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Shuizhi (Leech)---水蛭(powder100g/bottle)

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It is the dried whole body of Whitmania pigra Whitman, Hirudo nipponica Whitman or Whitemania acranulata Whiteman, family Hirudinidae. It is caught in summer and autumn, scalded to death in boiling water, dried in the sunshine, or at a low temperature. The raw or the scalded with talcum powder form is utilized as a medicine.

[ Medicinal Properties ]: Salty, bitter, moderate and mildly toxic; relate to liver meridian.

[ Medicinal Efficacies ]: Dissipate and removed blood stasis.

[ Clinical Applications ]: Blood stasis causing amenorrhea, abdominal mass and trauma.

To treat amenorrhea and abdominal mass, it is usually combined with Taoren, Sanleng and Sumu. For patients with general weakness, medicinals to tonify qi and nourish the blood should be utilized as assistants. For trauma and swollen pain, due to blood stasis and constipation, it may be combined together with Dahuang and Qianniuzi, such as, in the Duoming Powder.

In addition, in recent years it is need clinically to treat thrombocythemia, when combined with blood-activating and stasis-dispelling medicinals. It is more efficacious when decocted for a short period of time.

[ Usage and Dosage ]: 1.5-3g. In the powder form. 0.3-0.5g. It is better when processed into pills or a powder form. Or place directly the live one at the swollen area to suck the blood and remove blood-stasis.

[ Precautions ]: It is contraindicated to use with pregant women.

水蛭为水蛭科动物蚂蟥Whitemania pigra Whitman、水蛭Hirudo nipponia Whitman及柳叶蚂蟥W.acranulata Whitman的干燥体。全国大部分地区均有出产,多属野生.夏秋季捕捉。捕捉后洗净,用沸水烫死,切段晒干或低温干燥,生用,或用滑石粉烫后用。

       【药性】咸、苦,平。有小毒。归肝经。        【功效】破血通经,逐瘀消癥       
 
【应用】        1.血瘀经闭,癥瘕积聚。本品咸苦入血,破血逐瘀力强,主要用于血滞经闭,癥瘕积聚等证。常与虻虫相须为用,也常配三棱、莪术、桃仁、红花等药用,如抵当汤(《伤寒论》);若兼体虚者,可配人参、当归等补益气血药,如化癥回生丹(《温病条辨》)。       
 
2.跌打损伤,心腹疼痛。取本品的破血逐瘀之功,亦常用于跌打损伤,可配苏木、自然铜等药用,如接骨火龙丹(《普济方》)。治瘀血内阻,心腹疼痛,大便不通,则配伍大黄、牵牛子,如夺命散(《济生方》)。       
 
【用法用量】煎服,1.5~3g;研末服,0.3—0.5g。以入丸、散或研末服为宜。或以鲜活者放置于瘀肿局部吸血消瘀。        【使用注意】孕妇及月经过多者忌用。       
 
【古籍摘要】        1.《神农本草经》:”主逐恶血,瘀血,月闭,破血逐瘀,无子,利水道。”        2.《别录》:“堕胎。”        3.《本草衍义》:“治折伤。”       
 
【现代研究】        1.化学成分:主要含蛋白质。唾液中含有水蛭素,还含有肝素、抗血栓素及组织胺样物质。       
 
 2.药理作用:水蛭水煎剂有强抗凝血作用,能显著延长纤维蛋白的凝聚时间,水蛭提取物、水蛭素对血小板聚集有明显的抑制作用,抑制大鼠体内血栓形成,对弥漫性血管内凝血有很好的治疗作用。水蛭煎剂能改善血液流变学。能降血脂,消退动脉粥样硬化斑块,增加心肌营养性血流量,对抗垂体后叶素引起的心率失常或明显的T波、ST段的变化。促进脑血肿吸收,减轻周围脑组织炎症反应及水肿,缓解颅内压升高,改善局部血循环,保护脑组织免遭破坏。对皮下血肿也有明显抑制作用。水蛭水煎剂对肾缺血有明显保护作用,能降低血清尿素氮、肌酐水平,对升高的血清肿瘤坏死因子有明显的降低作用。水蛭素对肿瘤细胞也有抑制作用。此外,水蛭水煎剂尚有终止妊娠的作用。       
 
3.临床研究:水蛭片(每片含生药0.75g),每次2—4片,日3次,治疗冠心病、心绞痛100例。结果:显效34例,改善56例,无效9例,恶化1例。其中心电图恢复正常15例,改善44例,无效37例(天津医药,1980,(4):238)。生水蛭粉装胶囊(每粒含生药0.25g )治疗高脂血症150例,每次4粒,日3次,饭后服,4周为1疗程。结果血清胆固醇平均由5.398±1.084mmol/L降为 4.953±0.923mmol/L(p
 
4.不良反应:妊娠7—11日小鼠每日灌服水蛭煎剂0.5、1.0g/kg,均可使胎鼠体重下降,有明显致崎作用,死胎和吸收胎比例升高,堕胎作用显著。

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