? Clinical Experience of Radix Paeoniae Alba in Zhongjing (1)

In the era of Zhang Zhongjing, there was no distinction between red peony and Bai Mudan. What really distinguishes Paeonia lactiflora from Paeonia lactiflora is Tao Hongjing's Notes on Materia Medica in the Southern and Northern Dynasties. Dow is divided into red peony roots and white peony roots by color. Su Song in Song Dynasty divided Paeonia lactiflora into golden Paeonia lactiflora and wood Paeonia lactiflora in Materia Medica. The former is gray, that is, Bai Mudan in later generations, and the latter is red peony. According to the Manual of Chinese Herbal Medicine compiled after the founding of New China, Paeonia lactiflora is the dry root of Paeonia lactiflora, which is cultivated and mostly wild. According to China Pharmacology, Paeonia lactiflora is Paeonia lactiflora, Paeonia lactiflora is Shao Bo, and Paeonia lactiflora is also called Paeonia lactiflora, which is produced in Sichuan.

In terms of efficacy, Materia Medica Seeking Truth holds that Paeonia lactiflora and Paeonia lactiflora have the same indications, but there are differences. Paeonia lactiflora has the functions of astringing yin, benefiting nutrition, nourishing yin and enriching blood; Radix Paeoniae Rubra has the functions of eliminating pathogenic factors, promoting blood circulation and removing blood stasis. Cheng Wuji's Notes on Treatise on Febrile Diseases says: "Paeonia lactiflora, white tonify red diarrhea", Paeonia lactiflora nourishes blood, nourishes blood and softens liver, and Paeonia lactiflora cools blood and promotes blood circulation. Cheng's theory has a great influence on later generations. Li Shizhen is also affected by it. "Paeonia lactiflora can strengthen the spleen and purge the soil" and "Paeonia lactiflora can dispel evil and promote blood circulation". It is generally believed that Paeonia lactiflora can nourish blood and calm the liver, be good at astringing yin, be sour and sweet, and have astringent effect; Paeonia lactiflora is good at cooling blood and promoting blood circulation and removing blood stasis. Therefore, when learning Zhongjing Fang, we should choose Paeonia lactiflora or Paeonia lactiflora according to the actual clinical situation. However, some scholars in modern times believe that there is little difference between the two in terms of the source of medicinal materials.

Efficacy of Paeonia lactiflora

Relieve muscles and camp.

"Practical Dictionary of Medicinal Properties" records that Paeonia lactiflora "astringent acid produces fluid and benefits blood, astringent Yin Qi dispels pathogenic heat". Representatives include Guizhi decoction, Guizhi plus Gegen decoction, etc. The compatibility of Radix Paeoniae Alba and Ramulus Cinnamomi has two meanings: one is to reconcile Ying Wei, and the other is that Ramulus Cinnamomi is afraid of hurting Ying Wei and blood. In the clinical treatment of miscellaneous diseases of hyperhidrosis (night sweats or spontaneous sweating or summer anhidrosis), the author often treats patients with disharmony between camp and health after repeated treatment. Paeonia lactiflora, Ramulus Cinnamomi, ginger, jujube and 30-60 grams of Radix Astragali are commonly used, and the effect is good. Due to the weakness of Wei-qi, Wei-qi is not harmonious, so Astragalus can replenish qi to consolidate exterior, return to Shao to regulate Wei-qi, and add astringent products such as Long Mu and Schisandra. No sweat, because of the lack of defending yang, can not stimulate vaginal fluid, and then use astragalus to encourage defending qi, stimulate sputum, so that less return and its muscles sweat. One method has two effects, the key is to aim at the pathogenesis, and whether you sweat or not, you can get the effect.

Emergency analgesia

Peony and licorice soup is sour and sweet, and turns cloudy. Originally used to treat "acute foot contracture". After sweating due to taiyang disease, Yin points were injured, and yin fluid could not nourish the tendons and veins, so Shaoyao Gancao Decoction was the main treatment. Besides, there are many prescriptions to relieve pain. For example, Guizhi plus Shaoyao decoction is suitable for treating abdominal pain caused by solar apoplexy, while Paeonia lactiflora is added to treat "satiety pain". Xiaojianzhong decoction increases the dosage of Paeonia lactiflora for Guizhi decoction, and maltose is added to treat "sudden abdominal pain". Guizhi Huang Jia decoction and Guizhi decoction treat exterior syndrome of solar apoplexy, and Yangming fu-organs "great pain" increases jaundice and clears stomach; To relieve the pain, use peony. Shennong's Classic of Materia Medica says that Paeonia lactiflora "cures abdominal pain caused by pathogenic factors". Materia Medica also says: "Paeonia lactiflora and Glycyrrhiza uralensis can stop abdominal pain due to qi deficiency, Guizhi can stop abdominal pain due to blood deficiency, hawthorn and cattail can stop abdominal pain due to stagnation, Amomum villosum can stop abdominal pain due to pregnancy, Qin can stop abdominal pain due to heat dysentery, and Jiang, Fu and Gui can stop abdominal pain due to yin cold. The analgesic effect of Paeonia lactiflora is summarized incisively and vividly. Paeonia lactiflora can treat various pains according to different compatibility.

Experimental research shows that paeoniflorin in Paeonia lactiflora has spasmolytic effect, mainly through its direct effect on smooth muscle, and also has sedative, analgesic and anticonvulsant effects on the central nervous system. Therefore, the author also uses Paeonia lactiflora in clinic to treat some insomnia, irritability and anxiety, because it has sedative and anticonvulsant effects. Paeonia lactiflora or paeoniflorin has anti-inflammatory and anti-ulcer effects, and can prevent stress ulcer in rats, such as pain caused by ulcer. Xiaojianzhong decoction with white peony root can relieve smooth muscle spasm itself. Radix Paeoniae Alba extract can slightly increase gastric acid, atrophic gastritis will reach the third stage, and Radix Paeoniae Alba can be reused for gastric acid deficiency. Because gastric acid deficiency can also cause abdominal distension and indigestion, Radix Paeoniae Alba, Fructus Mume and Fructus Crataegi can be added to increase its acidity, which is very suitable for abdominal distension of atrophic gastritis caused by gastric acid deficiency. On the contrary, if it is bile reflux gastritis, reflux esophagitis, gastric and duodenal ulcer, peony with high acidity should be used less. If you want to use it, take its analgesic effect, but prevent the side effects of increasing gastric acid.

Shugan Jianpi

On behalf of Fang Sinisan. Treat "shaoyin disease, four adverse reactions", four adverse reactions and limb syncope due to yang deficiency. There are many conditions of limb syncope. There are cold syncope and heat syncope in Neijing. "Yang deficiency is cold syncope and yin deficiency is heat syncope" refers to deficiency of kidney yin and kidney yang. Deficiency of kidney yang and cold limbs are cold syncope; Deficiency of kidney yin leads to heat syncope of limbs. Zhang Zhongjing's cold syncope and heat syncope are different. "In syncope, Yin and Yang Qi are not in harmony", and the upper and middle jiao are not connected. He hit the middle coke with Dachengqi decoction, and the traffic was up and down. In high fever, "excessive heat leads to deep syncope", and patients with high fever also have Yangming fu-organs syndrome, which is manifested as shock and limb syncope. Yangming fu-organ diarrhea was treated with Dachengqi decoction. Yin and Yang Yang Qi were connected from top to bottom, and shock and limb syncope improved. Syncope of Sinisan is caused by poor qi activity, so use the product of smoothing qi. "Abdominal pain, onion removal and peony two Liang" in Sini powder is used to soothe the liver and spleen. After Zhongjing, Fang Ju Xiaoyao Powder, Zhang Jiebin Huagan Decoction and Chaihu Shugan Decoction are all based on Sini Powder, all of which have the functions of soothing the liver and strengthening the spleen. "Materia Medica Justice" says, "Nourishing blood and benefiting the liver and spleen is really yin, while dispersing the temper, and the posture of liver qi is horizontal, which is also white peony". Therefore, Paeonia lactiflora has the functions of calming the liver and nourishing blood, nourishing the liver and strengthening the spleen.

Experimental studies have proved that the extract of Paeonia lactiflora has obvious inhibitory effect on liver injury and ALT increase in rats caused by galactosamine and aflatoxin B 1, and Paeonia lactiflora also has liver protection effect. In experimental animals, Paeonia lactiflora has the function of protecting the liver. What Chinese medicine says about softening the liver is actually the function of protecting the liver. Because the liver is just dirty, it is in line with the characteristics of the liver to use drugs that nourish the yin and soften the liver.

Promote blood circulation and joint pain.

Shennong's Herbal Classics said: "Peony disperses blood stagnation, and breaks hard mass. It has the function of relieving arthralgia and promoting blood circulation, which may refer to peony. Biejiajian Pill "Jingui" is used to treat malaria mother, Dahuangchong Pill is used to treat liver cirrhosis, Guizhi Shaoyao Decoction is used to treat depression, and Paeonia lactiflora is used to promote blood circulation, dredge collaterals and remove blood stasis. Tao Hongjing, a famous doctor, said that Paeonia lactiflora can cure blood vessels, relieve middle energizer, disperse evil blood and drive away thief blood. " "Evil blood" refers to blood stasis. Thief's blood is inactive blood, or menstrual blood is blood stasis.

Experimental studies have proved that Paeonia lactiflora or paeoniflorin can dilate blood vessels and increase organ blood flow, while Paeonia lactiflora has antithrombotic and platelet aggregation effects, which can increase coronary blood flow, reduce blood pressure and increase cardiac output. This is widely used in cardiovascular diseases, which is itself an antithrombotic and antiplatelet aggregation function.

Clearing heat and stopping dysentery

Treatise on Febrile Diseases treats Yang deficiency syndrome with Qin Huang decoction. Dysentery is more common in exterior syndrome of sun and exterior syndrome of shaoyang. Qin Huang decoction is the originator of treating dysentery. Cheng Wuji said in Notes on Treatise on Febrile Diseases: "The bitterness should be strengthened, and the bitterness of Scutellaria baicalensis Georgi and Paeonia lactiflora should be restored to restrain stomach qi. Paeonia lactiflora also has spasmolytic and analgesic effects. Scutellaria baicalensis Georgi is the main prescription for treating dysentery. Qin Huang Shaoyao Decoction and Zhang Jiegu Shaoyao Decoction in the later edition of Living Yao Yao are all derived from this formula. Modern clinic has the functions of clearing intestine, relieving spasm and relieving pain for abdominal pain and diarrhea, dysentery with acute diarrhea, ulcerative colitis, Crohn's disease and irritable bowel syndrome.

Relaxation and elimination of pathogenic factors

Peony itself has no antidiarrheal effect, but it has the effect of astringing the stomach. The representative prescription of Paeonia lactiflora for relaxing bowels and purging pathogenic factors is Maren Pill, which is used to treat hypersplenism. "Treatise on Febrile Diseases and Taiyin Chapter" said: "Taiyin is a disease with weak pulse, which is convenient for people to continue. Dahuang Shaoyao decoction is weak and easy to move, so it should be reduced. Taiyin disease is generally characterized by weakness of spleen and yang, abdominal pain and diarrhea, which is convenient for people to continue. If you want to use rhubarb peony soup, you should reduce the dosage, so that people's stomachs are weak and easy to move. Therefore, rhubarb and peony should not be used for patients with weak stomach qi, which in turn proves that peony has a laxative effect. Paeonia lactiflora is a yin-cold medicine. If people use it to defecate, it may increase the frequency of defecation. The weak and smooth pulse is Taiyin disease. For patients with abdominal pain or "severe pain", Paeonia lactiflora combined with rhubarb shows that both of them have the effect of expelling pathogenic factors and relaxing bowels, and should be used with caution for patients with spleen-yang deficiency. Paeonia lactiflora in Xiaojianzhong decoction is mainly used for relieving pain, but Xiaojianzhong decoction is the basis of Guizhi decoction. Adding maltose is mainly used to treat abdominal pain caused by deficiency and cold of middle energizer. Clinically, the ulcer belongs to spleen and stomach deficiency and cold, so white peony is used to relieve pain, but if the stool is thin, the dosage of white peony should not be too much. It is reported that Shaoyao Gancao decoction has a good effect on 60 cases of habitual constipation. Generally, raw Paeonia lactiflora 24-40g and raw Glycyrrhiza uralensis Fisch 10- 15g are used. According to the author's clinical experience, single peony has poor laxative effect. Adding Fructus Aurantii Immaturus together, or taking Atractylodis Macrocephala in large doses, has a good effect on habitual constipation and senile constipation.

Stop leakage by preventing miscarriage

Such as Ejiao Tang Ai, namely Ejiao Aiye Siwu Decoction. "Women leak, or give birth half a month", there is peony in Siwu decoction, so Danggui Shaoyao powder is used to treat "women are pregnant and have abdominal cramps" because the fetal movement is uneasy after pregnancy, which leads to abdominal pain leakage. Danggui Shaoyao powder can be used to stop pain and leakage at the same time.

Modern research on the effect of Radix Paeoniae Alba on preventing miscarriage and stopping leakage may be related to its obvious antispasmodic effect on striated muscle or smooth muscle. Restlessness of fetal movement, uterine spasm, Paeonia lactiflora can relax uterine smooth muscle and help to protect the fetus. Dictionary of practical medicinal properties: Paeonia lactiflora treats "women's diseases before and after pregnancy", and Paeonia lactiflora is an important gynecological medicine.