《杏林探宝——认知中药》是由上海中医药大学推出的一门关于中药学的慕课课程，由上海中医药大学杨柏灿教授主讲。 上海中医药大学（Shanghai University of Traditional Chinese Medicine）的前身是上海中医学院，创建于1956年，是新中国诞生后国家首批建立的四所中医药高等院校之一，也是上海市属高校中唯一的一所医科类重点特色院校。 中药学根植于中华文化，是中医药学的重要组成部分，也凝聚着中华文明的精髓。其悠久的历史，卓越的防病治病效果，较少的毒副作用，成为中华民族防病治病不可或缺的选择。同时，中药的作用也日益引起国际社会的关注和重视。但不可否认，对中药的认识和应用存在着一些不容忽视的误区与盲区，非常有必要采取一定的方式，通过合适的平台传播、普及中药知识，使人们对中药有一个更为全面准确的认识，并能合理应用，让中药为人类的健康保健发挥更大的作用。
4-2 部分调理类药食两用品
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En provenance du cours de Shanghai Jiao Tong University
杏林探宝——认知中药
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À partir de la leçon
名贵药材在疾病防治中的地位
从药食同源的理论引入药食两用品的概念、种类、范围、适用范围及应用形式、应用原则，重点举例介绍个别药物的主要功用、特点、应用范围等。
介绍药物：生姜、牛蒡子、桑叶、白芷、葛根、鱼腥草、山楂、陈皮、薏苡仁、莲子、枸杞子、地骨皮等。
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杨柏灿教授，博士生导师
上海中医药大学中药学教研室
Previously we've learned
herbs that can be used for both food and medicine that mainly act to remove pathogenic factors.
Now let's move on to another type...
herbs that mainly act to regulate the body.
Regulation
includes two aspects:
remove pathogenic factors
and
regulate the bodily functions,
or tonify the body.
In this type,
I'll mainly introduce
three regulating herbs that can be used for both food and medicine.
First one,
Shan Zha (Fructus Crataegi).
I'm sure you are all familiar with Shan Zha.
Let's take a look.
You may have eaten Shan Zha cake or
Shan Zha piece.
Ice-sugar gourd may remind
you of your childhood.
This is one aspect.
Another aspect,
we can eat Shan Zha as a fruit.
Sometimes we can buy
fresh Shan Zha
in a grocery store,
or supermarket.
As a fruit, fresh Shan Zha
tastes sour and sweet.
So it can be medicine, food
and fruit.
In Chinese medicine,
Shan Zha mainly acts to promote digestion
and is mainly used to treat food retention.
From meridian tropism,
Shan Zha enters the spleen and stomach meridians.
We just mentioned
it's sour and sweet in flavor,
warm, slightly warm in property.
Therefore
I summarize its functions into four words:
dispersing, resolving, unblocking and circulating.
Let's take a look.
First,
it promotes digestion.
Undoubtedly,
it falls under the category of digestion-promoting herbs.
Its core and key action is to
promote digestion.
What's the characteristic of
promoting digestion?
First, Shan Zha has strong effect
in promoting digestion.
In terms of usage,
Shan Zha is
extensively
used for all kinds of food retention,
including retention of meat, flour
or grains.
Comparatively speaking,
It is best indicated for
food retention
due to overeat of high-fat or high-protein food.
Retention of meat
is not limited to meat only but
includes retention of
other high-fat
or high-protein food,
which can be treated with Shan Zha.
So,
undoubtedly the first aspect
is about problems due to food retention.
We know that
food retention is related to the spleen and stomach.
Symptoms include epigastric fullness, distension
and frequent hiccups
coupled with a foul odor,
whic is called belching with fetid odor and acid reflux.
Shan Zha can also be used to
treat diarrhea
or abdominal pain
due to overeat,
because it has strong digestion-promoting effect.
This is its first function.
The second characteristic in
promoting digestion
is that
it can stimulate appetite.
Some people
experience poor appetite
because of poor digestion even if
they only eat a little amount of food.
Shan Zha can promote food digestion
and stimulate your appetite.
As a result, it can be used for both food retention
and poor appetite.
Thirdly,
it can protect the spleen and stomach
in terms of prevention and treatment.
It can also strengthen the spleen and stimulate appetite.
On one hand, it can be used in
the treatment of weakness of the spleen and stomach.
On the other hand,
it can be used to prevent
possible damage to
the spleen and stomach.
So we can say Shan Zha
can directly promote digestion
increase appetite,
strengthen the spleen and protect the spleen and stomach.
So Shan Zha has very good
effect in this regard.
This is about its dispersing and resolving.
It also
acts to unblock and circulate.
Shan Zha can circulate qi, invigorate blood
and has strong effect in circulating blood and resolving stasis.
So it can be used to treat blood stasis.
We know that
blood stasis
can be seen
in all body parts
and in all clinical subspecialties.
Let's take pain for example,
headahce,
pain in the hypochondriac region,
abdominal pain,
joint pain,
or pain following traumatic injuries
can all be treated with Shan Zha.
Why?
Shan Zha can circulate blood and resolve stasis.
In addition,
Shan Zha is now also used to treat cardiac pain due to chest impediment,
because it can circulate blood, resolve stasis,
unblock collaterals and stop pain.
Consequently, for cardiac pain
due to obstructed flow of heart blood,
Shan Zha combined with San Qi (Radix et Rhizoma Notoginseng) and Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae)
can get a good effect.
Of course,
it can also be used for gynecological conditions due to blood stasis.
Dysmenorrhea,
amenorrhea,
or irregular menstruation
due to stagnant blood
can all be treated with Shan Zha.
Shan Zha can also be used to treat lochia.
So Shan Zha is now
extensively used in clinic
because of its blood-circulating function.
Since it can
promote digestion,
and circulate blood,
no matter as
food or medicine,
Shan Zha has the following new applications.
First,
it can be used for treatment and prevention
of high blood fat, overweight and obesity.
Some people just use Shan Zha alone,
a couple of hawthorn fruits (Shan Zha) every day
or dried hawthorn fruit
or drink like tea.
It tastes good
and works well.
Secondly,
it can be used to treat
high blood viscosity
and cardio-cerebrovascular diseases,
coronary artery disease,
and
ischemic cerebral diseases.
So Shan Zha
is a good
and cheap
product for both food and medicine.
Now,
let's move on to next
product in this type... Ju Pi (Pericarpium Citri Reticulatae),
I'm sure you are more familiar with it.
Ju Pi
means the tangerine pericarp.
We know that for Ju Pi,
the older, the better.
That's why Chen (means old) Pi is more common.
The older Ju Pi is better.
This is the first aspect.
Some of you may have found
that in herbal prescriptions,
sometimes Chen Pi is written
Guang Chen Pi,
because Chen Pi is available in many places in China;
however,
Chen Pi from Guangdong province is better.
Sometimes you may have found that
it's written
as
Xin Hui Pi,
i.e.,
Chen Pi from
Xin Hui, Guangdong province.
You can buy Chen Pi and remember
the older, the higher price.
There are many products
related to Chen Pi in our daily life,
for example, Chen Pi duck,
Chen Pi candy,
and Jiu Zhi Chen Pi, meaning
processed Chen Pi with 9 procedures.
We've all seen and eaten these products
and we all love
its good taste.
This is one aspect.
As Chinese medicine,
it falls under the category of
qi-regulating type.
Since it can regulate qi,
it must be pungent and dispersing;
and it's warm in property.
You may know that
I love tangerine
but I do not eat too much.
Why?
Because it's warm.
In this regard,
Chen Pi is warm
and
dry.
It's also a little bitter.
Warm, dry and bitter,
Chen Pi mainly works for the middle and upper jiao,
including the spleen, stomach and lung.
Li Shizhen summarized
its characteristics
in Ben Cao Gang Mu (The Grand Compendium of Materia Medica).
He desribed that it reduce, dry, disperse and harmonize
and can be used for
many diseases.
Its treatment effect
is related to its function in regulating qi and drying dampness.
Therefore he further
summarized
its combination in clinical practice.
It reinforces when used in combination with reinforcing herbs; it reduces when used in combination with reducing herbs;
it ascends when used in combination with ascending herbs; it descends when used in combination with descending herbs.
So I say
Chen Pi can reinforce, reduce, ascend and descend.
However, it mainly benefit
the lung and spleen.
Now let's take a look at
its first function:
regulates qi
and strengthens the spleen.
Since it regulates qi,
it is often used to treat disorders of qi circulation,
called Qi stagnation.
What kind of qi stagnation?
Qi stagnation of the spleen and stomach.
Chen Pi can be used to treat
qi stagnation of the spleen and stomach
due to
all kinds of reasons.
For qi stagnation due to cold-dampness,
Chen Pi can warm and circulate qi.
In this case, Chen Pi can be used in combination with other herbs that can dry dampness,
such as Cang Zhu (Rhizoma Atractylodis).
Let's talk abouot manifestations
of qi stagnation briefly.
Stagnation can cause distension, l fullness, pain and oppression.
Where?
The spleen and stomach.
Functional disorders of the spleen and stomach may
manifest as gastric fullness, distension, oppression and pain,
a poor appetite
or vomiting
due to
cold dampness.
We've just mentioned a digestion-promoting product.
In case you overeat
and experience qi stagnation due to food retention.
You need to promote digestion and circulate qi
by combining digestion-promoting product,
such as Shan Zha.
For qi stagnation due to weakness of the spleen and stomach,
you can combine with spleen-strengthening and qi-tonifying herbs,
such as Huang Qi (Radix Astragali) and Bai Zhu (Rhizoma Atractylodis Macrocephalae).
For vomiting due to ascending of stomach-qi,
you need to down-regulate qi
and combine with other herbs such as Ban Xia (Rhizoma Pinelliae).
This is the first function of Chen Pi...
simply
regulates qi and strengthens the spleen.
The spleen and stomach are very important
and qi stagnation of the spleen and stomach is quite common.
Chen Pi can be used for
qi stagnation of the spleen and stomach due to all kinds of reasons.
This is its first function.
Now let's come to its second function
dries dampness and resolves phlegm.
In Chinese medicine,
phlegm is
a very special
pathogenic factor.
Phlegm can cause a variety of problems.
Chen Pi is of great
significance in treating
complicated
phlegm.
How to treat phlegm?
Let's take a look.
In terms of the source,
phlegm mainly results from dampness,
we say phlegm is accumulation of dampness.
To treat phlegm,
you need to resolve dampness first,
we call dry dampness and resolve phlegm.
Chen Pi is warm and dry,
and can dry dampness and resolve phelgm,
targeting the source
and root of phlegm.
This is the first aspect.
Secondly,
in terms of the formation of phlegm
and affected body parts,
in Chinese medicine,
there are two classical sayings,
one is 'the spleen is the source of phlegm'.
Why?
Because phlegm results from dampness,
which is related to
dysfunctions of the spleen.
Why?
Because the spleen governs transportation and transformation.
What does it transport and transform?
It transports and transforms water dampness.
Dysfunctions of the spleen in transporting and transforming water dampness
can cause dampness,
which may in turn accumulate and
result in phlegm.
As a result, you have to strenghten the spleen to resolve phlegm.
We've mentioned that
Chen Pi enters the spleen and stomach meridians;
and it is warm, dry and bitter
and can strenghten the spleen.
Phlegm
may first attack the lung,
causing cough with profuse sputum.
Then you have to resolve phlegm
and relieve coughing.
Chen Pi can resolve phlegm.
This is the pathomechanism of
phlegm in terms of the location.
From the pathogenesis,
an important point is that
phlegm is tangible and qi is intangible,
circulation of intangible qi can be obstructed by tangible phlegm,
resulting in qi stagnation due to phlegm.
In this case, you need to resolve phlegm and circulate qi.
As a typical qi-regulating product,
Chen Pi can circulate qi.
Finally,
in terms of symptoms,
the most common and recognized
symptom of phlegm
is coughing,
cough with profuse phlegm.
Chen Pi can also stop coughing.
So we say Chen Pi can dry dampness
and resolve phlegm.
We can see its role in the treatment of
phlegm from the source, location,
pathogenesis and syndrome of phlegm.
Consequently there is a basic
formula for phlegm,
called Er Chen Tang (Two Matured Substances Decoction), which
only contain four ingredients.
Er means two. One of them is Chen Pi.
So we can say that
Chen Pi is really good
in life, diet
and clincal prescriptions.
Next, I'm going to introduce
the third regulating product...
Yi Yi Ren (Semen Coicis).
I believe you may know
its another name
Mi Ren,
the first word Mi means rice and the second word Ren means seeds.
Why does it get such a name?
It is white in color
and small in volume,
like white rice
and therefore got such a name.
Actually
Yi Yi Ren is very common
in our daily life.
In terms of flavor,
it is bland and slightly sweet.
So sometimes Yi Yi Ren is cooked in porridge,
especially in summer with heavy dampness.
Porridge containing Yi Yi Ren
can resolve dampness.
This is one aspect.
As medicine,
it is bland and often used
to promote diuresis and resolve dampness.
It is cold in property
and enters the spleen, stomach and lung meridians.
Its major function
is to resolve dampness
and treat dampness-related problems.
In addition, for damp-related problems,
Yi Yi Ren can treat both the symptoms and root cause.
We know dampness
is mainly associated with the spleen,
since the spleen governs tranportation and transformation of water-dampness.
We've previously mentioned that,
Dysfunctions of the spleen
or spleen deficiency may cause disturbance of transportation and transformation,
leading to dampness.
Yi Yi Ren can strengthen the spleen.
The second aspect...
for damp-related
problems,
we need to resolve dampness.
Yi Yi Ren has very good effect of promoting diuresis.
So Yi Yi Ren
mainly acts to strengthen the spleen and drain dampness,
targeting both the symptoms and root cause.
First let's have a look at
its application in
strengthening the spleen and draining dampness.
Many disorders are related to dampness.
First, Yi Yi Ren can
strengthen the spleen, promote diuresis and resolve edema.
Undoubtedly, in this regard,
it is often used to treat
edema and dysuria
due to retention of water dampness.
Yi Yi Ren alone can help with edema and dysuria.
This is the first aspect.
Secondly, by strengthening the spleen
and draining dampness,
Yi Yi Ren can stop diarrhea.
We've mentioned many times about
the relationship between dampness and diarrhea.
Dampness is often caused
by spleen qi deficiency,
further leading to retention of water dampness.
We can imagine that
dampness in the intestine
can cause diarrhea.
What should you do?
To remove dampness.
How?
By draining
dampness
and removing water dampness
to stop diarrhea.
Resolving dampness alone is not enough,
because dampness may reoccur
as a result of spleen deficiency.
In terms of the root cause,
the normal transporation and transformation of the spleen has to be recovered.
Yi Yi Ren
can directly drain dampness, stop diarrhea
and also strenghten the spleen.
That's why we say
it targets both the symptoms and root cause.
It is really effective for
diarrhea due to spleen deficiency with internal dampness.
We can cook Yi Yi Ren in
porridge
or in combination with rice,
Shan Yao (common yam rhizome)
and Bian Dou (hyacinth bean).
This is its function in stopping diarrhea.
Thirdly,
it can be used to treat leucorrhea by strengthening the spleen and draining dampness.
We've mentioned previously
that major attibuting factor of leucorrhea
is dampness,
and dampness is associated with the spleen.
So Yi Yi Ren can strenghten the spleen, drain dampness
and treat leucorrhea.
What's the difference between Yi Yi Ren and Bai Zhi (Radix Angelicae Dahuricae) in the treatment of leucorrhea?
It can be used to treat all kinds of
leucorrhea due to dampness,
such as white leucorrhea, yellow leucorrhea
and red leucorrhea.
The last point,
Yi Yi Ren can also be used to
treat stranguria by strengthening the spleen and draining dampness.
The stranguria here results from
damp-heat in the urinary bladder and
is clinically characterized by frequent, urgent and pain urination,
coupled with
fever.
This is about its function in treating stranguria.
Its second major application
is also related to its damp-resolving function.
In what aspect?
It can relax muscles/tendons and allevaite pain.
Why?
Dampness within joints or muscles
can cause spasm,
or joint deformity.
How?
Dampness affected the meridians and joints.
To treat this condition,
we need to first get rid of dampness,
and
relax muscles/tendons.
Yi Yi Ren can resolve dampness
and relax muscles/tendons,
and therefore
can be used to treat muscle spasm due to dampness.
This is its second major application.
Thirdly, it can clear heat and drain pus.
Cold in property,
Yi Yi Ren can resolve dampness
and remove pathogenic
heat.
In this regard,
it's mainly used in two aspects:
one is to clear the lung and drain pus.
It is cold in property and enters the lung meridian,
and can therefore clear lung heat,
accelerate pus draining
and treat lung abscess.
We have a famous classic formula
by Sun Simiao
called Qian Jin Wei Jing Tang (Valuable Phragmites Stem Decoction),
'Wei Jing' here is Lu Gne (reed rhizome).
This decoction contains Yi Yi Ren.
The second aspect:
it clear the intestine and drain pus,
mainly for
intestinal abscess,
which is similar to appendicitis.
For treatment of intestinal abscess, it is often used in combination with Fu Zi (Radix Aconiti Lateralis)
and Bai Jiang Cao (Herba Patriniae).
A famous formula by Zhang Zhongjing
called Yi Yi Fu Zi Bai Jiang San (Coix seed, monkshood and patrinia powder)
is specially used for intestinal abscess.
So Yi Yi Ren is very effective
for both food and medicine.
Based on what we have learned,
I'd like to summarize its characteristics:
it can reinforce and reduce, mainly reduce;
it mainly reinforce the spleen,
promote diuresis, resolve dampness, clear heat and drain pus;
it can treat both the upper and lower body, but mainly the lower body.
We mentioned that it can be used to treat the lung,
however, mainly the lower body.
It can regulate both interior
and exterior, but mainly the interior.
In this class,
I've introduced three regulating herbs that can be used for both food and medicine.
So much for this class.
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