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Copy of dahuang ( Rhubarb )---大黄-锦(powder100g/bottle)

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Dahuang is from the root and rhizome of Rheum palmatum L.,R. Decoctionuticum Maxim. ex Balf. or R. officinale Baill., family Polygonaceae. Medicinals from Rheum palmatum L., and R. Decoctionuticum Maxim.ex Balf. are slao called north Radix et Rhizoma Rhei; ones from R officinale Baill. are called south Radix et Rhizmoam Rhei. They are collected in the end of autumn or the spring before theplants sprouts. After which the cortex is removed, cut into pieces and it is then dried in the sunshine. The raw steamed or stir-baked with wine, or the charred forms cann be utilized for medicine.

[ Medicinal Properties ]: Bitter, cold; relate to spleen, stomach, large intestine, liver and heart meridians.

[ Medicinal Efficacies ]: remove stagnation by purgation; clear heat and discharge fire; cool blood and remove toxin; active blood and remove blood stasis; clear and purge damp-heat.

[ Usage and Dosage ]: 3-15g. Just right amount is for external use, and the crude one with stronger purgative action is used for downward discharging. It is later added to decoction or soaked in boiling water for oral use, and decocting too long will weaken the downward ation. That prepared with wine has weaker puragtive action and is suitable for blood stasis because of its better action of activating blood.The carbonized form is usually used for bleeding syndrome.

[ Precautions ]: It should be used carefully , or avoidded in pregnancy, menstruation, lactation or insufficiency of the spleen and stomach.
 
[ Clinical Applications ]: 1. Stagnation in the stomach and intestine and obstruction of the bowels       It is bitter in flavor, cold in nature and descending in actions, which can facilitate purging heat. It is effective especially for constipation due to stagnation of heat. It is usually used together iwth Mangxiao, Houpo and Zhishi, such as in Da Chengqi Decoction. If stagnatin of interior excess heat is accompanied with deficiency of qi and blood, Renshen and Danggui are added, such as in Huanglong Decoction. For yin deficiency due to stagnation of heat, Shengdihuang, Xuanshen, etc. are combined with, such as in Zengye Chengqi Decoction. For constipation due to insufficiency of spleen yang and cold stagnation, Fuzi and Ganjiang, etc. can also be added, such as in Wenpi Decoction. For early stage of dysentery of damp-heat sydrome with abdome with abdominal pain and tenesmus, it is usually combined with Huanglian, Muxiang, etc. such as in Shaoyao decoction. For food retention and unsmooth dysentery, it is usually combined with Qingpi and Binglang , such as in Muxiang Bingliang Pill.
 
2. Excess fire    It can discharge flaring of fire. For haematemesis, epistaxis and hemoptysis due to blood heat and redness of eyes, sore throat and swollen painful gum due to flaring fire, it is usually used together with Huangqin and Huanglian, such as in Xiexin Decoction.
 
3. Pyocutaneous disease due to toxic heat, burn and scald      For early stage of pyocutaneous disease, carbuncle and erysipelas, it is usually used together with Lianqiao and Baizhi. For abdominal pain due to intestinal abscess, Mudanpi, Taoren, etc. are added, such as in Dahuang MUdanpi Decoction. For burn and scald, it can be used in powder form being mixed with honey or combined with Diyu Powder, being mixed with sesame oil for external application.
 
4. Blood Stasis    For postpartum abdominal pain, it is used together with Taoren, TUbiechong etc, such as in Xiayuxue Decoction. For amenorrhea due to blood stasis, it is used together with Taoren, Guizhi, etc. such as in Taohe Chengqi Decoction. For trauma and blood stasis with swelling and pain, it is used together with Danggui, Honghua and Chuangshanjia, such as in Fuyuan Huoxue Decoction.
 
5. Jaundice of damp-heat and stranguria      For jaundice of damp-heat, it is usullay used together with Yinchenhao, Zhizi, such as in Yinchehao Decociton. For stranguria of damp-heat, it is used together with Cheqianzi, Qumai, etc., such as in Bazheng Powder.

大黄为蓼科植物掌叶大黄Rheum palmatum L.、唐古特大黄R.tanguticum Maxim.ex Balf.或药用大黄 R.officinale Baill.的干燥根及根茎。掌叶大黄和唐古特大黄药材称北大黄,主产于青海、甘肃等地。药用大黄药材称南大黄,主产于四川。于秋末茎叶枯萎或次春发芽前采挖。除去须根,刮去外皮切块干燥,生用,或酒炒,酒蒸,炒炭用。
      
【药性】苦,寒。归脾、胃、大肠、肝、心包经。       
 
【功效】泻下攻积,清热泻火,凉血解毒,逐瘀通经。       
 
【应用】        1.积滞便秘。本品有较强的泻下作用,能荡涤肠胃,推陈致新,为治疗积滞便秘之要药。又因其苦寒沉降,善能泄热,故实热便秘尤为适宜。常与芒硝、厚朴、枳实配伍,以增强泻下攻积之力,为急下之剂,用治阳明腑实证,如大承气汤(《伤寒论》);若大黄用量较轻,与麻仁、杏仁、蜂蜜等润肠药同用,则泻下力缓和,方如麻子仁丸(《伤寒论》)。若里实热结而正气虚者,当与补虚药配伍,以攻补兼施,标本并顾。如热结而气血不足者,配人参、当归等药,方如黄龙汤(《伤寒六书》);如热结津伤者,配麦冬、生地、玄参等,方如增液承气汤(《温病条辨》);若脾阳不足,冷积便秘,须与附子、干姜等配伍,如温脾汤(《千金方》)。       
 
 2.血热吐衄,目赤咽肿。本品苦降,能使上炎之火下泄,又具清热泻火,凉血止血之功。常与黄连、黄芩同用,治血热妄行之吐血、衄血、咯血,如泻心汤(《金匮要略》)。现代临床单用大黄粉治疗上消化道出血,有较好疗效。若与黄芩、栀子等药同用,还可治火邪上炎所致的目赤、咽喉肿痛、牙龈肿痛等证,如凉膈散(《和剂局方》)。       
 
3.热毒疮疡,烧烫伤。本品内服外用均可。内服能清热解毒,并借其泻下通便作用,使热毒下泄。治热毒痈肿疔疮,常与金银花、蒲公英、连翘等同用;治疗肠痈腹痛,可与牡丹皮、桃仁、芒硝等同用,如大黄牡丹汤(《金匮要略》)。本品外用能泻火解毒,凉血消肿,治热毒痈肿疔疖,如用治乳痈,可与粉草共研末,酒熬成膏的金黄散(《妇人大全良方》);用治口疮糜烂,多与枯矾等份为末擦患处(《圣惠方》)。治烧烫伤,可单用粉,或配地榆粉,用麻油调敷患处。       
 
 4.瘀血证。本品有较好的活血逐瘀通经作用,其既可下瘀血,又清瘀热,为治疗瘀血证的常用药物。治妇女产后瘀阻腹痛、恶露不尽者,常与桃仁、 土鳖虫等同用,如下瘀血汤(《金匮要略》);治妇女瘀血经闭,可与桃核、桂枝等配伍,如桃核承气汤(《伤寒论》);治跌打损伤,瘀血肿痛,常与当归、红花、穿山甲等同用,如复元活血汤(《医学发明》)。       
 
5.湿热痢疾、黄疸、淋证。本品具有泻下通便,导湿热外出之功,故可用治湿热蕴结之证。如治肠道湿热积滞的痢疾,单用一味大黄即可见效(《素问病机气宜保命集》),或与黄连、黄芩、白芍等同用;治湿热黄疸,常配茵陈、栀子,如茵陈蒿汤(《伤寒论》);治湿热淋证者,常配木通、车前子、栀子等,如八正散(《和剂局方》)。       
 
 此外,大黄可“破痰实”,通脏腑,降湿浊,用于老痰壅塞,喘逆不得平卧,大便秘结者,如礞石滚痰丸(《养生主论》)。       
 
【用法用量】煎服,5~15g;入汤剂应后下,或用开水泡服。外用适量。       
 
【使用注意】本品为峻烈攻下之品,易伤正气,如非实证,不宜妄用;本品苦寒,易伤胃气,脾胃虚弱者慎用;其性沉降,且善活血祛瘀,故妇女怀孕、月经期、哺乳期应忌用。       
 
【用药鉴别】生大黄泻下力强,久煎则泻下力减弱。酒制大黄泻下力较弱,活血作用较好,宜用于瘀血证。大黄炭则多用于出血证。       
 
【古籍摘要】        1.《神农本草经》:“下瘀血,血闭,寒热,破癥瘕积聚,留饮宿食,荡涤肠胃,推陈致新,通利水谷,调中化食,安和五脏。”       
 
 2.《药性论》:“主寒热,消食,炼五脏,通女子经候,利水肿,破痰实,冷热积聚,宿食,利大小肠,贴热毒肿,主小儿寒热时疾,烦热,蚀脓,破留血。”       
 
 3.《本草纲目》:“下痢赤白,里急腹痛,小便淋沥,实热燥结,潮热谵语,黄疸,诸火疮。”       
 
 4.《药品化义》:“大黄气味重浊,直降下行,走而不守,有斩关夺门之力,故号将军。专攻心腹胀满,胸胃蓄热,积聚痰实,便结瘀血,女人经闭。”       
 
【现代研究】        1.化学成分 :主要为蒽醌衍生物,主要包括蒽醌苷和双蒽醌苷。双蒽醌苷中有番泻苷A、B、C、D、E、F;游离型的苷元有大黄酸、大黄酚、大黄素、芦荟大黄素、大黄素甲醚等。另含鞣质类物质、有机酸和雌激素样物质等。       
 
2.药理作用:大黄能增加肠蠕动,抑制肠内水分吸收,促进排便;大黄有抗感染作用,对多种革兰氏阳性和阴性细菌均有抑制作用,其中最敏感的为葡萄球菌和链球菌,其次为白喉杆菌、伤寒和副伤寒杆菌、肺炎双球菌、痢疾杆菌等;对流感病毒也有抑制作用;由于鞣质所致,故泻后又有便秘现象;有利胆和健胃作用;此外,还有止血、保肝、降压、降低血清胆固醇等作用。       
 
 3.临床研究:据报道,以大黄为主或适当配伍还可用于治疗其它多种疾病,如:用生大黄10~20g,木香10g,开水浸泡后饮服,治疗胆绞痛,总有效率91.1%(中西医结合杂志,1991,3:183);单用大黄各种剂型,治疗急性胰腺炎266例,痊愈259例,无效7例。尿淀粉酶恢复正常平均2日,腹痛消失3日,发热消退5日(上海中医药杂志,1990,7:1);用大黄配白及,治疗36例急性胃粘膜病变所致的上消化道出血,总有效率91.7%(宁夏医学杂志,2001,2:119);以大黄丹参汤为主灌肠治疗小儿急性肾炎,均获良效(吉林中医药,2001,3:28)。
 
另有用大黄治疗冻伤、脂溢性皮炎、带状疱疹及高脂血症、肥胖症等。       

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