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清热药 Antipyretic herbs

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清热药

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本词条由国家卫生计生委临床医生科普项目/百科名医网 提供内容并参与编辑 。
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凡药性寒凉,以清泄里热为主要作用的药物,称为清热药。

性能功效

本类药大多药性寒凉,少数平而偏凉,味多苦,或甘,或辛,或咸。多人肺、胃、心、肝、大肠经。能清热、泻火、凉血、解热毒、退虚热,兼能燥湿、利湿、滋阴、发表等。

适应范围

主要适用于表邪已解、内无积滞的里热证,如外感热病高热、热痢、痈肿疮疡以及阴伤内热、湿热泻痢、温毒发斑、痈肿疮毒、阴虚潮热等。

临床分类

按其性能及临床应用之别,习惯分为五类:
1.清热泻火药
主要清泻湿热郁火,主治外感热病气分高热症,以及肺热、胃火、肝火、心火等脏腑火热证等。
2.清热燥湿药
主清热燥湿,兼以清热泻火、主治无论外感或内伤治湿热火毒诸症。
3.清热凉血药
多入心肝经,功主清热凉血,兼以滋润、活血,主治外感热病热入营血之神昏谵语,以及火热内生之火热妄行诸证。
4.清热解毒药
清热解毒,主治外感或内生湿热火毒诸证。
5.清虚热药
清虚热、除疳热,兼凉血。主治热病后期之阴伤发热、久病伤阴之骨蒸潮热,以及小儿疳热。

配伍方法

里热兼有表证者,当先解表或表里同治;气分热兼血分热者,宜气血两清;里热兼阴伤津亏者,要注意祛邪而不忘扶正,辅以养阴生津药;若里热积滞者,宜适当配合泻下药;兼脾胃虚弱者,宜适当辅以健胃药。

使用注意

本类药药性寒凉,易伤脾胃,凡脾胃虚弱、食少便溏者慎用;热病易伤津液,清热燥湿药宜化燥伤阴津,故阴虚津伤者亦当慎用;阴盛格阳、真寒假热之证,尤须明辨,不可妄投,要中病即止,避免克伐太过,损伤正气。

主要药理作用

清热药的抗感染作用是其清泄里热功效的主要药理学基础,而抗病原体作用是抗感染的主要作用环节,同时还有解热、抗炎、抗过敏、影响机体免疫功能、抗肿瘤等作用。
1.抗病原体
各种清热药对细菌、真菌、病毒、原虫等都有不同程度的抑制或杀灭作用。29种常用清热药中,只有一种未被证明有抗病原体作用。清热解毒、清热燥湿药抗菌、抗病毒作用更为显着。
(1)抗菌谱清热药抗菌谱较广。黄连、黄芩、黄柏、龙胆草、金银花、蒲公英、鱼腥草、紫草等,对金黄色葡萄球菌、溶血性链球菌、肺炎球菌、大肠杆菌、痢疾杆菌、变形杆菌等有抑制作用;黄连、黄柏对结核杆菌、钩端螺旋体有抑制作用;苦参、龙胆草、金银花、连翘、青黛、鱼腥草等能抗多种皮肤癣菌;金银花、连翘、蒲公英、穿心莲、秦皮、板蓝根、贯众、鱼腥草、苦参、紫草等能抗流感病毒、疱疹病毒等;白头翁、鸦胆子抗阿米巴原虫,而青篙、鸦胆子可抗疟原虫。
(2)抗菌机理大部分清热药的抗菌机理尚不清楚。黄连、黄柏、龙胆草等抗菌作用可能包括以下环节:破坏菌体结构,细胞膜出现皱缩并进入胞浆内;抑制核酸、蛋白质合成;干扰糖代谢等。
(3)抗菌有效成分现已明确的抗菌有效成分有小檗碱(黄连、黄柏、叁棵针)、黄芩素(黄芩)、绿原酸、异绿原酸(金银花)、秦皮乙素(秦皮)、苦参碱(苦参、山豆根)、连翘酯苷(连翘)、色胺酮(板蓝根、青黛)、癸酰乙醛(鱼腥草)等。
关于清热药的抗感染作用,应注意与抗生素作用之间存在一定差异。清热药用于急性感染性疾病,临床疗效确切,改善全身症状显著,但体外实验结果显示,无论单味药还是其有效成分的抗菌作用强度,一般均不及抗生素,说明清热药抗感染作用是通过多种作用环节产生的。除抗病原体作用外,抗细菌毒素、解热、影响免疫功能等也参与了抗感染作用。
2.抗毒素
许多清热药具有抗细菌内毒素作用,能提高机体对内毒素的耐受能力。金银花、蒲公英、穿心莲、黄连、黄芩、鸭跖草、水牛角等能降低大肠杆菌、霍乱弧菌等内毒素所致小鼠死亡率,减轻腹泻及肠道黏膜炎症反应。另外,穿心莲、苦木有抗蛇毒作用。
3.抗炎
大多数清热药具有抗急性炎症反应作用。金银花、大青叶、板蓝根、鱼腥草。穿心莲、黄连、黄芩、苦参、龙胆草、知母、桅子、赤芍、丹皮、苦木、鸭跖草、玄参、苦豆子等对二甲苯所致小鼠耳肿胀、角叉菜胶所致大鼠足肿胀等急性渗出性炎症有显着的抑制作用,并能降低组胺等引起的毛细血管通透性增加。金银花、知母、黄芩、丹皮、赤芍等对大鼠佐剂性关节炎也有一定的抑制作用。
4.解热
里热证多伴有发热,多数清热药有明显的解热作用。清热解毒药金银花、大青叶、板蓝根、穿心莲,清热燥湿药黄连、黄苹、苦芩、龙胆草,清热泻火药石膏、知母、栀子,清热凉血药赤芍、丹皮,以及清虚热药地骨皮等,对内毒素或酵母等引起的实验性动物发热,有程度不同的解热作用。栀子醇提物和青蒿水提物还能使动物的正常体温降低,产生降温作用。
5.对免疫功能的影响
清热药对免疫功能的影响较为复杂。一方面,多数清热药能提高机体的免疫功能,增强机体的抗病能力。蒲公英、金银花、鱼腥草、穿心莲、黄连、黄芩、栀子等可不同程度地增加白细胞数量,提高白细胞和巨噬细胞的吞噬能力,增强非特异性免疫功能;山豆根、金银花、黄连、黄芩等有促进细胞免疫的作用,山豆根、黄柏、金银花等有促进体液免疫的作用,从而增强特异性免疫功能。另一方面,某些清热药又可抑制异常的免疫反应,如黄芩、黄连、穿心莲等能对抗过敏反应,产生免疫抑制作用。
6.抗肿瘤
瘤为毒邪,某些清热药如苦参、紫草、北豆根、金银花、青黛等具有一定的抗肿瘤作用。
7.其他
黄芩、牡丹皮、牛黄等清热药还有不同程度的镇静、降压、保肝、利胆等作用。
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Antipyretic locking
This entry offers and co-edited by the National Health and Family Planning Commission clinicians science project / Wikipedia doctors network.
Statement
This entry may involve drugs content, online any recommendations on the use of drugs are not a substitute for medical advice.
Where the herbal cold to Qingxie in the heat as the main effect of the drug, called antipyretic.
Contents 1 Performance 2 Adaptation 3 efficacy clinical classification method 4 Compatibility 5 6 Note the use of the main pharmacological effects
Performance effect
The medicines are mostly herbal cold, a few flat and slightly cool, taste more bitter, or sweet, or spicy, or salty. Multiplayer lung, stomach, heart, liver, large intestine. Heat, purging fire, cooling blood, antipyretic drugs, back Hot, and to dampness, dampness, yin, published and so on.
Adaptation
Table evil has been mainly applied to the solution, within no stagnation in the heat syndrome, such as exogenous fever fever, heat dysentery, carbuncles sore and hurt Yin heat, heat Xie Li, warm spot poison, carbuncles sore, Yin virtual hot flashes and other.
Clinical classification
Do their properties and clinical applications, the habit is divided into five categories:
1. heat diarrhea gunpowder
The main heat Yu Qing Xie fire, attending exogenous fever gas separation hyperthermia, and Hyperactivity, Wei Huo, anger, and other organs Firelight hot card.
2. The heat dampness drugs
Primary heat dampness, and to heat purging fire, attending whether exogenous or internal injuries burning heat treatment Zhu Zheng.
3. Qingreliangxue medicine
After more into the darling, power main Qingreliangxue, and to moisturize, blood, attending exogenous fever heat penetrating the blood of coma and delirium, as well as the endogenous fiery hot folly all evidence.
4. The heat antidote
Detoxification, attending exogenous or endogenous heat burning all evidence.
5. Qingxudong hot medicine
Qingxudong heat, in addition to rickets heat, and cooling. The attending fever late injuries Yin fever, Gu Zheng chronic illness Shangyin hot flashes, and infantile malnutrition heat.
Compatibility Methods
In the heat of both tables Permit, the head of the table or table wen; Blood gas separation heat and heat are advised to clear the blood of two; in the heat and Yin injury Tianjin loss, and they should pay attention to dispelling evil and righting forget, auxiliary In YangYinShengJin drugs; if in the heat Indigestion, with diarrhea should be appropriate prescription; and spleen and stomach, the stomach should be complemented by appropriate drug.
Caution
The medicines herbal cold, easily hurt the stomach, where the spleen and stomach, eat less, loose stools with caution; fever easily hurt the body fluid, heat dampness drugs should dry Shangyin Tianjin, so the Yin-chun injured would also be conducted with caution ; Yin Sheng Geyang, real winter heat of the card, especially to be discernment, not jump throw, to the disease lasts, avoid grams of cutting too much, injury righteousness.
The main pharmacological effects
Antipyretic anti-inflammatory effects are the main pharmacological basis of its thermal effect Qingxie years, while anti-pathogenic role is part of a major role in resistance to infection, as well as antipyretic, anti-inflammatory, anti-allergic, affect immune function, anti-tumor and so on.
1. Anti-pathogen
Antipyretic various bacteria, fungi, viruses, protozoa and others have varying degrees of inhibition or killing effect. 29 kinds of commonly used antipyretic, only one has not been shown to have anti-pathogenic effect. Detoxification, heat dampness drugs antibacterial, antiviral more significant.
(1) Antibacterial spectrum antipyretic wider antibacterial spectrum. Berberine, skullcap, Cork, gentian, honeysuckle, dandelion, Houttuynia, comfrey, etc., Staphylococcus aureus, hemolytic streptococcus pneumoniae bacteria, Escherichia coli, Shigella, Proteus, which are inhibited; berberine , Treats for Mycobacterium tuberculosis, leptospirosis inhibition; Sophora, gentian, honeysuckle, forsythia, indigo, Houttuynia resistant to a variety of dermatophytes; honeysuckle, forsythia, dandelions, Andrographis, Qin skin, Radix, Guanzhong, Houttuynia, Sophora, comfrey and other resistant influenza virus, herpes virus; Pulsatilla, Brucea anti-amoeba, and artemisinin, Brucea resistant falciparum.
(2) antibacterial mechanism antipyretic most antibacterial mechanism is unclear. Berberine, Treats, gentian and other antibacterial effect may include the following areas: destroy cell structure, cell membrane and into the cytoplasm shrinkage occurs; inhibition of nucleic acid and protein synthesis; interfere with sugar metabolism.
(3) antimicrobial active ingredient is now clear that antimicrobial active ingredients have berberine (berberine, Treats, three trees pin), baicalein (skullcap), chlorogenic acid, chlorogenic acid (honeysuckle), aesculetin (Qinpi ), matrine (Sophora, tonkinensis), Forsythiaside (forsythia), tryptanthrin (Radix, indigo), decanoyl acetaldehyde (Houttuynia) and the like.
About antipyretic anti-inflammatory effects, we should note that there are some differences between the role of antibiotics and. Antipyretic for acute infectious diseases, clinical efficacy, a significant improvement in symptoms, but in vitro experiments showed that, regardless of the strength of the antimicrobial effect of a single herb or its active ingredient, generally not and antibiotics, antipyretic anti-inflammatory effects described by link multiple roles generated. In addition to anti-pathogenic effect, anti-bacterial toxin, antipyretic, affect immune function, also participated in the anti-inflammatory effects.
2. antitoxin
Many antipyretic having an internal anti-bacterial toxin effects, can improve the body's tolerance to endotoxin. Honeysuckle, dandelion, andrographis, berberine, skullcap, dayflower, buffalo horn, etc. can reduce E. coli endotoxin, mortality in mice caused by Vibrio cholerae, alleviate diarrhea and intestinal mucosal inflammation. In addition, Andrographis, bitter wood with anti-venom effect.
3. Anti-inflammatory
Most antipyretic effect with anti-acute inflammatory response. Honeysuckle, Folium, Radix, Houttuynia. Andrographis, berberine, skullcap, Sophora, gentian, altogether, gardenia, red peony, Dan, bitter wood, Commelina, Scrophulariaceae, bitter beans etc. xylene induced ear edema in mice, carrageenan carrageenan induced rat paw edema and other acute exudative inflammation has a significant inhibitory effect and can reduce the capillary permeability caused by histamine. Honeysuckle, Anemarrhena, skullcap, Dan, TPG and other adjuvant arthritis in rats also have a certain extent.
4. antipyretic
In heat syndrome is usually accompanied by fever, antipyretic most significant antipyretic effect. Drug detoxification honeysuckle, Folium, Radix, Andrographis, heat dampness drugs berberine, Huang Ping, bitter skullcap, gentian, heat diarrhea gunpowder plaster, Anemarrhena, gardenia, red peony medicine Qingreliangxue, Dan, and Qingxudong heat drug Digupi etc. endotoxin or yeast fever caused experimental animals, there are different degrees of antipyretic effects. Gardenia alcohol extract and Artemisia annua aqueous extract also reduced so that the normal body temperature of animals, producing a cooling effect.
5. The impact on immune function
Antipyretic influence on immune function is more complex. On the one hand, the majority of antipyretic can improve immune function, enhance the body's resistance to disease. Dandelion, honeysuckle, Houttuynia, Andrographis, berberine, skullcap, gardenia, etc. can be increased to varying degrees, the number of white blood cells, white blood cells and enhance the phagocytic activity of macrophages, enhancing non-specific immune function; tonkinensis, honeysuckle, berberine, skullcap so have the role of promoting cell-mediated immunity, tonkinensis, Cork, honeysuckle, which are to promote the role of humoral immunity, thereby enhancing specific immune function. On the other hand, some antipyretic and suppress the immune response abnormalities, such as skullcap, berberine, Andrographis, etc. can fight allergic reactions, resulting in immunosuppression.
6. Antitumor
Tumors of the toxin, such as Sophora some antipyretic, comfrey, Menispermi, honeysuckle, indigo and so have some anti-tumor effect.
7. Other
Skullcap, moutan, bezoar antipyretic there are different degrees of sedation, blood pressure, liver, gallbladder and so on.
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