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Gualou (Snakegourd Fruit)---瓜蒌

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It is the dried mature fruit of TrichoPowderthes kirilowii Maxim. and TrichoPowderthes rosthornill Harms, family Cucurbitaceae. The fruits are collected in autumn when they are ripe. They are dreid in shade or the peels and seeds are dried separtely after the pulp is removed. The peels or the seeds can be used in raw or stir-baked form. the seeds can also be made into frost-like powder. When the peel and seeds are used together, it is Quangulou.

 [ Medicinal Properties ]: Sweet and cold; relate to lung, stomach and large intestine meridians.

 [ Mediicnal Efficacies ] : Clear heat and resolve phlegm; ease chest to dissipate mass; moisten intestine and release bowls.

[ Clinical Applications ]: 1. Phlegm-heat causing cough and dyspnea       For inner accumulation of phlegm-heat manifested as cough with yellowish and thick  sputum, chest oppression and difficult defecation, it is combined with Huangqin, Dannanxing and Zhishi, such as Qingqi Huatan Pills.

2. Chest impediment, thoracic accumulation          For phlegm-turbidity obstruction and stagnation of yang qi in chest causing chest pain, it is combined with Xiebai and Banxia in Gualou Xiebai Banxie Decoction. For accumulation of phlegm-heat in chest, fullness and oppression in chest and hypochonth painin pressure, it is combined with Banxia and Huanglian, such as Xiaoxianxiong Decoction.

3. Pulmonary abscess, intestinal abscess, mammary abscess         In combination with Yuxingcao and Lugen, it treats pulmonary abscess coughing up pus and blood. For intestinal abscess, it is used with Baijiangcao and Hongteng. It treat swelling, pain and hot sensation in the early stage of mammary abscess with Pugongying and Jinyinhua.

4. Intestinal dryness with constipation          Gualouren or Gualourenshuang is usually used to combine Huomaren, Yuliren and Zhiqiao.

[ Usage and Dosage ]: 10-20g of Quangualou, 6-12g of Gualoupi or 10-15 of Gualouren is used.

[ Precautions ]: It is incompatible with Wutou.

瓜蒌为葫芦科植物栝楼 Trichosanthes kirilowii Maxim. 和双边栝楼T.rosthornii Harms的成熟果实。全国大部分地区均产，主产于河北、河南、安徽、浙江、山东、江苏等地。秋季采收，将壳与种子分别干燥。生用，或以仁制霜用。

       【药性】甘、微苦，寒。归肺、胃、大肠经。        【功效】清热化痰，宽胸散结，润肠通便。       
 
【应用】        1．痰热咳喘。本品甘寒而润，善清肺热，润肺燥而化热痰、燥痰。用治痰热阻肺，咳嗽痰黄，质稠难咯，胸膈痞满者，可配黄芩、胆南星、枳实等，如清气化痰丸（《医方考》）。若治燥热伤肺，干咳无痰或痰少质粘，咯吐不利者，则配川贝母、天花粉、桔梗等。       
 
 2．胸痹、结胸。本品能利气开郁，导痰浊下行而奏宽胸散结之效。治痰气互结，胸阳不通之胸痹疼痛，不得卧者，常配薤白、半夏同用，如栝楼薤白白酒汤、栝楼薤白半夏汤（《金匮要略》）。治痰热结胸，胸膈痞满，按之则痛者，则配黄连、半夏，如小陷胸汤（《伤寒论》）。       
 
 3．肺痈，肠痈，乳痈。本品能清热散结消肿，常配清热解毒药以治痈证，如治肺痈咳吐脓血，配鱼腥草、芦根等；治肠痈，可配败酱草、红藤等，治乳痈初起，红肿热痛，配当归、乳香、没药，如神效瓜蒌散（《妇人大全良方》）。        4．肠燥便秘。瓜萎仁润燥滑肠，适用于肠燥便秘，常配火麻仁、郁李仁、生地等同用。       
 
【用法用量】煎服，全瓜蒌1O～20g。瓜蒌皮 6～12g，瓜蒌仁1O～15g打碎入煎。        【使用注意】本品甘寒而滑，脾虚便溏者及寒痰、湿痰证忌用。不宜于乌头类药材同用。       
 
【鉴别用药】本品入药又有全瓜蒌、瓜蒌皮、瓜蒌仁之分。瓜蒌皮之功，重在清热化痰，宽胸理气；瓜蒌仁之功重在润燥化痰，润肠通便；全瓜蒌则兼有瓜蒌皮、瓜蒌仁之功效。       
 
【古籍摘要】        1．《名医别录》：“主胸痹，悦泽人面。”        2．《本草纲目》：“润肺燥，降火，治咳嗽，涤痰结，利咽喉，止消渴，利大肠消痈肿疮毒。”        3．《本草述》：“栝楼实，阴厚而脂润，故热燥之痰为对待的剂。若用寒痰、湿痰、气虚所结之痰，饮食积聚之痰，皆无益而有害者也。”       
 
【现代研究】        1．化学成分：本品合三萜皂苷，有机酸及盐类、树脂、糖类和色素。种子含脂肪油，皂苷等。瓜蒌皮含多种氨基酸及生物碱等。       
 
 2．药理作用：所含皂苷及皮中总氨基酸有祛痰作用；瓜蒌注射液对豚鼠离体心脏有扩冠作用；对垂体后叶引起的大鼠急性心肌缺血有明显的保护作用；并有降血脂作用。对金黄色葡萄球菌、肺炎双球菌、绿脓杆菌、溶血性链球菌及流感杆菌等有抑制作用。瓜蒌仁有致泻作用。       
 
 3．临床研究：瓜蒌制片或制成注射液用治冠心病有效（中草药通讯，1976，9：47）；注射液还可治疗喘息性气管炎及肺心病哮喘（北京中医，1984，1：22）；瓜蒌与全蝎配伍，研末服，可治妇女乳房纤维腺瘤（江苏中医杂志，1982，5：27）；
 
此外，瓜蒌与红花同用，水煎内服，治带状疱疹有良效（山东中医杂志，1993，6：40）       
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