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Ephedra, the king of relieving exterior syndrome.
Ephedra is a small shrub of Ephedraceae. Don't underestimate this humble hollow grass. It is one of the most representative drugs in China's traditional medical culture, the "originator" drug for relieving exterior symptoms and dispelling cold, and the "hero" of Chinese medicine in treating COVID-19's anti-epidemic war.

Ephedra sinica has been playing a representative role since it was recorded in Shennong Materia Medica Classic, and its efficacy has been fully exerted under Zhang Zhongjing, which has become the basis for the use of Ephedra sinica in many complicated prescriptions in later medical books.

Ephedra is warm, pungent and slightly bitter, and enters the lung and bladder meridian. Has the effects of sweating, relieving exterior syndrome, dispersing lung qi, relieving asthma, inducing diuresis and relieving swelling; Can be used for treating exterior syndrome of cold lung such as typhoid fever, blood stasis, rheumatism, and arthralgia. Ephedra green into the liver, hollow and straight outside, like hairy joints, so it can bypass the joints, in addition to body pain, directly to the fur, Germany first medicine.

Different processing methods of ephedra have different effects, such as cutting the middle part and removing knots. Raw ephedra has a strong effect of dispelling cold, and honey-baked ephedra has a strong effect of relieving cough and asthma. If there is no cough and asthma caused by lung heat caused by exogenous wind and cold, use fried ephedra. If ephedra is mashed, its medicinal properties will soften and it is suitable for the elderly and children.

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Mahuang decoction-symptoms are exogenous wind and cold, aversion to cold and fever, head and body pain, asthma and no sweat. It is used to demonstrate the exogenous wind-cold in the sun meridian. Sweating in Mahuang decoction is the cold water in the sun. Between the skin, it will automatically decompose and sweat.

Xiaoqinglong Decoction-Symptoms include exogenous wind and cold, Shui Han beating each other, lung qi benefiting from fatigue, unfavorable transport and transformation, accumulation of water and drink under the heart, aversion to cold and fever, no sweat, cough with excessive phlegm, and even edema caused by water and drink overflowing the skin. It can be used to treat symptoms such as drinking water vapor in exterior cold, cough and asthma, fever and thirst.

Daqinglong Decoction-Symptoms include exogenous wind-cold, internal heat stagnation, fever and aversion to cold, headache and body pain, and restlessness. It can be used for treating solar apoplexy and typhoid fever. Patients with high fever in the early stage of acute fever, such as upper respiratory tract infection, influenza, wind-cold acute bronchitis, epidemic cerebrospinal meningitis, etc. This side is both wind and cold.

02 ephedra taboo.

1, the pharmacological mechanisms of different medicinal parts are very different. Ephedra stems sweat and relieve exterior syndrome, while Ephedra leaves astringe qi and stop sweating. Pay attention to it when using.

2, dry throat should not be sweaty, ephedra pungent and warm taste is easy to cause secondary yin damage to patients.

3. "Don't sweat at home, sweat will lead to blood in the stool" refers to urinary system diseases, and those who have suffered from gonorrhea, lower energizer dampness, blood stasis and damp heat for a long time cannot use it.

4. "Although it hurts, you can't sweat." Patients with skin infectious diseases can't simply use ephedra's heat to sweat to help relieve pain at this time.

5, "home, don't sweat, sweat will sink on your forehead, your pulse will be tight, and you can't sleep directly." "Li Jia" refers to people who often have nosebleeds.

6. "If you die of bleeding, you shouldn't sweat. If you sweat, you will feel cold and tremble." People with blood in stool, blood in urine, heavy menstrual flow, and people with blood deficiency and qi deficiency should ban the method of sweating with ephedra.

7. People who usually sweat and night sweats can't use ephedra.

Ephedra has an extraordinary influence and significance in the whole history of traditional Chinese medicine, and it is the original medicine of Chinese herbal medicine. If used properly, ephedra is a good antipyretic drug. If it is used improperly in syndrome differentiation, it will also cause great risks. Zhang Zhongjing's Treatise on Febrile Diseases is thoroughly analyzed by sweating through six meridians syndrome differentiation. As a traditional Chinese medicine, we should be familiar with studying classics, inheriting classics, using drugs accurately, and making the best use of drugs.

(Text/Cheng Lei, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine)

■ Special support from Shanghai Pharmaceutical Group

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