2 English reference fuyuan huoxue decoction [Chinese medicine terminology validation committee. Chinese medicine terminology (2004)]
Fuyuan huoxue tang [Terminology Committee of Traditional Chinese Medicine. Terminology of Traditional Chinese Medicine (2004)]
Fuyuan Huoxue Tang [2 1 century bilingual dictionary of science and technology]
Decotion for promoting blood circulation [Xiangya Medical Dictionary]
3. Summarize Fuyuan Huoxue Decoction as the prescription name, and publish Volume III of Medical Invention. It consists of Bupleurum chinense, Trichosanthes kirilowii, Angelica sinensis, San Qian, Carthamus tinctorius, Glycyrrhiza uralensis, Squama Manis (processed with substitutes), Radix et Rhizoma Rhei (soaked in wine), and 50 peach kernels (soaked in wine, peeled, and ground into mud) [1]. It has the effects of soothing liver, dredging collaterals, promoting blood circulation and removing blood stasis. Treat traumatic injury, bad blood left under the side, unbearable pain, or abdominal pain, or swelling and pain at the beginning of constipation.
Fuyuan Huoxue decoction is used in traditional Chinese medicine for traumatic injury, and in modern medicine for treating intercostal neuralgia, costal chondritis and other patients with blood stasis and qi stagnation. From the modern pharmacological analysis of the eight traditional Chinese medicines, it can be seen that the prescription has certain antibacterial, anti-inflammatory, antioxidant injury, microcirculation improvement, anticoagulation and hemostasis, and immune function adjustment and promotion. At the same time, it also has central analgesic effect, nerve cell regeneration promotion and nerve cell protection from injury, so it has certain effects on traumatic injury, intercostal neuralgia, costal neuralgia, and costal cartilage injury. It is found that the prescription has a very positive effect on cardiovascular and cerebrovascular functions, and can be used in related diseases in clinic. [2]
Prescription composition: half a liang of Bupleurum, San Qian of Trichosanthes root and Angelica sinensis, two taels of safflower, licorice root and pangolin scales (processed with substitutes), one tael of rhubarb (soaked in wine) and fifty pieces of peach kernels (soaked in wine, peeled to the tip and ground into mud) [1].
Half a tael of Bupleurum, San Qian for Trichosanthes Radix and Angelica sinensis, two taels for Carthamus tinctorius, Glycyrrhrizae Radix and Squama Manis, one tael of rhubarb (soaked in wine) and fifty peaches (soaked in wine and peeled) [3].
Bupleurum root15g Trichosanthes root, angelica root, 9g safflower, licorice root, pangolin scales (processed), 6g rhubarb (soaked in wine), 30g peach kernel (soaked in wine, peeled, pointed and ground into mud), 50 pieces.
Radix Bupleuri 9g, Radix Trichosanthis 9g, Radix Angelicae Sinensis 9g, Flos Carthami 6g, Radix Glycyrrhizae 6g, Squama Manis 6g, Radix et Rhizoma Rhei (soaked in wine) 12g, and Semen Persicae 9g (soaked in wine). [4]
5 Except for peach kernel, the usage and dosage of Fuyuan Huoxue Decoction is as big as a bean. Take one or two servings, one and a half cups of water and half cups of wine, and fry until seven minutes. Remove me and take it warm before eating [1]. Take profit as the measure, and the profit will be reduced, which is not enough [1].
For the coarse powder, take one or two servings each time, and fry me with water and wine, and take it before eating, so as to benefit [3].
Except for peach kernel, the medicine is as big as a bean. Take 30 grams each time, 225 ml of water and 75 ml of wine, boil them to 2 10 ml, and take them at high temperature on an empty stomach. Take profit as the measure, gain and reduce pain, and you can't be satisfied.
6 Efficacy and Indications of Fuyuan Huoxue Decoction The function of Fuyuan Huoxue Decoction is to promote blood circulation and remove blood stasis, soothe the liver and dredge collaterals [3]. Treatment of traumatic injury, blood stasis left under the side, the pain is unbearable [3].
Fuyuan Huoxue decoction has the effects of soothing the liver, dredging collaterals, promoting blood circulation and removing blood stasis. Treat traumatic injury, bad blood left under the side, unbearable pain, or abdominal pain, or swelling and pain at the beginning of constipation.
The syndrome of 7 prescriptions of Jiefuyuan Huoxue Decoction is caused by collateral damage caused by trauma, blood leaving the meridians and stagnation in the ribs. The hypochondriac rib is the part where the liver meridian runs. Trauma, blood stasis and qi stagnation cause hypochondriac pain, and even unbearable pain. Treatment should be based on promoting blood circulation and removing blood stasis, and at the same time, soothing the liver, activating qi and dredging collaterals. In the prescription, rhubarb made from wine is used to cleanse blood stasis and septicemia, which leads to blood stasis descending; Chaihu soothes the liver and regulates qi, which makes qi activate blood, and can also introduce various drugs into the liver meridian; The two drugs are used together, one liter and one drop, to attack and disperse the blood stasis under the threat, and * * * is the monarch drug. Angelica sinensis, peach kernel and safflower promote blood circulation, remove blood stasis, reduce swelling and relieve pain, and * * * is the minister medicine. Pangolin breaks blood stasis and unblocks collaterals; Trichosanthes root can not only enter the blood to disperse blood stasis, but also clear away heat, dissipate stagnation and reduce swelling, and * * * is an adjuvant medicine. Glycyrrhiza uralensis Fisch is used to relieve pain and harmonize various medicines, in order to make medicines. Add wine and decoction to enhance the power of promoting blood circulation and dredging collaterals. The combination of all kinds of medicines can remove blood stasis, promote regeneration, promote the circulation of qi and dredge collaterals, and take advantage of it after taking the medicine, suggesting that blood stasis has gone down, so as to avoid hurting healthy qi. [4]
In the prescription, Bupleurum is used to relieve the qi of liver and gallbladder, Angelica sinensis is used to nourish blood and promote blood circulation, Manis Manis is used to remove blood stasis and dredge collaterals, Peach kernel and safflower are used to remove blood stasis and promote regeneration, Roots are used to moisten dryness and disperse blood, Glycyrrhiza uralensis is used to relieve pain, and rhubarb is used to cleanse blood stasis and septicemia. When all the medicines are used together, qi and blood flow smoothly, and liver collaterals are dredged, hypochondriac pain will be relieved. Zhang Bingcheng said: "If the dead go, the living will live, and the pain will be relieved and the yuan will recover." Therefore, the name is "recovery".
Bupleurum chinense and angelica sinensis in the prescription soothe the liver, promote qi, blood and relieve pain; Rhubarb promotes blood circulation and removes blood stasis, leading blood stasis downward; Peach kernel, safflower, pangolin and Trichosanthes root are used to moisten blood and dryness; Licorice and blood priority [3]. All the drugs are used together to remove blood stasis and promote regeneration, activate qi and blood circulation, and dredge liver and collaterals [3].
8 clinical application of Fuyuan Huoxue decoction Fuyuan Huoxue decoction is used to treat traumatic injury. The main points of syndrome treatment are hypochondriac swelling and pain, and unbearable pain. [4]
8. 1 Addition and subtraction If qi stagnation is serious, Radix Aucklandiae, Rhizoma Cyperi, Pericarpium Citri Reticulatae Viride and Fructus Aurantii should be added as appropriate to help promote qi circulation and relieve pain; For patients with severe blood stasis, Radix Notoginseng powder can be added, or frankincense and myrrh can be added as appropriate to enhance the effect of removing blood stasis and relieving pain [4].
Modern indications of Fuyuan Huoxue decoction in modern times are commonly used to treat chest and hypochondriac soft tissue injury, non-suppurative costal chondritis, intercostal neuralgia, mammary gland hyperplasia, etc. [3].
Fuyuan Huoxue decoction is suitable for intercostal neuralgia, costal chondritis and other patients with blood stasis and qi stagnation [5]
9. 1 costal chondritis The etiology of costal chondritis is unclear. Some people think that it is related to strain, chronic injury and virus infection. The clinical manifestations are mainly swelling, swelling and pain of chest costal cartilage. [5]
9.2 Intercostal Neuralgia Intercostal Neuralgia refers to severe pain in the area where the nerve is distributed, accompanied by muscle spasm and tenderness. Clinically, it is common in all kinds of mechanical injuries and intercostal neuritis caused by virus and bacterial infection, which leads to pain in the corresponding parts. At the same time, it can also be seen in benign or malignant intercostal nerve tumors, and the clinical manifestations are mainly severe pain. [5]
10 pharmacological action of Fuyuan Huoxue decoction [6]
10. 1 anti-inflammatory and anti-oxidative damage effects rhubarb has obvious anti-inflammatory effect, and its emodin has inhibitory effects on inflammatory exudation, edema, increased capillary permeability and leukocyte migration; Emodin inhibits the biosynthesis of inflammatory factor leukotrienes, activates monocytes to secrete tumor necrosis factor 2(TNF2) and interleukin 1, 6, 8(IL 1, IL-6, IL-8), inhibits the secretion of the above factors induced by endotoxin, and coordinates the activation of phytohemagglutinin (PHA) on monocytes to secrete IL-2 and interferon γ (INF γ). Rhubarb can scavenge oxygen free radicals, hydroxyl free radicals, H2O2 and other reactive oxygen species, and inhibit lipid peroxidation. It is a very effective antioxidant. Bupleurum can stimulate hypothalamus-pituitary-adrenocortical axis system to promote pituitary secretion of ACTH and enhance the anti-inflammatory effect of glucocorticoid, thus obviously inhibiting many inflammatory processes such as release of inflammatory mediators, leukocyte migration, capillary permeability, exudation and connective tissue proliferation. Bupleurum chinense also has the function of resisting normal pressure and hypoxia; Bupleurum injection can inhibit the production of malondialdehyde (MDA) in liver homogenate, and the fat-soluble components of Bupleurum can inhibit the lipid peroxidation of liver mitochondria. Angelica sinensis decoction, a minister medicine, has a significant inhibitory effect on inflammation caused by various inflammatory agents, reducing the release of PGE2 in inflammatory tissues, reducing the hemolytic activity of complement bypass, effectively scavenging oxygen free radicals and hydroxyl free radicals, significantly activating SOD, and has obvious antioxidant effect. Peach kernel decoction and peach kernel extract have strong anti-inflammatory effects, which can significantly inhibit the formation of inflammatory edema and granuloma, and inhibit the proliferation of inflammatory cells and fibroblasts. Peach kernel protein PRB has quite strong SOD-like activity, which can inhibit the production of superoxide anion in macrophages and increase with the increase of dose. Safflower yellow can inhibit inflammatory edema, increase capillary permeability and granuloma formation, and improve tolerance to hypoxia at the same time. Safflower water extract can scavenge free radicals and inhibit lipid peroxidation induced by free radicals in an obvious dose-effect relationship. The water extract of pangolin tablets has obvious anti-inflammatory effect, and the cyclic dipeptide separated from pangolin can improve the ability of hypoxia tolerance. Glycyrrhiza uralensis Fisch. has anti-inflammatory effects like phenylbutazone and hydrocortisone, and has inhibitory effects on stages I, II and III of inflammation, and also has significant inhibitory effects on immune inflammation such as Arthus phenomenon and Schwartzman reaction. Its effective components are glycyrrhizic acid and glycyrrhetinic acid, and both of them can inhibit the production of free radicals and lipid peroxide. The coumarin A contained in Glycyrrhiza uralensis Fisch has a strong scavenging effect on superoxide anion and free radical. More importantly, Bupleurum chinense and Glycyrrhiza uralensis can stimulate pituitary-adrenal axis, promote the secretion of cortical hormone and play a powerful anti-inflammatory and antipyretic role.
It can be seen that seven drugs in this prescription have anti-inflammatory and antioxidant effects, which is of great therapeutic significance for intercostal neuralgia and costal chondritis.
Effect of 10.2 on the function of nervous system and endocrine system rhubarb has antipsychotic effect. The crude saponin contained in Bupleurum has a strong analgesic effect when taken orally. The analgesic effect of crude saponin A and syrupy residue SR taken orally at 2g/kg each time is stronger than that of aspirin taken orally at 0.5g/kg once. At the same time, Bupleurum decoction also has sedative and antipyretic effects, which can excite hypothalamus-pituitary-adrenal cortex axis and promote ACTH secretion. Angelica sinensis has obvious analgesic effect. Intraperitoneal injection can reduce the degree of Seddon-like injury of sciatic nerve in rats, accelerate axon germination, promote nerve reinnervation, promote nerve regeneration, increase cerebral blood flow, accelerate blood circulation of brain tissue, improve neuron metabolism, reduce the volume of cerebral infarction and promote the repair and growth of neurons after cerebral ischemia injury. Peach kernel can increase cerebral blood flow. Carthamus tinctorius extract has obvious sedative and analgesic effects, and can enhance the central inhibition of barbiturates and chloral hydrate. At the same time, Carthamus tinctorius can alleviate the metabolic disorder of monoamine neurotransmitters in brain tissue and make the decreased neurotransmitters return to normal or close to normal. Safflower yellow can protect neurons from damage, and safflower extract has a strong protective effect on the degeneration of neurons after decompression and hypoxia. The medicine Glycyrrhiza FM 100 has sedative and analgesic effects, and the total ketone of Glycyrrhiza uralensis Fisch has protective effect on focal cerebral ischemia-reperfusion injury of middle cerebral artery, and intravenous drip of glycyrrhizic acid can alleviate brain edema. Glycyrrhiza uralensis Fisch can excite hypothalamus-pituitary-adrenal cortex axis, promote ACTH secretion, and promote the synthesis and release of corticosteroids. Glycyrrhiza uralensis Fisch itself has a corticosteroid-like effect.
The prescription has analgesic effect, nerve regeneration and protection, and is beneficial to the analgesic treatment and repair of intercostal neuralgia and costal chondritis.
Effect of 10.3 on blood circulation function Rhubarb has a dual-phase effect on blood circulation. Taking Rhubarb can inhibit the activity of Na+K+ATPase in cell membrane, increase the osmotic pressure of plasma, and make the water in tissues flow into blood vessels to dilute blood, thus reducing blood viscosity and improving hemorheology. Sennoside and rhubarb polysaccharide can inhibit platelet aggregation and reduce thrombosis; And rhubarb can slow down blood flow, aggregate red blood cells, increase local blood viscosity without dilating blood vessels, thus having hemostatic effect. Saikosaponin contained in Bupleurum has obvious anticoagulant effect, which can inhibit ADP-induced platelet aggregation, and its effect is similar to that of aspirin, which can inhibit the formation of platelet thromboxane caused by endogenous arachidonic acid and also lower blood pressure. Chinese angelica can obviously inhibit platelet aggregation, and sodium ferulate can selectively inhibit TXA2 synthetase activity, reduce TXA2 content, increase PGI2/TXA2 ratio, reduce cGMP content, increase cAMP/cGMP ratio, reduce blood viscosity, plasma fibrinogen, prolong coagulation time, reduce wet weight of thrombus, and delay thrombosis, thus having antithrombotic effect, reducing blood lipid and resisting arteriosclerosis. Peach kernel extract can reduce peripheral vascular resistance, increase cerebral blood flow, inhibit thrombosis in vitro, promote fibrinolysis, and significantly prolong the bleeding and coagulation time. Carthamus tinctorius decoction and red medicine yellow pigment have the functions of dilating blood vessels and lowering blood pressure, and can improve peripheral circulation disorders, accelerate blood flow, increase the number of open capillaries and reduce the degree of blood cell aggregation; Carthamus tinctorius decoction can obviously prolong the opening time of blood vessels, shorten the length of thrombus, reduce platelet count, inhibit platelet aggregation, and prolong coagulation time and prothrombin time. Pangolin water extraction and alcohol precipitation preparation can directly dilate blood vessels and reduce peripheral resistance; Pangolin decoction can obviously prolong coagulation time and reduce blood viscosity. Glycyrrhizin and glycyrrhizic acid contained in Glycyrrhiza uralensis Fisch can inhibit platelet aggregation. Glycyrrhizic acid can reduce blood cholesterol and triacylglycerol, and has anti-arteriosclerosis effect.
It can be seen that all the herbs except Trichosanthes root can be anticoagulated and antithrombotic, and can improve microcirculation. Only rhubarb has biphasic effect, which can stop bleeding and promote blood circulation, which has very positive therapeutic significance for hematoma and local inflammatory pain caused by traumatic injury.
Effect of 10.4 on cardiac function It is worth paying attention to that many kinds of herbs in this prescription have a very positive effect on cardiac function. Rhubarb, the monarch drug, has a cardiotonic effect. Angelica sinensis and its ferulic acid can reduce the accumulation of Ca2+ and Na2+ in myocardial cells, reduce the production of MDA and the release of CPK, LDH and AST, dilate coronary artery, increase coronary blood flow, reduce myocardial oxygen consumption and reduce myocardial infarction volume caused by myocardial ischemia-reperfusion injury. Ferulic acid contained in Angelica sinensis can slow down myocardial conduction, prolong the effective refractory period, eliminate reentry, prolong the plateau period, inhibit ectopic rhythm points and raise the threshold of fibrillation, thus having an antagonistic effect on arrhythmia caused by various reasons. Safflower has different inhibitory effects on myocardial ischemia, myocardial infarction and arrhythmia. Glycyrrhiza uralensis Fisch has antiarrhythmic effect, and intravenous drip of glycyrrhetinic acid can reduce the volume of myocardial infarction. Pangolin not only contains a lot of amino acids, but also contains zinc, sodium, titanium, calcium, lead, silicon, magnesium, phosphorus, iron, manganese, chromium, nickel, copper, vanadium, boron, aluminum, copper, tin 18 kinds of macroelements and trace elements, which are used to regulate the functions of cardiovascular system, nervous system, endocrine system and immune system.
Effect of 10.5 on immune function rhubarb can promote the release of intracellular Ca2+ and the influx of extracellular Ca2+, which has similar effects on brain cells, indicating that it has various immunomodulatory effects on intestinal mucosa. Emodin can coordinate PHA-activated monocytes to secrete IL-2 and INFγ, and protect bone marrow blood cells from immunosuppressants. Bupleurum polysaccharide injection can improve humoral immunity and cellular immunity, and can restore immunosuppression to a certain extent; It can significantly increase spleen coefficient, phagocytosis percentage and phagocytosis index of peritoneal macrophages and titer of neutralizing antibody in influenza virus serum. It can also significantly improve the transformation rate of ConA-activated spleen lymphocytes and the activity of NK cells. Low dose of saikosaponin can promote DNA synthesis and IL-2 production of spleen cells, while increasing dose can inhibit it. The ethanol extract of Angelica sinensis can promote the proliferation of T and B lymphocytes in spleen and thymus. Angelica lactone can enhance the function of cytotoxic T cells and increase their killing activity. Angelica sinensis immune active polysaccharide can promote the proliferation of spleen cells and has immune adjuvant-like effect in vivo. Angelica injection can increase the number and titer of antibodies, enhance the phagocytosis of macrophages, increase the content of NO, and significantly enhance the secretion of TNFα and IL 1 by macrophages. Safflower polysaccharide can obviously resist the immunosuppression of prednisolone, but safflower yellow can reduce the content of serum lysozyme and reduce the phagocytosis of peritoneal macrophages and whole blood cells. Trichosanthin contained in Trichosanthes kirilowii (the root of Trichosanthes kirilowii) has both immune enhancement and immunosuppression effects, and its decoction can promote the formation and differentiation of spleen immune cells. Trichosanthin can increase the percentage of CD4+ and CD20+T lymphocytes and decrease the percentage of CD8+T lymphocytes in peripheral blood of normal people, indicating that Trichosanthes kirilowii has the function of enhancing humoral immune function. Trichosanthin can also inhibit ConA-induced lymphatic metastasis, and inhibit humoral immunity and cellular immunity. Glycyrrhiza uralensis Fisch can not only enhance the activity of NK cells, induce interferon and have antiallergic effect, but also improve the phagocytosis of reticuloendothelial system and monocytes. Glycyrrhizin can enhance the secretion of IL-2 by lymphocytes induced by ConA. Sodium glycyrrhetinic acid can increase the ratio of T lymphocytes, β glycyrrhetinic acid is an inhibitor of the classical pathway of human complement, and licorice Lx can reduce the amount of antigen and has anti-allergic effect.
10.6 antibacterial effect of rhubarb, the monarch drug, has broad-spectrum antibacterial effect. Its effective components are rhein, emodin and aloe-emodin, and the most sensitive bacteria are staphylococcus, hemolytic streptococcus and gonococcus. Rhubarb decoction has inhibitory effect on favus xulan and Mongolian variety. It has strong inhibitory effect on influenza virus and herpes simplex virus, and its derivatives also have inhibitory effect on cytomegalovirus. The water extract of Radix Bupleuri has a strong inhibitory effect on common pathogenic bacteria such as influenza, diplococcus pneumoniae, hemolytic streptococcus, Vibrio cholerae, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Shigella dysenteriae, etc. At the same time, it has an inhibitory effect on influenza virus, vaccinia virus, hepatitis virus, poliovirus, herpes simplex virus, leptospira, plasmodium and tuberculosis, and also has an inhibitory effect on epidemic hemorrhagic fever virus. Chinese angelica decoction has inhibitory effects on Escherichia coli, typhoid Bacillus, dysentery Bacillus, diphtheria Bacillus, Pseudomonas aeruginosa and Staphylococcus aureus. Safflower can inhibit Streptococcus mutans. Trichosanthin can inhibit the replication of HIV in infected immune cells. The alcoholic extract of Glycyrrhiza uralensis Fisch and sodium glycyrrhetate have inhibitory effects on staphylococcus aureus, Helicobacter pylori, tuberculosis, Escherichia coli, amoeba and trichomonas, and have broad-spectrum antiviral effects, especially inhibiting the replication of HIV, herpes simplex virus and varicella-zoster virus. Glycyrrhiza polysaccharide can inhibit herpes simplex virus type I, vaccinia virus and vesicular stomatitis virus; Glycyrrhizic acid has a strong inhibitory effect on coxsackie virus, adenovirus and syncytial virus, while β -glycyrrhizin can inhibit HIV, while glycyrrhizin can inhibit hepatitis virus in addition to the above viruses.
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