页数：85页文件大小：54.92 MB来源： 中药学ppt课件
本课件先说明痰、咳、喘三者的关系，将本章药物分为化痰药与止咳平喘药两类，再逐味讲解半夏、天南星、白芥子、桔梗、贝母、瓜蒌、竹茹、苦杏仁、紫苏子、百部、枇杷叶等药物的来源、性味归经、功效应用与使用注意。
第十六章化痰、止咳、平喘药Expectorant, Antitussives and AntiasthmaticsDefinitionDrugs whose principal effects are to remove the stagnation of sputum and treat phlegm syndrome are called expectorants; drugs, which can alleviate or relieve cough and asthma are called antitussivesand antiasthmatics.
Most expectorantsalso have the effects of relieving cough asthma; antitussives and antiasthmatics , on the other hand the effect of resolving sputum. So they are generally referred to as drugs for resolving sputum and relieving cough and asthma.
凡具祛痰或消痰作用的药物，称为化痰药；能减轻或制止咳嗽和喘息的药物，叫止咳平喘药。一般咳喘每多挟痰，痰多亦必致咳喘，而化痰药多兼止咳、平喘之功，止咳平喘药亦多兼化痰之效。两类药合于一章，总称之为化痰止咳平喘药。
EffectsResolving phlegm; relieving cough and asthma功效：化痰、止咳、平喘。IndicationsExpectorants are used for treating phlegm syndrome;Antitussives and antiasthmatics are chiefly indicatedfor cough and asthma due to affection by exo-pathogenic factors and impairment of the functions of internal organs.适应证：痰多之咳喘以及癫痫惊厥、瘿瘤瘰疬、阴疽流注等证。
CompatibilityIn treatment, antitussivesand antiasthmaticsare often used in combination with Expectorants, and vice versa. Diseases that comes or stems from internal damage or exogenous invasion may lead to profuse sputum and cough.
Therefore, it is necessary in treatment to not only use proper antitussives, antiasthmatics and expectorants according to the disease condition, but also to use necessarycombination of drugs according to various etiological factors, and with due to consideration of the exterior and interior, deficiency and excess, and heat and cold of the disease, if satisfactory therapeutic effect is to be obtained.
配伍方法：①外感咳喘，当配伍解表药；②内伤喘咳，当配伍补益药；③兼有里热者，当配伍清热药；④兼有里寒者，当配伍温里药；⑤由痰引起的癫痫惊厥，当配安神药和平肝息风药；⑥瘿瘤瘰疬当配伍软坚散结药；⑦阴疽流注当配伍散寒通滞药。
使用注意：咳嗽兼咯血者，不宜用燥烈的化痰药；麻疹咳嗽不宜用温涩收敛的止咳药。Notes
第一节化痰药ExpectorantEffects and Indications Drugs for resolving cold-phlegm are warm and dry, and have the functions of warming the lung to eliminate phlegm. Drugs for resolving heat-phlegm are cold or cool, and have the functions of resolving heat-phlegm. Some of the drugs are sleekand have the function of moistening dryness. Some of the drugs are salty and have the function of softening hardness to dissipate stagnation.
Drugs for resolving heat-phlegm are used for treating cough, asthma, yellow thick sputum, and epilepsy, apoplexy, convulsion, goiter, scrofula.Drugs for resolving cold-phlegm are used for treating cold-phlegm syndrome and damp-phlegm syndrome, such as cough, asthma, profuse white phlegm, greasy coating, vertigo, numbness of the limb, deep rooted carbuncle of Yin nature and metastasis abscesses.
功效：分别具有温化寒痰和清化热痰的作用。适应证：温化寒痰药适用于寒痰、湿痰；清化热痰药适用于热痰、燥痰。①寒痰、湿痰：引起咳嗽、气喘、痰多以及痰湿阻于经络所致的肢节酸痛、阴疽流注、瘰疬诸证。宜选温燥化痰药。②热痰：咳喘胸闷，痰浓不爽以及癫痫惊厥、瘿瘤瘰疬等证。宜选寒凉化痰药。
化痰药歌诀化痰之药蒌桔复，白附白芥半二竹，白前川贝礞昆藻，浮石瓜子星前胡，海蛤黄药胖大海，猪胆瓦楞皂荚茹。详解：化痰药包括瓜萎、桔梗、旋复花、白附子、白芥子、半夏、天竺黄、竹沥、白前、川贝、礞石、昆布、海藻、浮海石、冬瓜子、天南星、前胡、海蛤壳、黄药子、胖大海、猪胆、瓦楞子、皂荚、竹茹。
半夏Rhizoma Pinelliae[Nomenclature] 三步跳、麻芋子等。
[Property, flavor and channeldistribution] 温,辛；有毒。归脾、胃、肺经。
[Indications]1.湿痰，寒痰证本品辛温而燥，为燥湿化痰，温化寒痰之要药，尤善治脏腑之湿痰，治痰湿阻肺之咳嗽气逆，痰多质稠者，如二陈汤；治湿痰眩晕，则配天麻、白术以化痰息风，如半夏白术天麻汤。近年来临床以半夏为主的化痰通窍汤治耳源性眩晕有效。治湿痰内盛，胃气失和而夜寐不安者，配秫米以化痰和胃安神。
半夏、白术、生南星、泽泻、菖蒲、桂枝、菊花半夏桂枝菊花白术生南星泽泻菖蒲化痰通窍汤
2.胃气上逆，恶心呕吐半夏为止呕要药。各种原因的呕吐皆可随证配伍用之，对痰饮或胃寒呕吐尤宜。常配生姜同用，如小半夏汤；若胃热呕吐，则配黄连；胃阴虚呕者，则配石斛、麦冬；胃气虚呕吐，则配人参、白蜜，如大半夏汤。至于妊娠呕吐，虽有妊娠禁忌之说，但历代也有配扶正安胎之品而用之者。近代有以本品制成注射液肌注，治各种呕吐者。
3.心下痞满，结胸，梅核气等。半夏辛开散结，化痰消痞。治心下痞满，湿热阻滞者，配干姜、黄连、黄芩，以苦辛通降，开痞散结，如半夏泻心汤；治痰热结胸，配瓜蒌、黄连，如小陷胸汤，治梅核气，气郁痰凝者，配紫苏，厚朴、茯苓等，以行气解郁，化痰散结，如半夏厚朴汤。
半夏干姜黄连黄芩半夏泻心汤
半夏黄连瓜蒌小陷胸汤
紫苏厚朴茯苓半夏半夏厚朴汤
4.瘿瘤痰核，痈疽肿毒及毒蛇咬伤等本品内服能消痰散结，外用能消肿止痛。治瘿瘤痰核，配昆布、海藻、贝母等；治痈疽发背、无名肿痛、毒蛇咬伤，以生品研末调敷或鲜品捣敷。
现代临床还以本品生用研末局部外用治子宫糜烂有效，若以其氯仿提取物用之则更佳；又有以本品与天南星等量生用研末为丸服治冠心病，对缓解心绞痛，改善心电图均有一定疗效，本品配菖蒲研末吹鼻取嚏治室上性心动过速者；以及以生半夏配其他药物治肿瘤等。
[Dosage and administration]煎服，3～10g，一般宜制过用，制半夏有姜半夏、法半夏等，姜半夏长于降逆止呃；法半夏长于干燥湿且温性较弱。半夏曲则有化痰消食之功。至于竹沥半夏，药性有温变凉，能清化热痰，主治热痰、风痰之证。外用适量。
桔梗Radix Platycodi[Nomenclature]苦桔梗、白桔梗、玉桔梗
[Indications] 1．肺气不宣的咳嗽痰多，胸闷不畅本品辛散苦泄，宣开肺气，化痰利气，无论属寒属热皆可应用。风寒者，配紫苏、杏仁，如杏苏散；风热者，配桑叶、菊花、杏仁，如桑菊饮；若胸膈痞闷，痰阻气滞，升降失司者，培枳壳以升降气机，理气宽胸。
杏仁紫苏桔梗杏苏散
桔梗桑叶菊花杏仁桑菊饮
2．咽喉肿痛，失音。本品能宣肺利咽开音。凡外邪犯肺，咽痛失音者，配甘草、牛蒡子等，如桔梗汤及加味甘桔汤。若咽喉肿痛，热毒盛者，配射干、马勃、板蓝根等以清热解毒利咽。
3．肺痈咳吐脓痰本品性散上行，能利肺气以排壅肺之脓痰。治肺痈咳而胸满，时出浊唾腥臭，久久吐脓者，配干草用之，如《金匮》桔梗汤；临床上更配以鱼腥草、冬瓜仁等以加强清肺排脓之效。此外，又可以其宣开肺气而通二便，用之癃闭、便秘。
[Dosage and administration]煎服，3～6g。用于排脓可用10g。
川贝母Bulbus Fritillariae Cirrhosae[Nomenclature]贝母
[Property, Flavor and Channel Distribution]微寒,苦、甘。归肺、心经。
[Indications]1.虚劳咳嗽，肺热燥咳。本品性寒味苦，能清肺泄热化痰，又味甘质润能润肺止咳，尤宜于内伤久咳，燥痰，热痰之证。用于肺虚劳嗽，阴虚久咳有痰者，常配沙参、麦冬等以养阴润肺化痰止咳；治肺热肺燥咳嗽，常配知母以清肺润燥化痰止咳，如二母丸。
2.瘰疬疮肿及乳痈，肺痈。本品能清热解郁化痰散结。治痰火郁结之瘰疬，配玄参、牡蛎等以化痰软坚消瘰疬，如消瘰丸；治热毒壅结之疮痈、肺痈，常配蒲公英、鱼腥草等以清热解毒，消肿散结。
[Dosage and Administration]煎服，3～10g。研末服，1～2g。
第二节止咳平喘药Antitussives and AntiasthmaticsEffects：Relieving cough and asthma止咳、平喘。Indications：Cough and asthma.Compatibility：据咳喘病因内伤外感之别，及其证状虚实寒热之异，选用适当的药物，恰当配伍。
止咳、平喘药歌诀止咳平喘杏款冬，百部紫菀苏子葶，白果桑皮枇杷叶，洋金地茶马兜铃。详解：止咳、平喘药包括杏仁、款冬花、百部、紫菀、苏子、葶苈子、白果、桑白皮、枇杷叶、洋金花、矮地茶、马兜铃。
苦杏仁Semen Armeniacae Amarum
2.肠燥便秘本品含油脂而质润，味苦而下气，故能润肠通便。常配柏子仁、郁李仁等同用，如《世医得效方》五仁丸。
枇杷叶Folium Eriobotryae
白果Semen Ginkgo
瓜蒌Fructus Trlchosanthis
桔梗Radix Platycodi
旋覆花Flos Inulae
白附子Rhizoma Typhonii
白芥子Semen Sinapis
半夏Rhizoma Pinelliae
天竺黄Concretio Silicea Bambusae
竹沥Succus Bambusae
川贝母Bulbus Fritillariae Cirrhosae
礞石Lapis Chloriti
昆布Thallus Laminariae, Thallus Eckloniae
海藻Sargassum
海浮石Pumex
冬瓜子Semen Benincasae【性味归经】甘，寒。【功能主治】清肺、化痰、排脓。适用于肺热咳嗽、肺痈、肠痈等症。
天南星Rhizoma Arisaematis
前胡Radix Peucedani
海蛤壳Concha Meretricis Seu Cyclinae
黄药子Rhizoma Dioscoreae
胖大海Semen Sterculiae Lychnophorae
猪胆Sus scrofa domestica Brisson【性味归经】苦、寒、咸；入肝、胆、肺、心、大肠经。【功能主治】治消渴、便秘、黄疸、百日咳、哮喘、泄泻、痢疾、目赤、喉痹、盯耳、痈肿。
瓦楞子Concha Arcae
皂荚Fructus Gleditsiae Abnormalis
竹茹Caulis Bambusae in Taeniam
苦杏仁Semen Armeniacae Amarum
款冬花Flos Farfarae
百部Radix Stemonae
紫菀RadixAsteris
紫苏子FructusPerillae
葶苈子Semen Lepidii, Semen Descurainiae
白果Semen Ginkgo
桑白皮Cortex Mori
枇杷叶Folium Eriobotryae
洋金花Flos Daturae
矮地茶Herba Ardisiae Japonicae
马兜铃Fructus Aristolochiae
The End
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