍,以及進一步發展中醫(yi)補(bu)益或扶正理論奠定了良好的(de)基礎(chu)。

當歸四逆湯簡介(jie)

目錄1拼音(yin)2英(ying)文參(can)(can)考(kao)3概述(shu)4《傷寒論》方之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 4.1組(zu)成4.2功(gong)(gong)(gong)效主(zhu)(zhu)(zhu)治(zhi)4.3當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)用(yong)法(fa)用(yong)量(liang)4.4方解4.5運(yun)用(yong)4.6現代適應證 4.6.1血(xue)(xue)栓(shuan)閉(bi)塞(sai)性脈(mo)管(guan)炎4.6.2無(wu)脈(mo)癥4.6.3雷諾(nuo)現象和雷諾(nuo)病(bing)4.6.4小兒麻痹 4.7當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)藥理(li)作(zuo)用(yong) 4.7.1對免疫功(gong)(gong)(gong)能的(de)(de)(de)影(ying)響(xiang)4.7.2抗炎、抗氧化(hua)作(zuo)用(yong)4.7.3對心(xin)臟、血(xue)(xue)管(guan)及血(xue)(xue)液流(liu)變學的(de)(de)(de)影(ying)響(xiang)4.7.4鎮靜(jing)、鎮痛及對神經系統功(gong)(gong)(gong)能的(de)(de)(de)影(ying)響(xiang)4.7.5對病(bing)原微生(sheng)物的(de)(de)(de)作(zuo)用(yong) 4.8各(ge)家(jia)論述(shu)4.9歌訣4.10出(chu)(chu)處(chu)(chu) 5明·方賢著《奇效良方》之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 5.1處(chu)(chu)方5.2功(gong)(gong)(gong)能主(zhu)(zhu)(zhu)治(zhi)5.3當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)用(yong)法(fa)用(yong)量(liang)5.4出(chu)(chu)處(chu)(chu) 6《衛(wei)生(sheng)寶鑒》卷(juan)十八方之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 6.1處(chu)(chu)方6.2制法(fa)6.3功(gong)(gong)(gong)能主(zhu)(zhu)(zhu)治(zhi)6.4當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)用(yong)法(fa)用(yong)量(liang)6.5出(chu)(chu)處(chu)(chu) 7《醫略(lve)六書》卷(juan)二十四(si)(si)(si)(si)方之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 7.1處(chu)(chu)方7.2功(gong)(gong)(gong)能主(zhu)(zhu)(zhu)治(zhi)7.3當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)用(yong)法(fa)用(yong)量(liang)7.4各(ge)家(jia)論述(shu)7.5出(chu)(chu)處(chu)(chu) 8《重訂通俗傷寒論》方之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 8.1組(zu)成8.2功(gong)(gong)(gong)效主(zhu)(zhu)(zhu)治(zhi)8.3運(yun)用(yong)8.4各(ge)家(jia)論述(shu)8.5出(chu)(chu)處(chu)(chu) 9《杏苑》卷(juan)六方之(zhi)(zhi)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 9.1組(zu)成9.2功(gong)(gong)(gong)能主(zhu)(zhu)(zhu)治(zhi)9.3當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang)的(de)(de)(de)用(yong)法(fa)用(yong)量(liang)9.4出(chu)(chu)處(chu)(chu) 10參(can)(can)考(kao)資料附:1古籍中的(de)(de)(de)當(dang)(dang)(dang)歸(gui)(gui)四(si)(si)(si)(si)逆(ni)(ni)湯(tang)(tang)(tang)(tang) 1拼音(yin) dāng guī sì nì tāng

2英文參(can)考 Danggui Sini Tang [21世(shi)紀雙語科技詞典(dian)]

danggui sini decoction [中(zhong)醫(yi)藥學名詞審定(ding)委員會.中(zhong)醫(yi)藥學名詞(2004)]

3概述 當(dang)歸四逆(ni)湯同名方(fang)劑(ji)約有六首,其中《傷寒(han)(han)論》記載者(zhe)為常用(yong)方(fang),其組成為當(dang)歸12g、桂枝9g、芍藥(yao)9g、細辛3g、炙甘草(cao)6g、通草(cao)6g、大棗(zao)8枚,具(ju)有發表(biao)溫中,溫經(jing)散寒(han)(han),養血(xue)通脈(mo)之功效(xiao)。主治因血(xue)虛(xu)受寒(han)(han)、寒(han)(han)邪凝(ning)滯經(jing)脈(mo)所致的(de)血(xue)虛(xu)寒(han)(han)厥(jue)證,是治療(liao)血(xue)虛(xu)寒(han)(han)厥(jue)證的(de)代表(biao)方(fang)劑(ji),現代常用(yong)于治療(liao)血(xue)栓閉塞性脈(mo)管炎、雷諾病、小兒下(xia)肢(zhi)麻痹、無脈(mo)癥、凍瘡(chuang)、婦女痛經(jing)等屬血(xue)虛(xu)寒(han)(han)凝(ning)者(zhe)。

4《傷寒論》方之當歸四逆湯 該(gai)方劑治(zhi)療機(ji)理(li)所(suo)列各項作用,可直中血栓閉塞性脈管炎、無(wu)脈癥(zheng)、雷諾病的發病機(ji)理(li),但對小兒麻痹所(suo)致小兒手(shou)足厥(jue)冷、脈沉細(xi)或細(xi)而(er)欲絕等表現(xian)的治(zhi)療機(ji)理(li)有待進一步研究(jiu)[1]。另(ling)外對于(yu)嚴重病例有必要(yao)配合使(shi)用現(xian)代醫(yi)學的溶栓治(zhi)療及免疫制劑[1]。

4.1組成

當歸、桂(gui)枝、芍藥、細辛各(ge)三兩(liang),炙(zhi)甘(gan)草、通草(即現在之(zhi)木(mu)通)各(ge)二(er)(er)兩(liang),大(da)棗(zao)二(er)(er)十(shi)五(wu)枚(mei)(一法(fa)十(shi)二(er)(er)枚(mei))[2]。

當歸12g、桂枝(zhi)9g、芍藥9g、細辛(xin)3g、炙甘(gan)草(cao)6g、通草(cao)6g、大(da)棗8枚[3]

當歸三兩(liang),桂枝(zhi)三兩(liang)(去皮),芍(shao)藥三兩(liang),細辛三兩(liang),甘(gan)草二兩(liang)(炙),通草二兩(liang),大棗二十五(wu)枚(mei)(擘,一法(fa),十二枚(mei))[4]。

4.2功效主治

《傷寒(han)論》方之當(dang)歸四逆湯功(gong)能溫經(jing)散寒(han),養血通脈(mo)[2]。主(zhu)治血虛受寒(han),手(shou)足(zu)(zu)厥冷,舌淡苔白,脈(mo)細欲(yu)絕(jue)者,或(huo)血虛寒(han)凝而致的(de)月經(jing)不調,脘腹冷痛(tong),及寒(han)入絡脈(mo),腰、股、腿、足(zu)(zu)疼痛(tong);近(jin)代(dai)也用于指(zhi)端動脈(mo)痙攣癥(雷(lei)諾病(bing))、凍(dong)瘡(chuang)初起[2]。

《傷寒(han)論》方之當歸四(si)逆湯具有發表溫中,溫經散寒(han),養(yang)血通脈之功效。主(zhu)治血虛(xu)寒(han)厥(jue)證。癥見血虛(xu)受(shou)寒(han),手足(zu)厥(jue)寒(han),口不渴,或腰、股(gu)、腿、足(zu)疼(teng)痛(tong),或麻木,舌淡苔白、脈沉細或細而欲(yu)絕,并治寒(han)入經絡,現用于早期雷(lei)諾(nuo)氏病及(ji)凍(dong)傷。

4.3當歸四逆湯的用法用量

水煎(jian),去渣,分三次(ci)服[2]。

以(yi)水8升,煮取3升,去滓,溫服1升,日3次。

以水八(ba)升(sheng),煮取三(san)升(sheng),去滓,溫(wen)服(fu)一升(sheng),一日三(san)次[4]

4.4方解

方中當歸、芍藥(yao)調養肝血(xue);桂枝(zhi)、細辛溫經(jing)散寒;炙(zhi)甘(gan)草(cao)、大棗補中健(jian)脾而益氣血(xue),協(xie)桂、芍更能調和營衛;木通協(xie)諸藥(yao)而通血(xue)脈[2]。各藥(yao)合用,共成(cheng)溫補通脈之劑[2]。

本(ben)方原治手足(zu)厥(jue)冷,脈(mo)(mo)(mo)(mo)細欲絕之(zhi)證[5]。此系血(xue)(xue)(xue)虛受寒(han)(han)(han)(han),血(xue)(xue)(xue)寒(han)(han)(han)(han)凝滯,血(xue)(xue)(xue)弱不(bu)充(chong)養(yang)四(si)肢(zhi),寒(han)(han)(han)(han)阻陽氣不(bu)得溫(wen)(wen)(wen)煦四(si)末,則見手足(zu)厥(jue)寒(han)(han)(han)(han),脈(mo)(mo)(mo)(mo)細欲絕之(zhi)證[5]。但雖脈(mo)(mo)(mo)(mo)細而(er)不(bu)見其他陽微陰盛(sheng)表現,可知是寒(han)(han)(han)(han)在(zai)經(jing)脈(mo)(mo)(mo)(mo),血(xue)(xue)(xue)脈(mo)(mo)(mo)(mo)不(bu)利所(suo)致[5]。此時(shi)既要(yao)溫(wen)(wen)(wen)經(jing)散(san)寒(han)(han)(han)(han),又(you)要(yao)養(yang)血(xue)(xue)(xue)通(tong)(tong)(tong)脈(mo)(mo)(mo)(mo)[5]。本(ben)方以(yi)桂(gui)枝(zhi)(zhi)湯去生姜,倍大棗,加當(dang)歸、通(tong)(tong)(tong)草(cao)、細辛(xin)(xin)組成(cheng)[5]。血(xue)(xue)(xue)虛寒(han)(han)(han)(han)凝,故用(yong)甘(gan)(gan)溫(wen)(wen)(wen)之(zhi)當(dang)歸,歸經(jing)入肝,補血(xue)(xue)(xue)和(he)血(xue)(xue)(xue),為(wei)溫(wen)(wen)(wen)補肝經(jing)要(yao)藥;桂(gui)枝(zhi)(zhi)辛(xin)(xin)溫(wen)(wen)(wen),溫(wen)(wen)(wen)經(jing)通(tong)(tong)(tong)脈(mo)(mo)(mo)(mo),以(yi)祛經(jing)脈(mo)(mo)(mo)(mo)中客(ke)留之(zhi)寒(han)(han)(han)(han)邪(xie)而(er)暢通(tong)(tong)(tong)血(xue)(xue)(xue)行,2味共用(yong)為(wei)君,是養(yang)血(xue)(xue)(xue)溫(wen)(wen)(wen)通(tong)(tong)(tong)之(zhi)法[5]。以(yi)白(bai)芍(shao)、細辛(xin)(xin)為(wei)臣(chen),白(bai)芍(shao)養(yang)血(xue)(xue)(xue)和(he)營(ying)(ying),與當(dang)歸相合(he),補益營(ying)(ying)血(xue)(xue)(xue),與桂(gui)枝(zhi)(zhi)相伍,內和(he)氣血(xue)(xue)(xue);細辛(xin)(xin)辛(xin)(xin)溫(wen)(wen)(wen),外(wai)溫(wen)(wen)(wen)經(jing)脈(mo)(mo)(mo)(mo),內溫(wen)(wen)(wen)臟腑(fu),通(tong)(tong)(tong)達(da)表里,以(yi)散(san)寒(han)(han)(han)(han)邪(xie),可助桂(gui)枝(zhi)(zhi)溫(wen)(wen)(wen)經(jing)散(san)寒(han)(han)(han)(han)[5]。通(tong)(tong)(tong)草(cao)為(wei)佐,以(yi)通(tong)(tong)(tong)經(jing)脈(mo)(mo)(mo)(mo)[5]。甘(gan)(gan)草(cao)、大棗味甘(gan)(gan),益氣健脾,調和(he)諸藥,重用(yong)大棗,既助歸、芍(shao)補血(xue)(xue)(xue),又(you)防桂(gui)、辛(xin)(xin)之(zhi)燥烈太過,免傷陰血(xue)(xue)(xue),是以(yi)為(wei)使(shi)(shi)[5]。諸藥合(he)用(yong),溫(wen)(wen)(wen)而(er)不(bu)燥,補而(er)不(bu)滯,共奏溫(wen)(wen)(wen)經(jing)通(tong)(tong)(tong)脈(mo)(mo)(mo)(mo)之(zhi)功效,使(shi)(shi)陰血(xue)(xue)(xue)充(chong),客(ke)寒(han)(han)(han)(han)除,陽氣振,經(jing)脈(mo)(mo)(mo)(mo)通(tong)(tong)(tong),手足(zu)溫(wen)(wen)(wen)而(er)脈(mo)(mo)(mo)(mo)亦復[5]。

本方中桂(gui)枝、芍藥之比是1:1,以桂(gui)枝溫經通脈(mo),配當歸乃養(yang)血溫通之法(fa);芍藥養(yang)血和營以助當歸補益營血[3]。

4.5運用

當歸(gui)四逆湯(tang)是治療血虛寒厥證的代(dai)表方劑[3]。凡臨床上(shang)出現以手(shou)足厥寒、舌(she)淡苔白(bai)、脈沉細或細而(er)欲絕等為主(zhu)要表現者(zhe),即可使用(yong)本方加減治療[3]。

加(jia)減法:若腰、股、腿、足(zu)疼痛(tong)(tong)(tong)(tong)屬(shu)血虛(xu)寒(han)凝者,加(jia)川斷、牛膝、雞(ji)血藤等(deng)(deng)活(huo)血祛(qu)瘀止(zhi)(zhi)痛(tong)(tong)(tong)(tong);婦女痛(tong)(tong)(tong)(tong)經屬(shu)血虛(xu)寒(han)凝者,加(jia)香附、烏藥等(deng)(deng)溫(wen)經行氣止(zhi)(zhi)痛(tong)(tong)(tong)(tong);或男(nan)子寒(han)疝,睪丸(wan)摯(zhi)痛(tong)(tong)(tong)(tong),牽(qian)引少(shao)腹冷痛(tong)(tong)(tong)(tong),肢(zhi)冷脈弦者,加(jia)烏藥、小茴香、良姜、香附等(deng)(deng)理氣止(zhi)(zhi)痛(tong)(tong)(tong)(tong);手足(zu)凍瘡(chuang),不論初期(qi)未潰(kui)或已潰(kui)者,均(jun)可加(jia)羌活(huo)、獨活(huo)、白芷等(deng)(deng)散寒(han)止(zhi)(zhi)痛(tong)(tong)(tong)(tong)[3]。加(jia)吳(wu)茱萸、生姜,又可治(zhi)本(ben)方證(zheng)內(nei)有(you)久寒(han),兼有(you)水飲嘔逆者;亦可用治(zhi)婦女血虛(xu)寒(han)凝之(zhi)經期(qi)腹痛(tong)(tong)(tong)(tong),及男(nan)子寒(han)疝,睪丸(wan)掣痛(tong)(tong)(tong)(tong),牽(qian)引少(shao)腹冷痛(tong)(tong)(tong)(tong)[5]。

使(shi)(shi)用(yong)(yong)注(zhu)意:本(ben)方只(zhi)適用(yong)(yong)于血虛寒(han)凝之四肢(zhi)逆冷,其它(ta)原因之肢(zhi)厥(jue)不宜使(shi)(shi)用(yong)(yong)。濕熱痹痛者禁(jin)用(yong)(yong)本(ben)方。

當歸(gui)四逆湯(tang)治(zhi)血痹(bi):患者周某,女,25歲。夜睡醒來,兩手(shou)(shou)發(fa)麻,似蟻走感,手(shou)(shou)指(zhi)活動不利,持針不便,但握(wo)力尚(shang)存(cun)。手(shou)(shou)微冷,觸覺(jue)痛覺(jue)無異變,脈(mo)(mo)沉細(xi)而(er)稍弦緊,舌淡苔白。此(ci)寒邪凝滯,經脈(mo)(mo)受阻,血行不運,肢端絡脈(mo)(mo)失(shi)養之候,治(zhi)以本方加(jia)川(chuan)芎(xiong)、黃(huang)耆、麻黃(huang)。兩劑后(hou)癥狀減輕,再取(qu)三劑而(er)愈。

當歸四(si)逆湯(tang)治早期雷諾氏病(bing)(bing):此病(bing)(bing)病(bing)(bing)機屬(shu)陽氣(qi)虛弱(ruo)不能溫(wen)(wen)養(yang)四(si)末(mo),寒(han)邪外襲,血(xue)脈凝滯所致。當用(yong)溫(wen)(wen)陽活(huo)血(xue),祛寒(han)通散之法,當歸四(si)逆湯(tang)頗為適合。用(yong)本方(fang)治療兩例(li),1例(li)用(yong)原(yuan)方(fang)加艾葉、紅花,服30余(yu)劑痊(quan)愈(yu);1例(li)服18劑痊(quan)愈(yu)。均經(jing)隨(sui)訪未見復發。

當歸四逆湯(tang)治(zhi)血栓(shuan)閉塞性脈(mo)管炎:本(ben)組1O例(li)。癥見下肢厥冷,劇烈疼痛,脈(mo)細澀,病程(cheng)分別為(wei)2月3年。以本(ben)方合耆附(fu)湯(tang)、四妙(miao)勇安湯(tang)治(zhi)療。結果:9例(li)痊愈(yu),1例(li)好(hao)轉。

當歸四(si)(si)逆(ni)湯治(zhi)凍(dong)傷(shang)(shang):趙某,男,30余(yu)(yu)歲。風(feng)雪交加,凍(dong)仆(pu)于(yu)地(di),爬行數里,偃臥于(yu)地(di)而待斃,鄰人發現(xian)后(hou)抬回(hui),手足厥(jue)逆(ni),臥難轉(zhuan)(zhuan)側。此凍(dong)傷(shang)(shang),投本方(fang),以厥(jue)回(hui)肢溫為度。四(si)(si)劑后(hou)身起紫泡如核桃,轉(zhuan)(zhuan)為凍(dong)瘡。數日后(hou)即能轉(zhuan)(zhuan)動,月余(yu)(yu)而愈。(《岳(yue)美中醫案集》)

4.6現代適應證

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當(dang)歸四(si)逆湯適用于血栓閉塞性脈管(guan)炎、無(wu)脈癥、雷諾病、小兒(er)下(xia)肢麻痹等(deng)屬血虛(xu)寒(han)凝者。

4.6.1血(xue)(xue)栓(shuan)閉塞性(xing)脈管(guan)炎(yan)(yan) 血(xue)(xue)栓(shuan)閉塞性(xing)脈管(guan)炎(yan)(yan)是一種累(lei)(lei)及(ji)(ji)血(xue)(xue)管(guan)的炎(yan)(yan)癥(zheng)性(xing)、階段(duan)性(xing)和周(zhou)期(qi)發(fa)作(zuo)的慢(man)性(xing)閉塞性(xing)疾(ji)病,主(zhu)要侵犯四肢(zhi)中的小動(dong)(dong)(dong)靜(jing)脈,尤以下肢(zhi)血(xue)(xue)管(guan)為多(duo)。該病確切病因(yin)(yin)尚未明確,可(ke)(ke)能與(yu)下列(lie)(lie)因(yin)(yin)素(su)有關:①外(wai)因(yin)(yin),如吸煙、寒冷(leng)、潮濕、慢(man)性(xing)損傷(shang)和感(gan)染。煙草浸液對實驗(yan)性(xing)動(dong)(dong)(dong)物(wu)可(ke)(ke)發(fa)生(sheng)脈管(guan)炎(yan)(yan)等。②內因(yin)(yin),自身免(mian)疫(yi)功(gong)能紊亂,病人血(xue)(xue)清中可(ke)(ke)發(fa)現抗核抗體、動(dong)(dong)(dong)脈中可(ke)(ke)發(fa)現免(mian)疫(yi)球蛋白(bai)及(ji)(ji)C3復合物(wu)均支持與(yu)免(mian)疫(yi)有關;性(xing)激(ji)素(su)及(ji)(ji)前列(lie)(lie)腺(xian)素(su)失(shi)調、遺傳也可(ke)(ke)能與(yu)本(ben)病有關。病理改變(bian)通常(chang)(chang)始于動(dong)(dong)(dong)脈再累(lei)(lei)及(ji)(ji)靜(jing)脈,由遠端向近端發(fa)展,病變(bian)呈階段(duan)性(xing)分布,活動(dong)(dong)(dong)期(qi)為血(xue)(xue)管(guan)全層(ceng)非化膿性(xing)炎(yan)(yan)癥(zheng),內皮(pi)(pi)(pi)細胞及(ji)(ji)成(cheng)纖維細胞增生(sheng),管(guan)腔血(xue)(xue)栓(shuan)堵塞等;后期(qi)炎(yan)(yan)癥(zheng)消退,新生(sheng)毛細血(xue)(xue)管(guan)形成(cheng),臨床(chuang)主(zhu)要表現為患肢(zhi)怕冷(leng)、皮(pi)(pi)(pi)溫降(jiang)低、皮(pi)(pi)(pi)色(se)蒼白(bai)或發(fa)紺、感(gan)覺異常(chang)(chang)、患肢(zhi)疼痛、時久則因(yin)(yin)缺血(xue)(xue)缺氧而發(fa)生(sheng)營養障礙,嚴重者(zhe)出現缺血(xue)(xue)性(xing)潰瘍(yang)或壞疽,觸摸時動(dong)(dong)(dong)脈搏動(dong)(dong)(dong)消失(shi)或減(jian)弱(ruo)等。

4.6.2無(wu)脈(mo)癥 無(wu)脈(mo)癥實際上是(shi)指大動(dong)脈(mo)炎,是(shi)主(zhu)(zhu)動(dong)脈(mo)及其(qi)主(zhu)(zhu)要分(fen)(fen)支(zhi)的慢性(xing)進行性(xing)、非特異性(xing)炎癥引(yin)起的不(bu)同部位(wei)(wei)動(dong)脈(mo)狹(xia)(xia)窄(zhai)或閉塞(sai),少數可出(chu)現(xian)動(dong)脈(mo)擴張或動(dong)脈(mo)瘤,出(chu)現(xian)相(xiang)應(ying)(ying)(ying)(ying)部位(wei)(wei)缺血(xue)(xue)(xue),鎖骨下動(dong)脈(mo)閉塞(sai)而致(zhi)橈動(dong)脈(mo)搏(bo)動(dong)消(xiao)失者人們常(chang)稱為(wei)(wei)(wei)“無(wu)脈(mo)癥”。病(bing)因(yin)至(zhi)今未明(ming),多(duo)認為(wei)(wei)(wei)與遺傳、內分(fen)(fen)泌(mi)異常(chang)、感染后機體發生(sheng)免疫功能紊亂(luan)有(you)關。主(zhu)(zhu)要累及彈力動(dong)脈(mo),多(duo)數侵及1~3支(zhi)動(dong)脈(mo),病(bing)變以主(zhu)(zhu)動(dong)脈(mo)分(fen)(fen)支(zhi)起始(shi)部較顯著,從動(dong)脈(mo)中(zhong)層及外(wai)膜(mo)開始(shi)波及內膜(mo),全(quan)(quan)層動(dong)脈(mo)壁呈階段性(xing)不(bu)規則的增生(sheng)和(he)纖維化,管腔不(bu)同程度的狹(xia)(xia)窄(zhai)或閉塞(sai),偶合并(bing)血(xue)(xue)(xue)栓(shuan)形成,基本病(bing)變為(wei)(wei)(wei)滲出(chu)、慢性(xing)非特異性(xing)炎癥和(he)肉芽腫(zhong)。臨床主(zhu)(zhu)要表(biao)現(xian)為(wei)(wei)(wei)發熱、全(quan)(quan)身(shen)不(bu)適、體重下降等全(quan)(quan)身(shen)癥狀,主(zhu)(zhu)動(dong)脈(mo)弓綜合征(zheng)者表(biao)現(xian)為(wei)(wei)(wei)頭暈(yun)、頭痛、視(shi)物昏(hun)花、反復暈(yun)厥(jue)、抽搐、偏癱、相(xiang)應(ying)(ying)(ying)(ying)肢體麻(ma)木酸(suan)痛、動(dong)脈(mo)搏(bo)動(dong)減弱或消(xiao)失,患側肢體血(xue)(xue)(xue)壓降低(di)。①胸腹主(zhu)(zhu)動(dong)脈(mo)型(xing)(xing):表(biao)現(xian)為(wei)(wei)(wei)下肢缺血(xue)(xue)(xue),雙下肢無(wu)力、發涼酸(suan)痛、跛行,腹部可聞及血(xue)(xue)(xue)管雜音,下肢血(xue)(xue)(xue)壓<上肢血(xue)(xue)(xue)壓。②肺(fei)動(dong)脈(mo)型(xing)(xing):表(biao)現(xian)為(wei)(wei)(wei)心悸、氣短、肺(fei)動(dong)脈(mo)瓣區雜音。③廣泛(fan)型(xing)(xing):累及血(xue)(xue)(xue)管的相(xiang)應(ying)(ying)(ying)(ying)部分(fen)(fen)出(chu)現(xian)相(xiang)應(ying)(ying)(ying)(ying)組(zu)織(zhi)器官的相(xiang)應(ying)(ying)(ying)(ying)癥狀。

4.6.3雷諾(nuo)現(xian)象和雷諾(nuo)病(bing)(bing) 雷諾(nuo)現(xian)象和雷諾(nuo)病(bing)(bing),指患者受(shou)寒冷或緊張(zhang) *** 后手指(趾)皮(pi)膚(fu)出(chu)現(xian)蒼白,繼而變(bian)紫、變(bian)紅,伴(ban)局部發冷、感覺異常(chang)和疼痛等(deng)短暫的(de)(de)臨床現(xian)象,常(chang)反復發作(zuo),無(wu)其(qi)他原(yuan)發病(bing)(bing)者為(wei)(wei)雷諾(nuo)病(bing)(bing),有(you)明確疾病(bing)(bing)繼發者為(wei)(wei)雷諾(nuo)現(xian)象。病(bing)(bing)因(yin)至今無(wu)一致(zhi)看法,有(you)人認(ren)為(wei)(wei)由交感神經活動(dong)性過高(gao)所致(zhi);有(you)人認(ren)為(wei)(wei)動(dong)脈血管(guan)(guan)(guan)壁(bi)病(bing)(bing)變(bian)導致(zhi)末(mo)梢血管(guan)(guan)(guan)對寒冷、情緒壓力等(deng) *** 出(chu)現(xian)過度反應所致(zhi)。目(mu)前(qian)認(ren)為(wei)(wei)血管(guan)(guan)(guan)內皮(pi)細胞(bao)功能異常(chang)是本病(bing)(bing)的(de)(de)病(bing)(bing)理生理基礎(chu)。早期無(wu)病(bing)(bing)理改變(bian),病(bing)(bing)情長者血管(guan)(guan)(guan)內皮(pi)增(zeng)厚,末(mo)梢指腹(fu)萎縮,遠端骨(gu)吸收。嚴重者出(chu)現(xian)指尖潰(kui)瘍、壞疽(ju)。

4.6.4小兒麻痹(bi)(bi) 小兒麻痹(bi)(bi)即(ji)脊髓灰(hui)質炎(yan),是(shi)由脊髓灰(hui)質炎(yan)病(bing)(bing)毒通過消(xiao)化道或(huo)呼吸道傳(chuan)播的一(yi)種傳(chuan)染病(bing)(bing),病(bing)(bing)毒侵入(ru)人體(ti)后經(jing)二次病(bing)(bing)毒血(xue)癥侵入(ru)神經(jing)系統,導致脊髓前角(jiao)運動神經(jing)元損害,使(shi)神經(jing)細(xi)胞(bao)病(bing)(bing)變,局部組織(zhi)充血(xue)、水腫,血(xue)管(guan)周圍炎(yan)性浸潤,病(bing)(bing)變嚴重者神經(jing)細(xi)胞(bao)壞死,瘢痕形成而造成持久(jiu)性麻痹(bi)(bi),大多(duo)表現(xian)(xian)為不對稱的單肢軟癱,后遺癥時出(chu)現(xian)(xian)患肢肌肉(rou)萎縮,肢體(ti)畸形,皮(pi)溫下降。

4.7當歸四逆湯的藥理作用

[7]

4.7.1對(dui)(dui)(dui)(dui)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)的(de)(de)(de)(de)(de)(de)影(ying)響(xiang) 君藥當歸對(dui)(dui)(dui)(dui)機體(ti)的(de)(de)(de)(de)(de)(de)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)有(you)(you)(you)(you)(you)(you)明(ming)(ming)顯(xian)(xian)的(de)(de)(de)(de)(de)(de)促(cu)進(jin)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),其(qi)(qi)有(you)(you)(you)(you)(you)(you)效成(cheng)分(fen)(fen)為當歸免(mian)疫(yi)(yi)(yi)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing)多(duo)(duo)(duo)糖(tang)(tang),具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)免(mian)疫(yi)(yi)(yi)佐劑(ji)樣活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),通過(guo)(guo)(guo)經典(dian)(dian)途徑使(shi)(shi)(shi)補(bu)體(ti)活(huo)(huo)(huo)(huo)(huo)化(hua)而具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)良好的(de)(de)(de)(de)(de)(de)補(bu)體(ti)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),同時具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)良好的(de)(de)(de)(de)(de)(de)干(gan)擾素(su)(su)誘(you)導(dao)(dao)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing);當歸免(mian)疫(yi)(yi)(yi)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing)多(duo)(duo)(duo)糖(tang)(tang)還能(neng)(neng)顯(xian)(xian)著(zhu)提(ti)(ti)高(gao)(gao)單核(he)吞噬(shi)(shi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)的(de)(de)(de)(de)(de)(de)功(gong)(gong)(gong)(gong)能(neng)(neng)活(huo)(huo)(huo)(huo)(huo)動,提(ti)(ti)高(gao)(gao)NO含(han)(han)量,增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)其(qi)(qi)分(fen)(fen)泌(mi)TNFα、IL1的(de)(de)(de)(de)(de)(de)能(neng)(neng)力(li),對(dui)(dui)(dui)(dui)糖(tang)(tang)皮(pi)質(zhi)激(ji)(ji)素(su)(su)所致(zhi)的(de)(de)(de)(de)(de)(de)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)拮抗(kang)(kang)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);當歸免(mian)疫(yi)(yi)(yi)活(huo)(huo)(huo)(huo)(huo)動多(duo)(duo)(duo)糖(tang)(tang)對(dui)(dui)(dui)(dui)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)有(you)(you)(you)(you)(you)(you)較強(qiang)(qiang)(qiang)的(de)(de)(de)(de)(de)(de)活(huo)(huo)(huo)(huo)(huo)化(hua)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)(dui)人(ren)脾(pi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)有(you)(you)(you)(you)(you)(you)促(cu)進(jin)有(you)(you)(you)(you)(you)(you)絲裂活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),可(ke)(ke)使(shi)(shi)(shi)B淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)分(fen)(fen)化(hua)到(dao)不同成(cheng)熟(shu)階段,部分(fen)(fen)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)群(qun)成(cheng)熟(shu)為抗(kang)(kang)體(ti)分(fen)(fen)泌(mi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao);當歸免(mian)疫(yi)(yi)(yi)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing)多(duo)(duo)(duo)糖(tang)(tang)還能(neng)(neng)直接激(ji)(ji)活(huo)(huo)(huo)(huo)(huo)參與(yu)(yu)抗(kang)(kang)體(ti)反(fan)(fan)應(ying)(ying)的(de)(de)(de)(de)(de)(de)T淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao),增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)毒T細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)功(gong)(gong)(gong)(gong)能(neng)(neng),增(zeng)(zeng)(zeng)(zeng)(zeng)加(jia)其(qi)(qi)殺傷活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),明(ming)(ming)顯(xian)(xian)促(cu)進(jin)脾(pi)臟淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)增(zeng)(zeng)(zeng)(zeng)(zeng)殖(zhi)。不僅(jin)如此,當歸所含(han)(han)阿魏(wei)酸(suan)具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)廣譜抗(kang)(kang)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)而對(dui)(dui)(dui)(dui)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)無抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);阿魏(wei)酸(suan)對(dui)(dui)(dui)(dui)Ⅰ、Ⅱ、Ⅲ、Ⅳ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)均有(you)(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)(dui)Ⅰ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)的(de)(de)(de)(de)(de)(de)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)可(ke)(ke)能(neng)(neng)與(yu)(yu)其(qi)(qi)能(neng)(neng)穩定細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)膜,抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肥大(da)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)脫(tuo)顆(ke)(ke)粒及(ji)減少炎性(xing)(xing)(xing)介質(zhi)釋(shi)放(fang)有(you)(you)(you)(you)(you)(you)關(guan);Ⅱ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)為皮(pi)膚血(xue)管炎,主(zhu)動和(he)(he)(he)被動Arthos反(fan)(fan)應(ying)(ying)屬Ⅲ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying),抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)Ⅱ、Ⅲ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)可(ke)(ke)能(neng)(neng)與(yu)(yu)當歸的(de)(de)(de)(de)(de)(de)抗(kang)(kang)炎作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)相關(guan)。桂枝對(dui)(dui)(dui)(dui)嗜異性(xing)(xing)(xing)抗(kang)(kang)體(ti)反(fan)(fan)應(ying)(ying)具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)補(bu)體(ti)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),同時抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)IgE所致(zhi)肥大(da)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)脫(tuo)顆(ke)(ke)粒,抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)組胺等過(guo)(guo)(guo)敏(min)介質(zhi)的(de)(de)(de)(de)(de)(de)釋(shi)放(fang),因而具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)較強(qiang)(qiang)(qiang)的(de)(de)(de)(de)(de)(de)抗(kang)(kang)過(guo)(guo)(guo)敏(min)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)。臣(chen)藥白(bai)(bai)(bai)芍(shao)水煎劑(ji)所含(han)(han)白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)對(dui)(dui)(dui)(dui)巨噬(shi)(shi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)有(you)(you)(you)(you)(you)(you)直接激(ji)(ji)活(huo)(huo)(huo)(huo)(huo)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),進(jin)一步研究(jiu)發(fa)現白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)對(dui)(dui)(dui)(dui)巨噬(shi)(shi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)發(fa)揮雙(shuang)相調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);體(ti)內(nei)(nei)及(ji)體(ti)外實驗表明(ming)(ming)白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)對(dui)(dui)(dui)(dui)T細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)功(gong)(gong)(gong)(gong)能(neng)(neng)呈機能(neng)(neng)與(yu)(yu)濃度(du)依賴性(xing)(xing)(xing)雙(shuang)相調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);對(dui)(dui)(dui)(dui)體(ti)液(ye)免(mian)疫(yi)(yi)(yi)的(de)(de)(de)(de)(de)(de)雙(shuang)相調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)也與(yu)(yu)白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)與(yu)(yu)T調(diao)(diao)(diao)節(jie)(jie)性(xing)(xing)(xing)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)的(de)(de)(de)(de)(de)(de)影(ying)響(xiang)有(you)(you)(you)(you)(you)(you)關(guan),即白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)對(dui)(dui)(dui)(dui)抗(kang)(kang)體(ti)生(sheng)成(cheng)的(de)(de)(de)(de)(de)(de)正負調(diao)(diao)(diao)節(jie)(jie)與(yu)(yu)其(qi)(qi)對(dui)(dui)(dui)(dui)TH及(ji)TS的(de)(de)(de)(de)(de)(de)調(diao)(diao)(diao)節(jie)(jie)有(you)(you)(you)(you)(you)(you)關(guan),白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)可(ke)(ke)使(shi)(shi)(shi)處于免(mian)疫(yi)(yi)(yi)低下狀態(tai)(tai)的(de)(de)(de)(de)(de)(de)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)恢(hui)復正常。白(bai)(bai)(bai)芍(shao)總(zong)(zong)苷(gan)(gan)(gan)(gan)(gan)對(dui)(dui)(dui)(dui)垂(chui)體(ti)-腎(shen)上(shang)腺(xian)軸的(de)(de)(de)(de)(de)(de)雙(shuang)相調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)可(ke)(ke)能(neng)(neng)是(shi)其(qi)(qi)調(diao)(diao)(diao)節(jie)(jie)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)的(de)(de)(de)(de)(de)(de)另一途徑。除此之外從白(bai)(bai)(bai)芍(shao)分(fen)(fen)離出的(de)(de)(de)(de)(de)(de)酸(suan)性(xing)(xing)(xing)多(duo)(duo)(duo)糖(tang)(tang)PeonanSB和(he)(he)(he)中性(xing)(xing)(xing)多(duo)(duo)(duo)糖(tang)(tang)PeonanSA均有(you)(you)(you)(you)(you)(you)網狀內(nei)(nei)皮(pi)系統的(de)(de)(de)(de)(de)(de)激(ji)(ji)活(huo)(huo)(huo)(huo)(huo)效果。通草(cao)(cao)(cao)總(zong)(zong)多(duo)(duo)(duo)糖(tang)(tang)可(ke)(ke)提(ti)(ti)高(gao)(gao)血(xue)清(qing)溶(rong)菌(jun)酶活(huo)(huo)(huo)(huo)(huo)力(li),提(ti)(ti)高(gao)(gao)網狀內(nei)(nei)皮(pi)系統和(he)(he)(he)單核(he)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)吞噬(shi)(shi)功(gong)(gong)(gong)(gong)能(neng)(neng),提(ti)(ti)高(gao)(gao)血(xue)清(qing)抗(kang)(kang)體(ti)水平(ping),抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)遲發(fa)型(xing)過(guo)(guo)(guo)敏(min)反(fan)(fan)應(ying)(ying)。大(da)棗能(neng)(neng)提(ti)(ti)高(gao)(gao)體(ti)內(nei)(nei)單核(he)-吞噬(shi)(shi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)系統的(de)(de)(de)(de)(de)(de)吞噬(shi)(shi)功(gong)(gong)(gong)(gong)能(neng)(neng),促(cu)進(jin)溶(rong)血(xue)及(ji)溶(rong)血(xue)空斑,促(cu)進(jin)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)轉化(hua)及(ji)提(ti)(ti)高(gao)(gao)外周血(xue)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)分(fen)(fen)解,促(cu)進(jin)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)增(zeng)(zeng)(zeng)(zeng)(zeng)殖(zhi),具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)明(ming)(ming)顯(xian)(xian)抗(kang)(kang)補(bu)體(ti)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing)及(ji)抗(kang)(kang)Ⅰ型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)。甘(gan)(gan)草(cao)(cao)(cao)甜(tian)素(su)(su)能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肥大(da)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)釋(shi)放(fang)組胺,并能(neng)(neng)增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)ConA誘(you)導(dao)(dao)的(de)(de)(de)(de)(de)(de)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)分(fen)(fen)泌(mi)IL2的(de)(de)(de)(de)(de)(de)能(neng)(neng)力(li);甘(gan)(gan)草(cao)(cao)(cao)次酸(suan)能(neng)(neng)升高(gao)(gao)淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)比率;甘(gan)(gan)草(cao)(cao)(cao)酸(suan)二胺能(neng)(neng)提(ti)(ti)高(gao)(gao)血(xue)清(qing)INFα水平(ping);β甘(gan)(gan)草(cao)(cao)(cao)次酸(suan)是(shi)人(ren)體(ti)補(bu)體(ti)經典(dian)(dian)途徑的(de)(de)(de)(de)(de)(de)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)劑(ji);甘(gan)(gan)草(cao)(cao)(cao)不僅(jin)誘(you)導(dao)(dao)干(gan)擾素(su)(su)和(he)(he)(he)增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)NK細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)的(de)(de)(de)(de)(de)(de)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),而且其(qi)(qi)所含(han)(han)甘(gan)(gan)草(cao)(cao)(cao)酸(suan)能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肥大(da)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)脫(tuo)顆(ke)(ke)粒而具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)抗(kang)(kang)過(guo)(guo)(guo)敏(min)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),甘(gan)(gan)草(cao)(cao)(cao)酸(suan)還能(neng)(neng)增(zeng)(zeng)(zeng)(zeng)(zeng)加(jia)脾(pi)臟及(ji)胸(xiong)腺(xian)的(de)(de)(de)(de)(de)(de)重(zhong)量,增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)網狀內(nei)(nei)皮(pi)系統的(de)(de)(de)(de)(de)(de)活(huo)(huo)(huo)(huo)(huo)性(xing)(xing)(xing),使(shi)(shi)(shi)體(ti)內(nei)(nei)抗(kang)(kang)體(ti)產(chan)生(sheng)顯(xian)(xian)著(zhu)增(zeng)(zeng)(zeng)(zeng)(zeng)加(jia);甘(gan)(gan)草(cao)(cao)(cao)多(duo)(duo)(duo)糖(tang)(tang)則(ze)可(ke)(ke) *** 淋(lin)(lin)巴(ba)(ba)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)增(zeng)(zeng)(zeng)(zeng)(zeng)殖(zhi),甘(gan)(gan)草(cao)(cao)(cao)Lx不僅(jin)可(ke)(ke)以抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)巨噬(shi)(shi)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)的(de)(de)(de)(de)(de)(de)免(mian)疫(yi)(yi)(yi)反(fan)(fan)應(ying)(ying),而且可(ke)(ke)以降低抗(kang)(kang)原量而顯(xian)(xian)示免(mian)疫(yi)(yi)(yi)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),防治(zhi)青(qing)霉素(su)(su)過(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)休克。細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)辛煎劑(ji)對(dui)(dui)(dui)(dui)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)胞(bao)(bao)(bao)(bao)(bao)免(mian)疫(yi)(yi)(yi)和(he)(he)(he)體(ti)液(ye)免(mian)疫(yi)(yi)(yi)均有(you)(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),但(dan)能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)過(guo)(guo)(guo)敏(min)性(xing)(xing)(xing)介質(zhi)的(de)(de)(de)(de)(de)(de)釋(shi)放(fang),對(dui)(dui)(dui)(dui)速(su)發(fa)型(xing)變(bian)態(tai)(tai)反(fan)(fan)應(ying)(ying)有(you)(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)。由此可(ke)(ke)見該方劑(ji)絕大(da)多(duo)(duo)(duo)數藥味對(dui)(dui)(dui)(dui)免(mian)疫(yi)(yi)(yi)功(gong)(gong)(gong)(gong)能(neng)(neng)有(you)(you)(you)(you)(you)(you)促(cu)進(jin)、增(zeng)(zeng)(zeng)(zeng)(zeng)強(qiang)(qiang)(qiang)和(he)(he)(he)調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),僅(jin)細(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)(xi)辛有(you)(you)(you)(you)(you)(you)抑(yi)(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),但(dan)方劑(ji)中白(bai)(bai)(bai)芍(shao)具(ju)(ju)(ju)(ju)有(you)(you)(you)(you)(you)(you)強(qiang)(qiang)(qiang)大(da)的(de)(de)(de)(de)(de)(de)雙(shuang)相調(diao)(diao)(diao)節(jie)(jie)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)則(ze)可(ke)(ke)使(shi)(shi)(shi)上(shang)述作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)及(ji)機體(ti)免(mian)疫(yi)(yi)(yi)紊亂恢(hui)復平(ping)衡。更重(zhong)要的(de)(de)(de)(de)(de)(de)是(shi)甘(gan)(gan)草(cao)(cao)(cao)對(dui)(dui)(dui)(dui)垂(chui)體(ti)-腎(shen)上(shang)腺(xian)皮(pi)質(zhi)軸的(de)(de)(de)(de)(de)(de)興奮(fen)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)以及(ji)甘(gan)(gan)草(cao)(cao)(cao)酸(suan)的(de)(de)(de)(de)(de)(de)氫化(hua)可(ke)(ke)的(de)(de)(de)(de)(de)(de)松(song)樣作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),均可(ke)(ke)使(shi)(shi)(shi)體(ti)內(nei)(nei)皮(pi)質(zhi)激(ji)(ji)素(su)(su)增(zeng)(zeng)(zeng)(zeng)(zeng)多(duo)(duo)(duo),其(qi)(qi)優越(yue)的(de)(de)(de)(de)(de)(de)“允(yun)許”作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)可(ke)(ke)協(xie)調(diao)(diao)(diao)全身其(qi)(qi)他激(ji)(ji)素(su)(su)發(fa)揮作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),提(ti)(ti)高(gao)(gao)了機體(ti)內(nei)(nei)分(fen)(fen)泌(mi)的(de)(de)(de)(de)(de)(de)調(diao)(diao)(diao)節(jie)(jie)能(neng)(neng)力(li),起到(dao)“扶正固(gu)本”的(de)(de)(de)(de)(de)(de)治(zhi)療(liao)作(zuo)(zuo)(zuo)(zuo)(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)。

該方劑對免疫功能的(de)影響可切(qie)中血栓閉塞(sai)性脈管(guan)炎、無(wu)脈癥、雷諾病等發病的(de)免疫機理(li)。

4.7.2抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)、抗(kang)(kang)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong) 君(jun)藥(yao)(yao)(yao)當(dang)(dang)歸具(ju)(ju)有(you)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)、抗(kang)(kang)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)、抗(kang)(kang)輻射、抗(kang)(kang)化(hua)(hua)(hua)(hua)(hua)學物(wu)(wu)質(zhi)(zhi)損傷(shang)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),當(dang)(dang)歸水(shui)煎(jian)劑對(dui)(dui)(dui)(dui)多種致(zhi)炎(yan)(yan)(yan)(yan)(yan)劑引起的(de)(de)急(ji)、慢性(xing)(xing)(xing)(xing)(xing)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)均(jun)(jun)有(you)顯(xian)(xian)(xian)(xian)(xian)著(zhu)(zhu)的(de)(de)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),并能(neng)(neng)降(jiang)(jiang)低(di)(di)(di)(di)炎(yan)(yan)(yan)(yan)(yan)性(xing)(xing)(xing)(xing)(xing)組織(zhi)(zhi)中(zhong)(zhong)PGE2的(de)(de)釋(shi)(shi)放量,降(jiang)(jiang)低(di)(di)(di)(di)補體旁路溶血(xue)活(huo)(huo)(huo)(huo)性(xing)(xing)(xing)(xing)(xing);當(dang)(dang)歸對(dui)(dui)(dui)(dui)超氧(yang)(yang)陰(yin)(yin)離(li)子(zi)及(ji)(ji)(ji)羥(qian)自(zi)由基(ji)有(you)很強的(de)(de)清(qing)除(chu)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),當(dang)(dang)歸水(shui)煎(jian)劑對(dui)(dui)(dui)(dui)人血(xue)及(ji)(ji)(ji)大(da)腦(nao)中(zhong)(zhong)SOD及(ji)(ji)(ji)Ca2+ATP酶活(huo)(huo)(huo)(huo)性(xing)(xing)(xing)(xing)(xing)有(you)十分(fen)(fen)顯(xian)(xian)(xian)(xian)(xian)著(zhu)(zhu)的(de)(de)激活(huo)(huo)(huo)(huo)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)脂(zhi)質(zhi)(zhi)過(guo)(guo)(guo)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)反應(ying);當(dang)(dang)歸注(zhu)射液能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)漿(jiang)TXB2的(de)(de)產生(sheng),增(zeng)加血(xue)漿(jiang)6KetoPGFⅠα水(shui)平(ping),糾正腦(nao)缺(que)血(xue)TXA2/GGI2的(de)(de)比值(zhi),降(jiang)(jiang)低(di)(di)(di)(di)腦(nao)缺(que)血(xue)死(si)亡率。桂枝對(dui)(dui)(dui)(dui)多種致(zhi)炎(yan)(yan)(yan)(yan)(yan)物(wu)(wu)質(zhi)(zhi)所致(zhi)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)的(de)(de)各(ge)個環節均(jun)(jun)有(you)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),能(neng)(neng)明顯(xian)(xian)(xian)(xian)(xian)降(jiang)(jiang)低(di)(di)(di)(di)毛細血(xue)管(guan)通透性(xing)(xing)(xing)(xing)(xing)、滲(shen)出、水(shui)腫及(ji)(ji)(ji)肉芽組織(zhi)(zhi)增(zeng)生(sheng)。臣藥(yao)(yao)(yao)芍藥(yao)(yao)(yao)有(you)顯(xian)(xian)(xian)(xian)(xian)著(zhu)(zhu)的(de)(de)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),其(qi)(qi)(qi)有(you)效(xiao)成分(fen)(fen)為芍藥(yao)(yao)(yao)總苷(gan),能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)IL1、TNF、PGE2的(de)(de)過(guo)(guo)(guo)度分(fen)(fen)泌,提高SOD、GSHPx活(huo)(huo)(huo)(huo)性(xing)(xing)(xing)(xing)(xing),降(jiang)(jiang)低(di)(di)(di)(di)MDA水(shui)平(ping);對(dui)(dui)(dui)(dui)實驗(yan)性(xing)(xing)(xing)(xing)(xing)非特異性(xing)(xing)(xing)(xing)(xing)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)及(ji)(ji)(ji)免(mian)疫性(xing)(xing)(xing)(xing)(xing)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)均(jun)(jun)有(you)明顯(xian)(xian)(xian)(xian)(xian)的(de)(de)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),而且對(dui)(dui)(dui)(dui)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)的(de)(de)毛細血(xue)管(guan)通透性(xing)(xing)(xing)(xing)(xing)亢進(jin)、滲(shen)出、水(shui)腫、增(zeng)生(sheng)不(bu)同環節均(jun)(jun)有(you)不(bu)同的(de)(de)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);芍藥(yao)(yao)(yao)水(shui)提取物(wu)(wu)有(you)增(zeng)強耐(nai)缺(que)氧(yang)(yang)的(de)(de)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),可降(jiang)(jiang)低(di)(di)(di)(di)整體耗氧(yang)(yang)量并使(shi)體溫降(jiang)(jiang)低(di)(di)(di)(di);芍藥(yao)(yao)(yao)總苷(gan)及(ji)(ji)(ji)其(qi)(qi)(qi)所含(han)丹皮苷(gan)對(dui)(dui)(dui)(dui)超氧(yang)(yang)陰(yin)(yin)離(li)子(zi)及(ji)(ji)(ji)羥(qian)自(zi)由基(ji)有(you)清(qing)除(chu)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),丹皮苷(gan)可顯(xian)(xian)(xian)(xian)(xian)著(zhu)(zhu)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肝(gan)臟(zang)脂(zhi)質(zhi)(zhi)過(guo)(guo)(guo)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)物(wu)(wu)的(de)(de)形成和SPT升(sheng)高。細辛(xin)所含(han)揮發(fa)油有(you)明顯(xian)(xian)(xian)(xian)(xian)的(de)(de)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),其(qi)(qi)(qi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)機制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)除(chu)增(zeng)強腎上腺(xian)皮質(zhi)(zhi)功能(neng)(neng),促進(jin)ACTH釋(shi)(shi)放外,尚能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)過(guo)(guo)(guo)程中(zhong)(zhong)的(de)(de)炎(yan)(yan)(yan)(yan)(yan)性(xing)(xing)(xing)(xing)(xing)介(jie)質(zhi)(zhi)釋(shi)(shi)放,對(dui)(dui)(dui)(dui)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)性(xing)(xing)(xing)(xing)(xing)介(jie)質(zhi)(zhi),并有(you)較強的(de)(de)清(qing)除(chu)超氧(yang)(yang)陰(yin)(yin)離(li)子(zi)的(de)(de)能(neng)(neng)力和抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肝(gan)脂(zhi)質(zhi)(zhi)過(guo)(guo)(guo)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),對(dui)(dui)(dui)(dui)超氧(yang)(yang)陰(yin)(yin)離(li)子(zi)誘發(fa)的(de)(de)透明質(zhi)(zhi)酸(suan)(suan)和關(guan)節炎(yan)(yan)(yan)(yan)(yan)中(zhong)(zhong)氨基(ji)多糖的(de)(de)解聚具(ju)(ju)有(you)保護作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),因此對(dui)(dui)(dui)(dui)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)的(de)(de)各(ge)個環節、各(ge)不(bu)同階段(duan)均(jun)(jun)有(you)顯(xian)(xian)(xian)(xian)(xian)著(zhu)(zhu)的(de)(de)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)。通草具(ju)(ju)有(you)明顯(xian)(xian)(xian)(xian)(xian)的(de)(de)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)消腫作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),提高血(xue)SOD活(huo)(huo)(huo)(huo)力,降(jiang)(jiang)低(di)(di)(di)(di)血(xue)及(ji)(ji)(ji)肝(gan)中(zhong)(zhong)LPO含(han)量。大(da)棗所含(han)大(da)棗多糖可提高全(quan)(quan)血(xue)SOD、CAT活(huo)(huo)(huo)(huo)力,清(qing)除(chu)自(zi)由基(ji),降(jiang)(jiang)低(di)(di)(di)(di)腦(nao)、肝(gan)、血(xue)中(zhong)(zhong)MDA及(ji)(ji)(ji)LPO含(han)量,清(qing)除(chu)全(quan)(quan)血(xue)化(hua)(hua)(hua)(hua)(hua)學發(fa)光中(zhong)(zhong)的(de)(de)活(huo)(huo)(huo)(huo)性(xing)(xing)(xing)(xing)(xing)氧(yang)(yang),抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)損傷(shang)。甘(gan)草則具(ju)(ju)有(you)保泰(tai)松(song)或氫化(hua)(hua)(hua)(hua)(hua)可的(de)(de)松(song)樣的(de)(de)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),其(qi)(qi)(qi)抗(kang)(kang)炎(yan)(yan)(yan)(yan)(yan)成分(fen)(fen)是(shi)甘(gan)草酸(suan)(suan)和甘(gan)草次(ci)酸(suan)(suan),通過(guo)(guo)(guo)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)PGE2作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)及(ji)(ji)(ji)減少(shao)內源性(xing)(xing)(xing)(xing)(xing)PGE2產生(sheng)對(dui)(dui)(dui)(dui)滲(shen)出、水(shui)腫、肉芽組織(zhi)(zhi)增(zeng)生(sheng)以及(ji)(ji)(ji)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)的(de)(de)Ⅰ、Ⅱ、Ⅲ期都有(you)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),還能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)變態反應(ying)性(xing)(xing)(xing)(xing)(xing)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)如Arthus現(xian)象及(ji)(ji)(ji)Schwartzman反應(ying)。甘(gan)草對(dui)(dui)(dui)(dui)免(mian)疫性(xing)(xing)(xing)(xing)(xing)炎(yan)(yan)(yan)(yan)(yan)癥(zheng)(zheng)(zheng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)機制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)可能(neng)(neng)與(yu)下列(lie)三(san)種因素有(you)關(guan):一是(shi)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)纖溶系(xi)統的(de)(de)活(huo)(huo)(huo)(huo)化(hua)(hua)(hua)(hua)(hua);二是(shi)降(jiang)(jiang)低(di)(di)(di)(di)血(xue)清(qing)對(dui)(dui)(dui)(dui)毛細血(xue)管(guan)通透性(xing)(xing)(xing)(xing)(xing)的(de)(de)促進(jin)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong);三(san)是(shi)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)細胞膜的(de)(de)通透性(xing)(xing)(xing)(xing)(xing)亢進(jin)。甘(gan)草酸(suan)(suan)及(ji)(ji)(ji)甘(gan)草次(ci)酸(suan)(suan)還能(neng)(neng)抑(yi)(yi)(yi)(yi)(yi)制(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)自(zi)由基(ji)及(ji)(ji)(ji)過(guo)(guo)(guo)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)脂(zhi)質(zhi)(zhi)的(de)(de)生(sheng)成而具(ju)(ju)有(you)抗(kang)(kang)氧(yang)(yang)化(hua)(hua)(hua)(hua)(hua)作(zuo)(zuo)用(yong)(yong)(yong)(yong)(yong)(yong)(yong),這對(dui)(dui)(dui)(dui)于治(zhi)療休克及(ji)(ji)(ji)心肌梗死(si)十分(fen)(fen)重要。

4.7.3對心(xin)(xin)(xin)(xin)臟、血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan)及(ji)(ji)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)液流(liu)(liu)(liu)(liu)(liu)變學的(de)(de)(de)(de)影響 君藥(yao)當(dang)(dang)歸(gui)具(ju)有(you)明(ming)顯的(de)(de)(de)(de)抗心(xin)(xin)(xin)(xin)律失(shi)常(chang)作(zuo)(zuo)用(yong)(yong)(yong)(yong),可(ke)減(jian)慢傳導(dao),延(yan)長有(you)效不應期(qi)(qi),消(xiao)除折返(fan),延(yan)長平臺期(qi)(qi),抑制(zhi)(zhi)異(yi)位(wei)節(jie)律點及(ji)(ji)提(ti)高致顫(zhan)閾(yu)等;當(dang)(dang)歸(gui)能(neng)(neng)增(zeng)(zeng)加冠(guan)(guan)脈(mo)(mo)(mo)(mo)(mo)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu),減(jian)少冠(guan)(guan)脈(mo)(mo)(mo)(mo)(mo)閉塞所致心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)梗死(si)范圍,對心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)細(xi)胞的(de)(de)(de)(de)缺(que)糖、缺(que)氧性(xing)損傷有(you)保(bao)(bao)護作(zuo)(zuo)用(yong)(yong)(yong)(yong),同時能(neng)(neng)抗自由(you)基,降(jiang)低(di)氧耗量(liang);能(neng)(neng)穩定心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)細(xi)胞膜(mo),保(bao)(bao)護線(xian)粒體即溶酶(mei)體的(de)(de)(de)(de)功能(neng)(neng);當(dang)(dang)歸(gui)注(zhu)射液可(ke)通過興(xing)奮β受體而發揮對低(di)氧性(xing)肺動(dong)脈(mo)(mo)(mo)(mo)(mo)高壓的(de)(de)(de)(de)保(bao)(bao)護作(zuo)(zuo)用(yong)(yong)(yong)(yong);當(dang)(dang)歸(gui)能(neng)(neng)明(ming)顯抑制(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)小(xiao)(xiao)板(ban)(ban)(ban)聚(ju)集,降(jiang)低(di)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu)黏滯(zhi)度,降(jiang)低(di)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)漿纖維(wei)蛋白(bai)原(yuan)(yuan),延(yan)長凝血(xue)(xue)(xue)(xue)(xue)(xue)(xue)酶(mei)原(yuan)(yuan)時間,而具(ju)有(you)抗血(xue)(xue)(xue)(xue)(xue)(xue)(xue)栓形成(cheng)的(de)(de)(de)(de)作(zuo)(zuo)用(yong)(yong)(yong)(yong);有(you)報道5%當(dang)(dang)歸(gui)注(zhu)射液治(zhi)療(liao)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)栓閉塞性(xing)脈(mo)(mo)(mo)(mo)(mo)管(guan)炎療(liao)程4周,有(you)效率(lv)達89%。桂枝能(neng)(neng)增(zeng)(zeng)加冠(guan)(guan)脈(mo)(mo)(mo)(mo)(mo)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu)量(liang),增(zeng)(zeng)加心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)營(ying)養性(xing)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu)量(liang),降(jiang)低(di)缺(que)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)再灌注(zhu)心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)室顫(zhan)的(de)(de)(de)(de)發生率(lv),減(jian)少心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)LDH、CPK、LPO的(de)(de)(de)(de)生成(cheng),提(ti)高SOD活(huo)性(xing);降(jiang)低(di)全血(xue)(xue)(xue)(xue)(xue)(xue)(xue)黏度,降(jiang)低(di)纖維(wei)蛋白(bai)原(yuan)(yuan)含(han)量(liang),抗凝血(xue)(xue)(xue)(xue)(xue)(xue)(xue)酶(mei),抑制(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)小(xiao)(xiao)板(ban)(ban)(ban)聚(ju)集,擴張(zhang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan),改善外周循環。白(bai)芍(shao)(shao)水提(ti)取(qu)物能(neng)(neng)拮抗垂體后葉素所致心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)缺(que)血(xue)(xue)(xue)(xue)(xue)(xue)(xue),擴張(zhang)冠(guan)(guan)狀(zhuang)動(dong)脈(mo)(mo)(mo)(mo)(mo),增(zeng)(zeng)加心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)營(ying)養性(xing)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu),擴張(zhang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan),同時能(neng)(neng)抑制(zhi)(zhi)ADP及(ji)(ji)花生四烯酸誘(you)導(dao)的(de)(de)(de)(de)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)小(xiao)(xiao)板(ban)(ban)(ban)聚(ju)集;芍(shao)(shao)藥(yao)總苷還能(neng)(neng)減(jian)輕血(xue)(xue)(xue)(xue)(xue)(xue)(xue)小(xiao)(xiao)板(ban)(ban)(ban)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)栓濕重,抑制(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)栓形成(cheng)。細(xi)辛揮發油對心(xin)(xin)(xin)(xin)臟具(ju)有(you)正性(xing)肌(ji)(ji)(ji)力(li)和(he)正性(xing)頻率(lv)作(zuo)(zuo)用(yong)(yong)(yong)(yong),可(ke)使(shi)冠(guan)(guan)脈(mo)(mo)(mo)(mo)(mo)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu)增(zeng)(zeng)加;細(xi)辛所含(han)消(xiao)旋(xuan)甲基烏藥(yao)堿有(you)強心(xin)(xin)(xin)(xin)和(he)擴張(zhang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan)的(de)(de)(de)(de)作(zuo)(zuo)用(yong)(yong)(yong)(yong),能(neng)(neng)提(ti)高休克動(dong)物的(de)(de)(de)(de)平均(jun)動(dong)脈(mo)(mo)(mo)(mo)(mo)壓、左室收縮壓、冠(guan)(guan)脈(mo)(mo)(mo)(mo)(mo)竇(dou)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)流(liu)(liu)(liu)(liu)(liu)量(liang),降(jiang)低(di)中心(xin)(xin)(xin)(xin)動(dong)脈(mo)(mo)(mo)(mo)(mo)壓。甘(gan)草(cao)所含(han)甘(gan)草(cao)黃(huang)酮能(neng)(neng)縮小(xiao)(xiao)心(xin)(xin)(xin)(xin)肌(ji)(ji)(ji)梗死(si)范圍,拮抗多種原(yuan)(yuan)因引起的(de)(de)(de)(de)心(xin)(xin)(xin)(xin)律失(shi)常(chang);甘(gan)草(cao)次酸具(ju)有(you)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan)緊張(zhang)素ⅡAT1受體的(de)(de)(de)(de)激(ji)動(dong)劑樣作(zuo)(zuo)用(yong)(yong)(yong)(yong);甘(gan)草(cao)有(you)抗動(dong)脈(mo)(mo)(mo)(mo)(mo)粥(zhou)樣硬化(hua)的(de)(de)(de)(de)作(zuo)(zuo)用(yong)(yong)(yong)(yong),甘(gan)草(cao)酸有(you)抑制(zhi)(zhi)磷脂酶(mei)A2的(de)(de)(de)(de)活(huo)性(xing)及(ji)(ji)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)小(xiao)(xiao)板(ban)(ban)(ban)聚(ju)集的(de)(de)(de)(de)作(zuo)(zuo)用(yong)(yong)(yong)(yong)。該方劑的(de)(de)(de)(de)這(zhe)些(xie)作(zuo)(zuo)用(yong)(yong)(yong)(yong)均(jun)有(you)利于血(xue)(xue)(xue)(xue)(xue)(xue)(xue)管(guan)狹(xia)窄和(he)閉塞的(de)(de)(de)(de)治(zhi)療(liao)。

4.7.4鎮(zhen)(zhen)(zhen)靜、鎮(zhen)(zhen)(zhen)痛及(ji)(ji)對神(shen)經(jing)系統功能的(de)影響 君藥當(dang)歸有(you)(you)(you)鎮(zhen)(zhen)(zhen)靜、鎮(zhen)(zhen)(zhen)痛作(zuo)用(yong)(yong),當(dang)歸可(ke)(ke)擴張腦血管,改善腦循(xun)環,改善神(shen)經(jing)元代謝,減少腦梗死范圍(wei),促(cu)進(jin)腦缺(que)血損傷后神(shen)經(jing)生(sheng)長(chang)和修復相(xiang)關蛋白(bai),促(cu)進(jin)神(shen)經(jing)細(xi)(xi)(xi)胞黏附(fu)分子及(ji)(ji)微(wei)血管相(xiang)關蛋白(bai)的(de)表(biao)(biao)達,減少細(xi)(xi)(xi)胞凋亡,通過促(cu)進(jin)bcl2的(de)表(biao)(biao)達對半暗帶(dai)的(de)細(xi)(xi)(xi)胞凋亡產生(sheng)抑制作(zuo)用(yong)(yong);促(cu)進(jin)神(shen)經(jing)再生(sheng)及(ji)(ji)再支配。桂枝所(suo)含桂皮醛(quan)有(you)(you)(you)明(ming)顯的(de)鎮(zhen)(zhen)(zhen)靜作(zuo)用(yong)(yong),且有(you)(you)(you)一定(ding)的(de)鎮(zhen)(zhen)(zhen)痛作(zuo)用(yong)(yong),并有(you)(you)(you)解熱、抗驚厥(jue)作(zuo)用(yong)(yong)。臣藥白(bai)芍(shao)具(ju)有(you)(you)(you)明(ming)顯的(de)鎮(zhen)(zhen)(zhen)痛作(zuo)用(yong)(yong),芍(shao)藥苷(gan)與甘(gan)(gan)草FM100也(ye)有(you)(you)(you)顯著(zhu)鎮(zhen)(zhen)(zhen)痛和鎮(zhen)(zhen)(zhen)靜的(de)協同(tong)效(xiao)果,芍(shao)藥同(tong)甘(gan)(gan)草合用(yong)(yong)可(ke)(ke)治療(liao)中(zhong)樞性(xing)(xing)或末(mo)梢性(xing)(xing)肌痙(jing)攣以(yi)及(ji)(ji)因痙(jing)攣引起的(de)疼痛;白(bai)芍(shao)還有(you)(you)(you)抗驚厥(jue)作(zuo)用(yong)(yong)。細(xi)(xi)(xi)辛揮發油(you)有(you)(you)(you)明(ming)顯的(de)中(zhong)樞抑制作(zuo)用(yong)(yong),小劑量(liang)鎮(zhen)(zhen)(zhen)靜,大(da)劑量(liang)催眠和抗驚厥(jue),對大(da)腦皮層、海馬、中(zhong)腦網狀(zhuang)結構等的(de)作(zuo)用(yong)(yong)與巴比妥類相(xiang)似,其鎮(zhen)(zhen)(zhen)痛強(qiang)度(du)與氨替比林(lin)相(xiang)當(dang)。細(xi)(xi)(xi)辛水煎劑也(ye)有(you)(you)(you)鎮(zhen)(zhen)(zhen)痛作(zuo)用(yong)(yong)。通草具(ju)有(you)(you)(you)明(ming)顯的(de)解熱作(zuo)用(yong)(yong)。大(da)棗具(ju)有(you)(you)(you)催眠鎮(zhen)(zhen)(zhen)靜作(zuo)用(yong)(yong)。甘(gan)(gan)草具(ju)有(you)(you)(you)罌粟堿樣特異性(xing)(xing)解痙(jing)能力,因而具(ju)有(you)(you)(you)解除痙(jing)攣作(zuo)用(yong)(yong),甘(gan)(gan)草FM100具(ju)有(you)(you)(you)鎮(zhen)(zhen)(zhen)靜、鎮(zhen)(zhen)(zhen)痛作(zuo)用(yong)(yong),并有(you)(you)(you)抗驚厥(jue)作(zuo)用(yong)(yong);甘(gan)(gan)草黃酮對大(da)腦缺(que)血再灌(guan)注有(you)(you)(you)保(bao)護作(zuo)用(yong)(yong);甘(gan)(gan)草酸靜滴可(ke)(ke)提高缺(que)血再灌(guan)注大(da)腦線(xian)粒體(ti)ATP酶(mei)、腦組織(zhi)乳酸脫(tuo)氫酶(mei)活(huo)性(xing)(xing),減輕(qing)腦水腫(zhong)。

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4.7.5對(dui)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)原微生(sheng)物的作用(yong)(yong)(yong)(yong) 君藥當(dang)歸(gui)煎劑對(dui)大(da)腸桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、傷寒桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、痢(li)(li)疾(ji)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、白(bai)(bai)喉(hou)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、金黃(huang)色葡(pu)萄球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、銅綠(lv)假單(dan)胞(bao)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong)。桂(gui)枝揮發(fa)油對(dui)炭疽桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、肺炎(yan)球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、大(da)腸桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、變形桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、霍(huo)亂弧(hu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、沙門菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、痢(li)(li)疾(ji)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、傷寒及(ji)副傷寒桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、金黃(huang)色葡(pu)萄球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、白(bai)(bai)色葡(pu)萄球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、結核桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、孤(gu)兒病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)、流(liu)感病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)及(ji)梅毒(du)(du)(du)(du)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong)。白(bai)(bai)芍煎劑體外試驗對(dui)多種致病(bing)(bing)(bing)(bing)(bing)(bing)(bing)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong),除(chu)上(shang)述部分細(xi)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)外對(dui)志賀痢(li)(li)疾(ji)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、溶血性鏈(lian)(lian)球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、草(cao)(cao)綠(lv)色鏈(lian)(lian)球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、肺炎(yan)鏈(lian)(lian)球(qiu)(qiu)(qiu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、銅綠(lv)假單(dan)胞(bao)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、百日咳桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、霍(huo)亂弧(hu)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)以及(ji)許多真菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong),并且(qie)有(you)直接(jie)抗病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)作用(yong)(yong)(yong)(yong)。細(xi)辛醇浸劑、揮發(fa)油、煎劑對(dui)革蘭氏(shi)陽性菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、枯草(cao)(cao)桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、傷寒桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong),對(dui)黃(huang)曲霉菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)等16種真菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong),對(dui)合(he)胞(bao)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong)。甘草(cao)(cao)除(chu)對(dui)上(shang)述部分細(xi)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong)外,對(dui)幽門螺旋桿(gan)(gan)(gan)(gan)(gan)菌(jun)(jun)(jun)(jun)(jun)(jun)(jun)、阿米(mi)巴原蟲(chong)、華支睪吸蟲(chong)、滴蟲(chong)均(jun)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong),并且(qie)有(you)直接(jie)的廣譜(pu)抗病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)作用(yong)(yong)(yong)(yong)。甘草(cao)(cao)多糖對(dui)水皰口炎(yan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)、Ⅰ型單(dan)純皰疹病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)、牛(niu)痘(dou)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)有(you)抑(yi)(yi)(yi)制(zhi)(zhi)作用(yong)(yong)(yong)(yong);甘草(cao)(cao)酸抑(yi)(yi)(yi)制(zhi)(zhi)柯(ke)薩奇病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)、合(he)胞(bao)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)、腺病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)能力(li)強(qiang);甘草(cao)(cao)酸單(dan)胺能滅活HIV,甘草(cao)(cao)甜素除(chu)對(dui)上(shang)述病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)抑(yi)(yi)(yi)制(zhi)(zhi)外,還能抑(yi)(yi)(yi)制(zhi)(zhi)肝炎(yan)病(bing)(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)(du)(du)。

4.8各家論述

1.《金鏡內(nei)臺(tai)方議(yi)》:陰血內(nei)虛.則不能榮于(yu)脈(mo),陽氣外虛,則不能溫于(yu)四末,故手足厥(jue)寒,脈(mo)細欲絕也。故用當(dang)歸(gui)為君,以補血,以芍藥為臣(chen),輔(fu)之而(er)養營氣;以桂枝、細辛(xin)之苦,以散寒濕(shi)氣為佐;以大棗甘草(cao)(cao)為使(shi),而(er)益其(qi)(qi)中,補其(qi)(qi)不足;以通草(cao)(cao)之淡而(er)能行其(qi)(qi)脈(mo)道(dao)與厥(jue)也。

2.《古方選注》:當歸四(si)逆不用(yong)姜、附者(zhe),陰(yin)血虛微(wei),恐重劫其陰(yin)也,且(qie)四(si)逆雖(sui)寒,而不至于冷(leng),亦(yi)惟有調和厥(jue)陰(yin),溫(wen)經復(fu)營而已,故用(yong)酸甘(gan)以(yi)(yi)緩(huan)(huan)中,辛甘(gan)以(yi)(yi)溫(wen)表,寓治(zhi)肝(gan)(gan)四(si)法,桂枝之(zhi)辛以(yi)(yi)溫(wen)肝(gan)(gan)陽(yang),細辛之(zhi)辛以(yi)(yi)通肝(gan)(gan)陰(yin),當歸之(zhi)辛以(yi)(yi)補肝(gan)(gan),甘(gan)、棗之(zhi)甘(gan)以(yi)(yi)緩(huan)(huan)肝(gan)(gan),白芍之(zhi)酸以(yi)(yi)瀉肝(gan)(gan),復(fu)以(yi)(yi)通草(cao)利陰(yin)陽(yang)之(zhi)氣,開(kai)厥(jue)陰(yin)之(zhi)絡(luo)。

3.《醫(yi)宗金鑒》:此方取桂枝湯君以(yi)當歸者,厥陰主肝為(wei)血室也;佐細辛味極(ji)辛,能達(da)3陰,外(wai)(wai)溫經而內(nei)溫臟(zang);通草(cao)其性極(ji)通,善(shan)開關節,內(nei)通竅而外(wai)(wai)通營;倍加大棗,即建中加飴用甘之法;減去生姜,恐辛過甚而迅散也。

4.9歌訣

當歸四逆(ni)桂芍棗,細辛甘草與通草;血虛(xu)肝寒四肢厥(jue),煎(jian)服(fu)此(ci)方樂(le)陶陶[3]。

4.10出處

《傷寒論》

5明·方賢著《奇效良方》之當歸四逆湯

5.1處方

當歸、桂枝、芍藥(yao)、細辛,各二錢半。通(tong)草(cao)、甘草(cao),各一(yi)錢半。

5.2功能主治

明(ming)·方(fang)賢著《奇(qi)效良方(fang)》之當歸(gui)四逆湯主治手(shou)足厥寒(han),脈(mo)細欲絕(jue)者。

5.3當歸四逆湯的用法用量

上作一服,水二鐘(zhong),紅棗一枚,煎至一鐘(zhong),不拘時服。

5.4出處

明·方(fang)賢著《奇效良方(fang)》

6《衛生寶鑒》卷十八方之當歸四逆湯

6.1處方

當歸尾2.1克 附子(炮)官桂(gui) 茴香(炒)柴胡(hu)(hu)各1.5克 芍(shao)藥(yao)1.2克 茯苓(ling) 玄胡(hu)(hu)索 川楝(lian)子各0.9克(酒煮)澤瀉0.6克

6.2制法

上藥哎咀。

6.3功能主治

《衛生寶(bao)鑒》卷十八方之(zhi)當歸四(si)逆湯(tang)主治疝氣(qi),臍腹(fu)冷痛,牽引(yin)腰胯。

6.4當歸四逆湯的用法用量

用水350毫升,煎至(zhi)150毫升,去滓,空(kong)腹(fu)時溫服(fu)。

6.5出處

《衛生寶鑒》卷十八

7《醫略六書》卷二十四方之當歸四逆湯

7.1處方

附子1錢(qian)半(ban)(炮),官桂1錢(qian)半(ban),白芍(shao)1錢(qian)半(ban)(酒(jiu)炒(chao)),柴胡5分,當歸3錢(qian),吳茱1錢(qian)(醋炒(chao)),楝子2錢(qian)(酒(jiu)炒(chao)),小茴3錢(qian)(醋炒(chao)),澤(ze)瀉1錢(qian)半(ban)。

7.2功能主治

《醫略六書(shu)》卷二十四(si)方之(zhi)當歸四(si)逆湯(tang)主治(zhi)陽虛寒疝,脈緊細者。

7.3當歸四逆湯的用法用量

水煎,去滓溫服。

7.4各家論述

陽(yang)虛于下(xia),寒束于經,虛陽(yang)不(bu)能布敷(fu)而經氣(qi)被遏,故虛疝時(shi)時(shi)發作(zuo)焉。附子補火扶陽(yang),官桂(gui)溫經散寒,當歸(gui)養血(xue)榮經,白芍(shao)斂陰柔筋,柴胡升清(qing)陽(yang)以(yi)除邪,吳(wu)茱降(jiang)逆氣(qi)以(yi)下(xia)達,澤瀉(xie)瀉(xie)濁陰清(qing)腎府(fu),小茴溫經氣(qi)卻疝疾,川楝子瀉(xie)濕(shi)熱(re)以(yi)平虛疝也。

7.5出處

《醫略六書》卷二十四(si)

8《重訂通俗傷寒論》方之當歸四逆湯

8.1組成

全(quan)當歸3錢(qian),桂枝尖(jian)5分,北細辛3分(蜜炙),鮮蔥(cong)白(bai)(bai)1個(切寸),生白(bai)(bai)芍3錢(qian),清(qing)炙草5分,絳通草1錢(qian),陳(chen)紹酒(jiu)1瓢(沖)。

8.2功效主治

《重(zhong)訂通(tong)俗傷寒論(lun)》方之當(dang)歸四(si)逆湯具有滋(zi)陰通(tong)脈之功效。主治手(shou)足厥寒,脈細欲絕。

8.3運用

如(ru)宿病寒疝,小腹痛(tong)甚(shen),口(kou)吐白(bai)沫者(zhe),則加(jia)吳茱(zhu)萸(yu)以(yi)止疝痛(tong),生姜汁(zhi)以(yi)止吐沫。

8.4各家論述

方中(zhong)歸、芍(shao)榮養血絡(luo)(luo)為君;臣以桂、辛(xin),辛(xin)通經脈(mo),使經氣(qi)通暢(chang)(chang),絡(luo)(luo)氣(qi)自能(neng)四(si)布,尤必佐以絳(jiang)通、蔥(cong)、酒(jiu)者,一(yi)取其(qi)速通經隧,一(yi)取其(qi)暢(chang)(chang)達絡(luo)(luo)脈(mo);使以炙草,辛(xin)得甘助而發力愈速也。此為養血滋(zi)陰(yin),活絡(luo)(luo)通脈(mo)之良方。

8.5出處

《重訂通俗傷寒論》

9《杏苑》卷六方之當歸四逆湯

9.1組成

當歸1錢(qian)5分(fen)(fen),官桂(gui)1錢(qian)5分(fen)(fen),白芍藥1錢(qian)5分(fen)(fen),細(xi)辛1錢(qian)5分(fen)(fen),甘草(cao)(炙)1錢(qian),通(tong)草(cao)1錢(qian),吳茱(zhu)萸5分(fen)(fen)。

9.2功能主治

《杏苑(yuan)》卷六方(fang)之(zhi)當歸四逆湯(tang)主(zhu)治陰(疒頹??)大(da)如斗(dou),諸藥(yao)不能(neng)效者。

9.3當歸四逆湯的用法用量

用生姜5片,水煎熟(shu),空(kong)心溫服。

9.4出處

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