中医学教学课件：12 medicinal herbs

1、第九章 chapter 9The science of medicinal herbs中药学又称药性，对中药各种性质和功能的一种概括，包括四又称药性，对中药各种性质和功能的一种概括，包括四气、五味、升降浮沉、归经及毒性等内容气、五味、升降浮沉、归经及毒性等内容。The drug property of the herbs describe the therapeutic significance and energetic characteristics including the four property(cold cool hot warm) and five tastes(spicy

2、sweet sour bitter salty),functional tendency,(ascending descending floating sinking), tropism, and toxicity.一、中一、中 药药 的的 性性 能能The property of medicinal herbs 第一节第一节 中药基本知识中药基本知识Section1thebasicknowledgeofmedicinalherbs（一）（一） 四四 气气 four propertyn四气是指药物具有寒、热、温、凉四种不同的药性，又称四性。药四气是指药物具有寒、热、温、凉四种不同的药性，又称四

3、性。药物的寒、热、温、凉是从药物作用于机体所发生的反应概括出来的。物的寒、热、温、凉是从药物作用于机体所发生的反应概括出来的。温次于热，凉次于寒。凡能治疗温热性疾病的药物，多属凉性或寒温次于热，凉次于寒。凡能治疗温热性疾病的药物，多属凉性或寒性；凡能治疗寒凉性疾病的药物，多属热性或温性。此外，还有一性；凡能治疗寒凉性疾病的药物，多属热性或温性。此外，还有一些寒、热之性不甚明显，作用平和的药物称平性药。些寒、热之性不甚明显，作用平和的药物称平性药。nFour property: the nature of the medicinal herbs such as cold, cool, hot a

4、nd warm, which is from the experience of the application to the body during the administration. Warm is slighter than hot, and cool is slighter than cold. Medicinal herbs cool or cold in property is applied to the illness caused by hot or warm evil, and vice versa. Furthermore , some medicinal herbs

5、 are bland in property, the nature of which is not obvious.n五味是指药物具有辛、甘、酸、苦、咸五种滋味五味是指药物具有辛、甘、酸、苦、咸五种滋味, 药味不同，药味不同，则作用不同。则作用不同。 nFive taste is spicy, sweet, sour, bitter and salty. Different taste means different efficacy.（二）五（二）五 味味 five taste 辛辛“能散、能行能散、能行”，即具有发散、行气、行血作用。辛味药，即具有发散、行气、行血作用。辛味药多用于治疗表

6、证、气滞及血瘀等病证多用于治疗表证、气滞及血瘀等病证Spicy herbs can disperse and promote the Qi flow and blood circulation, mainly indication for exterior syndrome, Qi stagnation and blood stasis.甘甘“能补、能和、能缓能补、能和、能缓”，即具有补益、调和、缓急的作用。，即具有补益、调和、缓急的作用。补益药、调和药及止痛药多具有甘味，故甘味药多用于虚证、脏补益药、调和药及止痛药多具有甘味，故甘味药多用于虚证、脏腑不和及拘挛疼痛等病证腑不和及拘挛疼痛等病证

7、Sweet herbs can tonify, hamonize and moderate, mainly for tonification of deficiency, hamonization the property of medicinal herbs, regulation the function of viscera and analgesia.五五 味味酸酸“能收、能涩能收、能涩”，即具有收敛、固涩作用。酸味药大多用于，即具有收敛、固涩作用。酸味药大多用于治疗体虚多汗、肺虚久咳、久泻滑脱、遗精遗尿、崩漏带下等病证治疗体虚多汗、肺虚久咳、久泻滑脱、遗精遗尿、崩漏带下等病证Sour

8、 herbs can absorb and control, mainly indication for astringency such as sweating, chronic cough, chronic diarrhea, enuresis, spermorrhea, metrorrhagia and metrostaxis,and leukorrhea.苦苦“能泄、能燥能泄、能燥”，即具有通泄、燥湿等作用。如清热燥湿药，即具有通泄、燥湿等作用。如清热燥湿药大多具有苦味，故能泄热燥湿，常用于实热火证及湿热等病证大多具有苦味，故能泄热燥湿，常用于实热火证及湿热等病证。Bitter her

9、bs reduce and dry, mainly for reduce heat and turbid dampness inside.五五 味味咸咸“能下、能软能下、能软”，即具有泻下通便、软坚散结等作用。如泻，即具有泻下通便、软坚散结等作用。如泻下药、软坚药大多具有咸味，故咸味药常用于治疗大便秘结、瘰疠下药、软坚药大多具有咸味，故咸味药常用于治疗大便秘结、瘰疠瘿瘤、癥瘕痞块等病证。瘿瘤、癥瘕痞块等病证。Salty herbs can soften hardness nodules and purge stools, mainly indication are constipation,

10、subcutaneous nodules and scrofula.五五 味味n “淡淡”味药，本类药无明显味道；味药，本类药无明显味道；“淡淡”则则“能渗、能渗、能利能利”，即能渗湿利小便；常用于水肿、小便不利，即能渗湿利小便；常用于水肿、小便不利等病证。等病证。n The bland herbs is not obvious in the taste and can effuse as the diuresis for edema and retention of urine.n “涩涩”与与“酸酸”味药作用相似，大多具有收敛固涩味药作用相似，大多具有收敛固涩作用，常用于虚汗、久泄、遗精、

11、出血等病证作用，常用于虚汗、久泄、遗精、出血等病证 。n The herbs of acerbity is similar to the sour herbs in the indication and therapeutic efficacy. 五五 味味淡淡 酸酸 涩涩升即上升提举；降即下达降逆；浮即向外发散；沉即向内收敛。升即上升提举；降即下达降逆；浮即向外发散；沉即向内收敛。The ascending goes up towards upper parts while the descending goes down towards lower parts, the floating

12、comes outwards while the sinking goes inwards.升、降、浮、沉即是指药物对机体有向上、向下、向外、向内四升、降、浮、沉即是指药物对机体有向上、向下、向外、向内四种不同作用趋向。药物的这种性能可用于调整机体气机紊乱，使种不同作用趋向。药物的这种性能可用于调整机体气机紊乱，使之恢复正常的生理功能，或因势利导，驱邪外出，达到治愈疾病之恢复正常的生理功能，或因势利导，驱邪外出，达到治愈疾病的目的。的目的。The tendency is for the therapeutic efficacy of the medicinal herbs, which hav

13、e effect on the regulation of the Qi flow inside to enable it recover or expel the evil to come out so as to heal the illness.（三）（三）升升降降浮浮沉沉概概 念念药物对某经（脏腑或经络）或某几经发生明显作药物对某经（脏腑或经络）或某几经发生明显作用，而对其他经作用较少，甚至无作用，这种对用，而对其他经作用较少，甚至无作用，这种对机体某部分的选择性作用称归经。机体某部分的选择性作用称归经。Medicinal herbs usually produce therapeut

14、ic efficacy in preference of the meridians and viscus in predominance, while in the other parts of the body there seems to be fewer effects. （四）（四） 归归 经经tropism 酸枣仁酸枣仁能安神治心悸失眠，归心经；能安神治心悸失眠，归心经；SuanzaorenSuanzaoren palpitation and insomnia heart merdian麻黄麻黄止咳平喘，归肺经；止咳平喘，归肺经；MahuangMahuang cough and a

15、sthma lung meridian全蝎全蝎能解痉止痛，归肝经。能解痉止痛，归肝经。 QuanxieQuanxie spasm and pain liver meridian 归归 经经有一些药物，可以同时归入数经，说明该药对数经病变均有治疗作有一些药物，可以同时归入数经，说明该药对数经病变均有治疗作用。用。Some medicinal herbs is polyphyletic in tropism since the therapeutic efficacy is comprehensive.如山药能补肾固精、健脾止泻、养肺益阴，归肾、脾、肺经。如山药能补肾固精、健脾止泻、养肺益阴，归肾

16、、脾、肺经。Yam: reinforcing kidney to strengthen essence, tonifying spleen to treat diarrhea, and nourish yin of lung.归经指明药物治病的应用范围，药物的归经不同，治疗的范围也就归经指明药物治病的应用范围，药物的归经不同，治疗的范围也就不同。不同。Tropism is the range of indication and these two aspects are closely related.归归 经经概念概念 毒性是指药物对机体的损害性，毒性反应与副作用不同，它毒性是指药物对机体的

17、损害性，毒性反应与副作用不同，它对人体的危害性较大，可危及生命。对人体的危害性较大，可危及生命。Toxicity of herbs is the poisioning efficacy to the body, the impact of which is different to the adverse reaction. Toxicity cause severe harm to the body, sometimes lethal.正确认识中药毒性正确认识中药毒性是安全用药的重要保证。有毒中药大多效强功捷，是安全用药的重要保证。有毒中药大多效强功捷，临床用之得当，则可立起沉疴；若用之失当

18、，则可引起中毒临床用之得当，则可立起沉疴；若用之失当，则可引起中毒 。 To recognize the importance of the toxicity of medicinal herbs is the key of the safe medication. Toxic medicinal herbs are powerful in the therapeutic efficacy with the accurate indication while applied in the contraindication it might cause intoxication. （五）（五）中

19、中药药毒毒性性toxicity中中 药药 毒毒 性性 的的 现现 代代 研研 究究1.中枢神经系统毒副作用中枢神经系统毒副作用 Toxicity on CNS2. 心血管系统的毒副作用心血管系统的毒副作用 Toxicity on cardiovascular system3. 消化系统的毒副作用消化系统的毒副作用 Toxicity on digestive system4. 肝肾功能的损害肝肾功能的损害 Hepatic and nephric toxicity 5. 过敏过敏 Allergic reaction6. 致畸致癌作用致畸致癌作用 Teratogenesis and teratoge

20、nesis配伍compatibility二、中药的应用二、中药的应用the application of medicinal herbs用药禁忌contraindication剂量和用法dosage and administration概念概念 根据不同病情和临床辨证，有选择地将两种或两根据不同病情和临床辨证，有选择地将两种或两种以上药物组合在一起应用种以上药物组合在一起应用According to the indication and syndrome differentiation, two different medicinal herbs are used together for t

21、he treating purpose.“七情七情” 表示药物之间的相互作用，是表示药物之间的相互作用，是长期临床用药长期临床用药实践中对单味药的应用和药物的配伍关系的总结实践中对单味药的应用和药物的配伍关系的总结Seven relations: to show the interaction of herbs, which comes from the clinical experience of the long-term application, contains the indication and the mutual relations.（一）配（一）配 伍伍compatibili

22、ty 单行单行 用一味药治疗疾病谓单行用一味药治疗疾病谓单行Singular application: Using a single medicinal herb 相须相须 两种性能、功效相同或近似的药物合用，以增强疗效的一种配伍方法两种性能、功效相同或近似的药物合用，以增强疗效的一种配伍方法Mutual reinforcement: two or more ingredients with similar property and effects are used in combination to reinforce each others efficacy 相使相使 两种药合用，一种药物

23、为主，另一种药物为辅，辅药可以提高主药功效两种药合用，一种药物为主，另一种药物为辅，辅药可以提高主药功效的配伍方法谓相使的配伍方法谓相使Mutual assistance: two medicinal herbs are used , one as the dominate factor and the other as the assistant to raise the efficacy. 相畏相畏 一种药物的毒副作用，被另一种药物所抑制一种药物的毒副作用，被另一种药物所抑制,使其毒副作用减轻或消失使其毒副作用减轻或消失的配伍方法称相畏的配伍方法称相畏Mutual restraint: m

24、utual restraining effect of different medicinal herbs to weaken or neutralize each othersharmfulness.七七 情情seven relations 相杀相杀 一种药物能够清除另一种药物毒副作用的配伍一种药物能够清除另一种药物毒副作用的配伍Mutual detoxication: one medicinal herb can relieve or move the toxicity and adverse reaction of the other. 相恶相恶 一种药物能破坏另一种药物的功效，使其作用

25、减弱，甚至消失一种药物能破坏另一种药物的功效，使其作用减弱，甚至消失的一种配伍的一种配伍Mutual inhibition: one herb and the other can act on each other, result in the original effcacy weakened, even lost. 相反相反 两种药物配伍应用后，产生毒性反应或副作用两种药物配伍应用后，产生毒性反应或副作用Incompatibility: toxicity and adverse reaction may result when the two ingredients are combina

26、ted.七七 情情中药用药禁忌主要包括配伍禁忌、妊娠用药禁忌及服药食忌三方面中药用药禁忌主要包括配伍禁忌、妊娠用药禁忌及服药食忌三方面的内容；的内容；注意用药禁忌是用药安全和药物疗效的保证注意用药禁忌是用药安全和药物疗效的保证The indication of the usage in medicinal herbs is mainly at three aspects: inproper compatibility, inproper medication in gestation, and food taboo during administration.The attention to

27、care about this ensure the safe administration of medicinal herbs and significant efficacy.（二）用药禁忌（二）用药禁忌contraindication概概 念念指某些药物配伍使用，会产生或增强毒副作用，或破坏和降低原指某些药物配伍使用，会产生或增强毒副作用，或破坏和降低原药物的药效，因此临床应当避免配伍使用药物的药效，因此临床应当避免配伍使用Incompatibility during prescription will leads to the strengthing of adverse react

28、ion and toxicity, meanwhile the therapeutic efficacy will shrink, which is ought to be prevented. 配伍禁忌配伍禁忌inproper compatibilityn中药配伍禁忌的范围主要包括药物七情中相反、相恶两中药配伍禁忌的范围主要包括药物七情中相反、相恶两个方面的内容。历代医家对配伍禁忌药物的认识，都不个方面的内容。历代医家对配伍禁忌药物的认识，都不一致，金元时期才把药物的配伍禁忌概括为：一致，金元时期才把药物的配伍禁忌概括为：nThe inproper compatibility include

29、s the relations such as mutual inhibition and incompatibility.n十八反、十九畏十八反、十九畏n18 incompatible medication and 19 mutual antagonism.配配 伍伍 禁禁 忌忌概概 念念指对妊娠母体或胎儿具有损害作用，干扰正常妊娠的药物。根据指对妊娠母体或胎儿具有损害作用，干扰正常妊娠的药物。根据药物作用的强弱，一般分为禁用和慎用两类药物作用的强弱，一般分为禁用和慎用两类The effects of the medicinal herbs will damage the fetus, an

30、d disturb the normal pregnancy process. The herbs are usually classified into two categories such as contraindicated and used with caution. 妊娠用药禁忌妊娠用药禁忌inproper medication in gestation概概 念念忌口：服药期间对某些食物的禁忌，生冷、油腻、辛辣刺激食物忌口：服药期间对某些食物的禁忌，生冷、油腻、辛辣刺激食物Food taboo: during medication, pay attention to the diet, forbidden the food such as raw or cold food,