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Zhimu ( Anemarrhena Rhizome )---知母

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This medicinal is the dried rhizome of Anemarrhena asphodeloide Bge, pertaining to Liliaceae. It is collected in spring and autumn. The one which is removed fibrous root and sun-dried, is known as Hair Zhimu .After peeled about sun dried, it is cut into slices. The raw form is used or after stir-baked with a salt solution.

[ Medicinal Properties ]: Bitter, sweet and cold; relate to lung, stomach and kidney meridians.

[ Medicinal Efficacies ]: Clear heat ad purge fire; generate fluids and moisten dryness.

[ Usage and Dosage ]: 6-12 g.

[ Precautions ]: It can promote defecation,so patients with loose stool due to spleen insufficiency should be cautions when using it.
 
[ Clinical Applications ]: 1. Excessive heat in lung and stomach     Zhimu is the most significant medicinal to purge excessive heat of the lung and stomach in qi level. Also it is good at treating fever of external contraction with high fever and thirst, in combination with Shigao; for example in Baihu Decoction.
 
2. Lung heat, cough, yin-deficiency and dry cough     It treats dry cuogh and lung heat, in comination with Beimu; for example in Ermu Decoction.
 
3. Bone-steaming and tidal fever    It is indicated for bone-steaming, tidal fever and night sweats due to yin deficiency with effulgent fire, combined with Huangbo and Shengdihuang; for example in Zhibai Dihuang Pills.
 
4. Internal heat, Xiaoke (diabetes), intestinal dryness and constipation     For Xiaoke ( diabetes) due to internal heat, it is combined with Tianhuafen and Gegen; for example in Yuye Decoction. For constipation due to intestinal dryness, it is in combination with Shengdi, Xuanshen and Maidong.
[ Medicinal Comparison ]: Similarities: Both Shigo and Zhimu can clear heat and purge fire, remove thirst, so they are applicable in excessive heat in qi level of warm disease and cough due to lung heat.
 
Differences: Shigo is strong in clearing heat and good at purging fire, so it is good at purging excessive fire of lung and stomach to treat cough and asthma due to lung heat, and toothache due to stomach fire. The calcined Shigao externally applied can promote tissue regeneration. Zhimu is good at nourishing yin and moistening dryness to nourish yin of lung, stomach and kidney, so it can treat dry cough due to lung heat, Xiaoke( diabetes) due to yin deficiency and yin deficiency with effulgent fire.

知母为百合科植物知母Anemarrhena asphodeloides Bge.的干燥根茎。主产于河北、山西及山东等地。春、秋二季采挖,除去须根及泥沙,晒干,习称“毛知母”。或除去外皮,晒干。切片入药,生用,或盐水炙用。
      
【药性】苦、甘,寒。归肺、胃、肾经。       
 
【功效】清热泻火,生津润燥。       
 
【应用】        1.热病烦渴。本品味苦甘而性寒质润,苦寒能清热泻火除烦,甘寒质润能生津润燥止渴,善治外感热病,高热烦渴者,常与石膏相须为用,如白虎汤(《伤寒论》)。       
 
 2.肺热燥咳。本品主入肺经而长于泻肺热、润肺燥,用治肺热燥咳,常配贝母用,如二母散(《证治准绳》);若配杏仁、莱菔子,可治肺燥久嗽气急,如宁嗽煎(《奇方类编》)。       
 
 3.骨蒸潮热。本品兼入肾经而能滋肾阴、泻肾火、退骨蒸,用治阴虚火旺所致骨蒸潮热、盗汗、心烦者,常配黄柏、生地黄等药用,如知柏地黄丸(《医宗金鉴》)。       
 
4.内热消渴。本品性甘寒质润,能泻肺火、滋肺阴,泻胃火、滋胃阴,泻肾火、滋肾阴,可用治阴虚内热之消渴证,常配天花粉、葛根等药用,如玉液汤(《医学衷中参西录》)。       
 
5.肠燥便秘。本品功能滋阴润燥,可用治阴虚肠燥便秘证,常配生地黄、玄参、麦冬等药用。       
 
【用法用量】煎服,6—12g。       
 
【使用注意】本品性寒质润,有滑肠作用,故脾虚便溏者不宜用。       
 
【鉴别用药】石膏、知母均能清热泻火,可用治温热病气分热盛及肺热咳嗽等证。但石膏泻火之中长于清解,重在清泻肺胃实火,肺热喘咳、胃火头痛牙痛多用石膏;知母泻火之中长于清润,肺热燥咳、内热骨蒸、消渴多选知母。       
 
【古籍摘要】        1.《神农本草经》:“主消渴热中,除邪气,肢体浮肿,下水,补不足益气。”      
  2.《用药法象》:“泻无根之肾火,疗有汗之骨蒸,止虚劳之热,滋化源之阴。”       
 3.《本草纲目》:“知母之辛苦寒凉,下则润肾燥而滋阴,上则清肺金而泻火,乃二经气分药也。”       
 
 【现代研究】        1.化学成分:本品根茎含多种知母皂苷、知母多糖;此外,尚含芒果苷、异芒果苷、胆碱、尼克酰胺、鞣酸、烟酸及多种金属元素、粘液质、还原糖等。     
   2.药理作用:知母浸膏动物实验有防止和治疗大肠杆菌所致高热的作用;体外实验表明,知母煎剂对痢疾杆菌、伤寒杆菌、副伤寒杆菌、霍乱弧菌、大肠杆菌、变形杆菌、白喉杆菌、葡萄球菌、肺炎双球菌、β-溶血性链球菌、白色念珠菌及某些致病性皮肤癣菌等有不同程度的抑制作用;其所含知母聚糖A、B、C、D有降血糖作用,知母聚糖B的活性最强;知母皂苷有抗肿瘤作用。      
  3.临床研究:用知母、夏枯草,煎水冷湿敷患处,治疗头皮毛囊周围炎19例,均有效(临床皮肤科杂志,1985,5:275);以知柏坤草汤(由知母、黄柏、丹参、益母草、大黄、牛膝组成)治疗前列腺肥大80例,总有效率为86.3%(中西医结合杂志,1988,3:155);用知母皂苷口服液口服,治疗原发性肾病综合征30例,能明显减轻糖皮质激素所产生的副作用(实用医学杂志,2001,7:583)。       

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