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Chapter 4 herbs that purge
introduction
the concepts
downward
Interior
syndrome
里实证
Stagnation in interior ，
Heat, water stock in interior
胃肠积滞
indications
1、acute diseases： acute pancreatitis, acute
biliary duct infection, acute appendicitis, acute
intestinal obstruction
2、infectious diseases： meningitis, hepatitis
Dysentery
3、internal diseases： ascetic fluid,
peritonitis
constipation
渗出性胸膜
common effects
Puerging action
泻下作用
a. Stimulate the movement of intestine(dahuang)
b. Increase water content of the intestine
(mangxiao)
C. Moisten the stool (Hou Ma Ren)
Induce urination
Downward water
Anti-microbes
Anti-toxin
Anti-amoebic dysentery
Anti-
inflammation Anti-cancer
Dahuang大黄
Function
Dwonward heat detox in interstine
indication
components
Heat-constipation, bleeding:
Ulcer hematemesis
Dysentery & acute enteritis,
Acute abdominal inflammation
(pancreatitis, Peritonitis),
Renal failure, Hyperlipidema
anthroquinone(main), glycoside, rhein,
Chrysophanol, emodin, acatechin,
gallic acid
Main pharmacology effects
1. Effects on digestive system
(1) purging actions
Stimulate intestinal movement, however,
it can cause constipaton if it is decocted for
long time, because of tannic acid
泻下
How to purge?
main
oral
rhein
Small intestine
Large intestine
Small portion
liver
transfe
r
aglycon
E. coli
aglycon
Aglycon stimulate N in interstine- movement fast
gallic acid inhibitNa+-K+-ATP enzyme– water stay in intestine
(2)Protect liver & cholagogize(benefit the
gallbladder)
1)It can help the gallbladder contraction,
promote Bile secretion
2) It can low serum cholesterol level
3) It can prolong the life of the liver cells &
promote regeneration of liver cells
(4) Stimulate pancreatic secretions & restrain
the activity of pancreatic juice
(5) Anti-peptic ulcer
1)It can control the activity of hydrogen ion
in digestion
2) It can prevent stress to ulcer by means of
promoting the PGE2; inhibit acid; inhibit
2. Promote renal function
(1) It can lower the level of BUN ,
(2) Diuresis: inhibit Na+-K+-ATP enzyme，
reabsorb Na+ .
3. Effects on Circulation system
(1) Stop bleeding
1）the a-catechin & gallic acid can increase the
adherence of platelets.
2）It can increase the contraction of blood vessels.
(2) Reduce blood stosis
1）lower cholesterol & triglycerides
2）reduce the blood viscosity
4. Anti-infection/inflammation
1) broad spectrum antibiotic, bacteria & virus,
suppressing production of TNF & IL-1.
2) anti-pyretic & sedating actions
3) Reduce CNS fever medium, PGE, & cAMP.
4) Inhibit Na+－K+－ATP enzyme acvtivity, reduce
ATP production-reduce fever.
5. Anti-cancer
Can suppress the RNA & DNA synthesis of cancer cells
6. anti-psychotics抗精神病
Side effects
 It causes pathologic changes in liver & thyroid
with hypertrophy of tissue cells.
 Common adverse effects: nausea, vomitting,
diarrhea & abdominal pain.
 Drug interaction: prolonged use of Dahuang
may cause loss of potassium, leading to
increased toxicity of cardiac glycosides, such
as digoxin