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Chuanlianzi (Fructus Toosendan)---川楝子(powder100g/bottle)

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It is dreid mature fruit of Melia toosendan Sieb.et Zucc., family Meliaceae. The medicinal productd in Sichuan Province is superior. The fruits are collected in winter when they become ripe. With impurities removed, they are dried and pounded into pieces for using. The raw or stir-baked can be used.

[ Medicinal Properties ]: Bitter , cold and slightly toxic; relate to liver, small intestine and gallbladder meridians.

[ Medicinal Efficacies ]: Soothe liver, promote qi flow and relieve pain; kill parasites. treat tinea.

[ Clinical Applications ]: 1. Pain in hypochondrium, epigastrium and abdomen, hernia with pain        Since it is bitter and cold and purges heat, it is effective for disharmoney between liver and stomach, heat in liver meridian causing pain in epigastrium, abdomen and hypochondrium,in combination with Chaihu, Zhishi and Baishao; for transformation of depresssed liver qi into fire causing hypochondriac pain, it is combined with Yanhusuo in Jinliangzi Powder; for hernia of cold type with lower abdomial pain, the stir-bakedis used with Wuzhuyu, XIaohuiuxiang and Muxiang, such as Daoqi decoction.

2. Helminthic accumulation with abdominal pain       It is combined with Shijunzi and Binglang.

3. Head tinea     It is baked alone till it turns brown, ground into powder, made into ointment and applied to the affected parts.

[ Usage and Dosage ]: 4.5-9g. It is used externally with appropriate amount.

[ Precautions ] : Since it is bitter and cold , it is used with caution for patients with deficiency-cold of spleen and stomach.

[ Side effects ]: Over dosage for oral administration may lead to poisoning, manifested as liver impairment, toxic hepatitis, mental disorder, visual difficulty, gastritis, enteritis, bleeding ofinternal oragans, lowered blood pressure, exhaustion of respiratory circulation and even death.

川楝子楝科植物川楝树 Melia toosendan Sieb. et Zucc.的干燥成熟果实。我国南方各地均产,以四川产者为佳。冬季果实成熟时采收,除去杂质,干燥。用时打碎。生用或炒用。

【药性】苦,寒。有小毒。归肝、胃、小肠、膀胱经。        【功效】行气止痛,杀虫。       
 
【应用】        1.肝郁化火所致诸痛证。本品苦寒降泄,能清肝火、泄郁热、行气止痛。每与延胡索配伍,用于肝郁气滞或肝郁化火胸腹诸痛,如金铃子散(《素问病机气宜保命集》);治肝胃气痛,与延胡索同用,或以金铃子散四逆散合用。用治疝气痛,以治疗热疝为宜,可配延胡索、香附、橘核、芒果核等同用;寒疝腹痛则宜配暖肝散寒之品小茴香、木香、吴茱萸等,如导气汤(《医方简义》)。       
 
 2.虫积腹痛。本品苦寒有毒,能驱杀肠道寄生虫,味苦又能降泄气机而行气止痛。可用治蛔虫等引起的虫积腹痛,每与槟榔、使君子等同用。        此外,本品苦寒有毒,能清热燥湿,杀虫而疗癣。可用本品焙黄研末,以油调膏,外涂治头癣、秃疮。       
 
【用法用量】煎服,4.5~9g。外用适量。炒用寒性减低。        【使用注意】本品有毒,不宜过量或持续服用,以免中毒。又因性寒,脾胃虚寒者慎用。       
 
【古籍摘要】        1.《本草纲目》:“楝实,导小肠膀胱之热,因引心包相火下行,故心腹痛及疝气为要药。”        2.《本草经疏》:“楝实,主温病伤寒,大热狂烦者,邪在阳明也,苦寒能散阳明之邪热,则诸证自除。”       
 
 3.《本经逢原》:“川楝,苦寒性降,能导湿热下走渗道,人但知其治疝之功,而不知其荡热止痛之用。《本经》主温病烦狂,取以引火毒下泄,而烦乱自除。其杀虫利水道,总取以苦化热之义。古方金铃子散,治心包火郁作痛,即妇人产后血结心痛,亦宜用之。以金铃子能降火逆,延胡索能散结血,功胜失笑散而无腥秽伤中之患。”       
 
【现代研究】        1.化学成分:本品含川楝素、楝树碱、山奈醇及脂肪油等。       
 
2.药理作用:本品所含川楝素为驱虫有效成分,与山道年相比,作用缓慢而持久,对猪蛔虫、蚯蚓、水蛭等有明显的杀灭作用;川楝子有松弛奥狄氏括约肌,收缩胆囊,促进胆汁排泄的作用;能兴奋肠管平滑肌,使其张力和收缩力增加;川楝子对金黄色葡萄球菌、多种致病性真菌有抑制作用;尚有抗炎、抗癌作用。      
 
  3.临床研究:以川楝子、乌梅各40g、川椒、黄连各20g、生大黄10g烘干混合为末,制成胶囊剂,治疗胆道蛔虫症,治102例,均获痊愈(上海中医药杂志,1985,8:28);以生大黄、郁金各10g,金铃子、山楂各12g,积雪草20g,每日1剂水煎服,治疗急性胆囊炎60例,痊愈43例(湖北中医杂志,1987,2:17);以金铃泻肝汤(川楝子、乳香、没药、龙胆草、大黄等)治疗胆系感染150例,痊愈 130例,好转20例(辽宁中医杂志,1991,4:27);以川楝子去核取肉,研末,用猪油或凡士林调膏外涂局部,治疗头癣、秃疮,有良好效果(中医杂志,1962,9:181);
 
此外有用川楝子复方治疗急性乳腺炎、乳腺增生、睾丸疾病、蛲虫病等。       
 
 4.不良反应:中毒较轻时,可见头晕、头痛、思睡、恶心呕吐、腹痛等,严重时会出现呼吸中枢麻痹,中毒性肝炎、内脏出血、精神失常等症状。川楝子临床应用一般无严重反应,但不少地方以苦楝子代用或用量过大引起中毒则较多见。本品主要毒性成分是川楝素,苦楝萜酮内酯等。川楝子对胃肠道有刺激作用,对肝脏有损害,会阻断神经肌肉接头的正常传递功能,还会造成急性循环衰竭和中枢性呼吸衰竭而死亡。预防中毒措施:控制用量,一般内服用量3~10g,不可过量或持续使用(因为川楝素为强积累物质);注意品种,苦楝子毒性比川楝子大,不可以前者替代川楝子使用。中毒救治的方法为:催吐或洗胃,服用泻药如番泻叶或硫酸镁等;服蛋清或活性炭吸附毒素,以保护胃粘膜;中药解毒可用白糖、甘草煎服;对症治疗。       
 
【其它】同科属不同种植物苦楝树Melia azedarach L.的果实苦楝子,性状、成分及药效与本品略有不同,苦楝子毒性较川楝子为大,应区别用药,不能混淆。       

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