Chapter 4 herbs that purge

introduction

the concepts

downwarddownwardInterior

syndrome 里实证

Stagnation in interior 胃肠积滞，Heat, water stock in interior

indications

1 、 acute diseases ： acute pancreatitis, acute biliary duct infection, acute appendicitis, acute intestinal obstruction2 、 infectious diseases ： meningitis, hepatitis Dysentery 3 、 internal diseases ： ascetic fluid,

peritonitis 渗出性胸膜 constipation

common effects

Puerging action 泻下作用Puerging action 泻下作用

a. Stimulate the movement of intestine(dahuang)b. Increase water content of the intestine (mangxiao)C. Moisten the stool (Hou Ma Ren)

Induce urination

Downward water

Anti-microbesAnti-toxin

Anti-amoebic dysentery

Anti-inflammation Anti-cancer

Dahuang大黄Function indicationFunction indication

componentscomponents

Dwonward heat detox in interstine

Heat-constipation, bleeding: Ulcer hematemesis

Dysentery & acute enteritis, Acute abdominal inflammation

(pancreatitis, Peritonitis), Renal failure, Hyperlipidema

anthroquinone(main), glycoside, rhein, Chrysophanol, emodin, acatechin, gallic acid

Main pharmacology effects

1. Effects on digestive system(1) purging actions 泻下

Stimulate intestinal movement, however, it can cause constipaton if it is decocted for long time, because of tannic acid

How to purge?

rhein Small intestine Large intestine

oral

mai

n

liver

Small portion

aglycon

transfer

E. coli

aglyconAglycon stimulate N in interstine- movement fastgallic acid inhibitNa+-K+-ATP enzyme– water stay in intestine

(2)Protect liver & cholagogize(benefit the gallbladder)1)It can help the gallbladder contraction, promote Bile secretion2) It can low serum cholesterol level3) It can prolong the life of the liver cells & promote regeneration of liver cells

(4) Stimulate pancreatic secretions & restrain the activity of pancreatic juice(5) Anti-peptic ulcer1)It can control the activity of hydrogen ion in digestion2) It can prevent stress to ulcer by means of promoting the PGE2; inhibit acid; inhibit

2. Promote renal function

(1) It can lower the level of BUN , (2) Diuresis: inhibit Na+-K+-ATP enzyme ，reabsorb Na+ .

3. Effects on Circulation system(1) Stop bleeding

1 ） the a-catechin & gallic acid can increase the adherence of platelets. 2 ） It can increase the contraction of blood vessels.

(2) Reduce blood stosis

1 ） lower cholesterol & triglycerides2 ） reduce the blood viscosity

4. Anti-infection/inflammation 1) broad spectrum antibiotic, bacteria & virus,suppressing production of TNF & IL-1.2) anti-pyretic & sedating actions3) Reduce CNS fever medium, PGE, & cAMP. 4) Inhibit Na+ － K+ － ATP enzyme acvtivity, reduceATP production-reduce fever. 5. Anti-cancerCan suppress the RNA & DNA synthesis of cancer cells6. anti-psychotics 抗精神病

Side effects

It causes pathologic changes in liver & thyroid with hypertrophy of tissue cells.

Common adverse effects: nausea, vomitting, diarrhea & abdominal pain.

Drug interaction: prolonged use of Dahuang may cause loss of potassium, leading to increased toxicity of cardiac glycosides, such as digoxin