Chapter 4 herbs that purge introduction the concepts

Chapter 4 herbs that purge introduction the concepts downward Interior syndrome 里实证 Stagnation in interior ， Heat, water stock in interior 胃肠积滞

indications 1、acute diseases： acute pancreatitis, acute biliary duct infection, acute appendicitis, acute intestinal obstruction 2、infectious diseases： meningitis, hepatitis Dysentery 3、internal diseases： ascetic fluid, peritonitis constipation 渗出性胸膜

common effects 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-microbes Anti-toxin Anti-amoebic dysentery Anti- inflammation Anti-cancer

Dahuang大黄 Function indication components 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 Stimulate intestinal movement, however, it can cause constipaton if it is decocted for long time, because of tannic acid 泻下

How to purge? main oral rhein Small intestine Large intestine Small portion liver transfe r aglycon E. coli aglycon Aglycon stimulate N in interstine- movement fast gallic acid inhibit. Na+-K+-ATP enzyme– water stay in intestine

(2)Protect liver & cholagogize(benefit the gallbladder) 1)It can help the gallbladder contraction, promote Bile secretion 2) It can low serum cholesterol level 3) 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 ulcer 1)It can control the activity of hydrogen ion in digestion 2) It can prevent stress to ulcer by means of promoting the PGE 2; 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 & triglycerides 2）reduce the blood viscosity

4. Anti-infection/inflammation 1) broad spectrum antibiotic, bacteria & virus, suppressing production of TNF & IL-1. 2) anti-pyretic & sedating actions 3) Reduce CNS fever medium, PGE, & c. AMP. 4) Inhibit Na+－K+－ATP enzyme acvtivity, reduce ATP production-reduce fever. 5. Anti-cancer Can suppress the RNA & DNA synthesis of cancer cells 6. 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