升降浮沉課件

1、 1. Four Characters （四性） 2. Five Taste （五味） 3. Meridian （歸經(jīng)） 4. Lifting, lowering, floating and sinking （升降浮沉）1. Four Characters 四性 (Qi) ( The temperature Characteristic )Clinic PracticingTreating cold syndrome with hot-natured drugs (or heating the cold). Treating heat syndrome with cold-natured dr

2、ugs ( or cooling the heat)Identify the “Real cold syndrome with fake heat syndromes” or “Real heat syndromes with fake cold syndromes”According to the development of disease to choose proper herbsTreating both heat & cold symptoms with both cold & hot natured drugsCold & CoolHot & WarmEvenTCM treatm

3、entClear Heat;Cool the heat toxin in Blood;Clear Empty Heat;Phlegm-heat;Promote defecating;Promote urination;Nourish Yin;Calm down liver wind;Warm the internal cold;Expel the external cold;Tonify the Yang Qi;Warm up the meridian;Rescue the exhausted Yang;Could be widely used; HerbShi Gao; Jin Yin Hu

4、a; Qin Hao; Gua Lou; Da Huang; Shen Di; Ling Yang JiaoGang Jiang; Gui Zhi; Ma Huang; Fu Zi; Du Huo; Rou Gui; Gan Cao;2. Five Taste 五味SpicySweetBitterSourSaltyContra-IndicationAll types of Def.DampnessPregnant womenAny condition of excess: Damp or StagnationFluid accumulat-ionExterior WindProlapseDia

5、rrhea, Profuse urineDampSp. Def. , Blood Def. , Yin def. Loose stools歸經(jīng)Clear heat from heart: irritability, restlessness, insomnia The herb which enter the small intestine are cold to treat damp heat urinary problem or expel water through intestineTransform damp and treat wind damp, phlegm, diarrhea

6、 or toxic swellingMany herbs which enter the stomach channel clear heat, especially toxic heat All herbs in the surface releasing categories enter lung channelsTreat damp heat diarrhea or intestinal abscessTonify Yin, Yang or essence; Clear empty heat in kidney; or help drain dampTreat jaundice or t

7、o guide the herb to the shao yang energetic levelTreat wind syndromes like inchy skin, bloody diarrhea, or tremors, drain liver fire, relieve liver Qi stagnation, or treat eye problem due to heat Treat edema; Drain damp heat from the lower burner; 4. lifting, lowering, floating and sinking 升降浮沉 Vary

8、ing disease often appear to bear a tendency to move upward, downward, towards the exterior or the interior. Corresponding to the above, the direction of actions of medicinal herbs on human body also have the lifting, lowering, floating and sinking distinctionliftingLoweringFloatingSinkingThe directi

9、on of herbal actions is toward the upper parts, which are indicated for a disease in a lower and deeper partsThey function toward the lower parts and possess the action of descending adverse Qi and are indicated for the disease due to adverse ascending of pathogenic factorsFloating herbs function to

10、ward the upper and outward parts, generally exert the effects of sweating and dispersing and are indicated for the disease in the upper and superficial partsSinking herbs function toward the lower and inward parts, have the effects of lowering the adverse flow of Qi and relaxing bowels and are indic

11、ated for the disease in the lower and interiorHuang Qi + Sheng Ma: Dai Zhe Shi; Cheng Xiang; Shi Jue MingMaHuang; Zi Su; Fang Feng; Du HuoDa Huang; Mu TongProlapse diseaseCough, dizziness, vomitingExterior coldConstipation; dysuria A=(1, 1, 1)B=(0, 1, 1)C=(1, 1, 1)D=(0, 1, 1)E=(0, 0, 0)F=(1, 0, 1)Fe

12、ature vectors:DescriptorFeature vectorPositive examplesNegative examples Feature vectors in input space:A=(1, 1, 1)B=(0, 1, 1)C=(1, 1, 1)D=(0, 1, 1)E=(0, 0, 0)F=(1, 0, 1)ZInput spaceXYBAEFFeature vectorkNN methodSupport Vector Machines(SVM) methodSupport Vector Machines(SVM) method 1. Mutual reinfor

13、cement （相須） 2. Mutual assistance （相使 ） 3. Mutual restraint or detoxication（相畏 or相殺） 4. Mutual Antagonism （相惡） 5. Mutual Incompatibility （相反） 1. Mutual reinforcement （相須） That is, two or more ingredients with similar properties and effects are used in combination to reinforce each others action Mutua

14、l reinforcementEffects & ActionDa Huang + Mang XiaoPurgating actionTao Ren + Hong HuaInvigorating the bloodZhi Mu + Huang BaiClear deficient feverRu Xiang + Mo YaoInvigorating the bloodFu Zi + Gan JiangWarm up the Yang QiQuan Xie +Wu GongStop muscle Spasm 2. Mutual assistance （相使 ） That is, Chinese

15、medicinal herbs that are not certainly similar but have some relationship in the aspect of medicinal properties and actions are used in combination, in which one herb is taken as the dominate factor and the others as its assistants to raise its therapeutic effects. Dominate herbAssistant herbsEffect

16、s & ActionHuang QiFang JiPromote water circulation & permeating the dampnessHuang LianMu XiangStop diarrhea & abdomen painDa Huang Huang QinClear damp-heat3. Mutual restraint or detoxification（相畏or相殺） That is, mutual restraining effect of different medicines to weaken or neutralize each others harmf

17、ulness, such as toxicity or side-effects. Mutual restraintBan Xia; Dan Nan XingSheng JiangRen ShengWu Ling ZhiFu ZiGan JiangFu ZiGan Cao Mutual Antagonism (相惡) The ability of two substances to minimize or neutralize each others positive effectsBa DouQian Niu ZiGan Yin Wan ( 感應(yīng)丸 )Ding XiangYu JinShi

18、Xiang Fan Hun San ( 十香反魂散 )Chuan Wu & Cao WuXi JiaoDa Huo Luo Wan ( 大活絡(luò)丸 )Ren ShenWu Ling ZhiRou GuiChi Shi Zhi*Liu Huang*Pu Xiao*Shui Yin*Pi Shuang*Lang Du*Mi Tuo Shen*Ya Xiao*San Leng Mutual Incompatibility (相反)Cause side effects or toxicity if use togetherGan CaoGan SuiDa JiYuan HuaHai ZaoDosage:

19、 Gan Cao= Gan Sui Wu Tou( Fu Zi )Ban XiaGua LouBei MuBai JiBai LianBei Mu or Ban Xia + Fu Zi ( No evidence support it )Li LuRen ShenDang ShenDan ShenXuan ShenSha ShenKu ShenXi Xin Bai ShaoXi Xin + Li Lu: cause animal death in the labMethod Training SetTesting SetTesting MethodHerb-Pair AccuracyNon-H

20、erb-Pair AccuracyPNN3603910-fold CV87.9%91.6%kNN72.1%97.1%SVM78.1%97.6%TCM herbal ingredient pairs displaying pharmacokinetic synergism By inhibiting the actions of the drug efflux transporters, resulting in an accumulation of the TCM herbal ingredients and thus a potentiation of their effects in th

21、e target cells. An example is the combination of genistein (from Semen Sojae Praeparata, Oleum Glycines, Radix Sophorae Japoniae, Flos Sophorae, Fructus Sophorae, Folium Sophorae Japoniae, Semen Glycines Max, Caulis Spatholobi, Radix Sophorae Tonkinensis) and paclitaxel (from Taxus Chinensis)Mechani

22、sm of synergistic actions of paclitaxel and genisteinTCM herbal ingredient pairs displaying pharmacokinetic synergism By modulating its metabolism, resulting in an accumulation of the TCM herbal ingredient and thus a potentiation of their effects in the target cells. An example is the combination of

23、 TCM herbal ingredient pair comprising of caffeine (from Radix Camellia Sinensis, Folium Camelliae Sinensis, Fructus Camellia Sinensis, Folium Ilicis Cornutae, Cortex Firmianae Plantanifoliae, Radix Firmianae Plantanifoliae, Flos Firmianae Plantanifoliae, Folium Firmianae Plantanifoliae, Semen Firmi

24、anae) and apigenin (from Herba Lagotidis, Flos Campsis, Herba Artemisiae Anomalae, Herba Ephedrae, Flos Buddlejae, Herba Artemisiae Anomalae, Flos Genkwa, Radix seu Cortex Daphnes Genkwae, Radix Campsis Grandiflorae) Mechanism of synergistic actions of caffeine and apigeninTCM herbal ingredient pair

25、s displaying pharmacodynamic synergism The combination of eugenol (from Fructus Artemisiae Argyi, Folium Artemisiae Argyi, Caulis Perillae Frutescentis, Folium Perillae Frutescentis, Dianthus Superbus, Fructus Perillae Preparata, Alpinia Galangae, Flos Caryophylli, Radix Syzygii Aromatic, Liquor Des

26、tillata Caryophylli, Cortex Syzygii Aromatic, Ramulus Syzygii Aromatic, Fructus Galangae, Pericarpium Zanthoxyli, Flos Lonicerae, Herba Asari) and low concentration of quercetin (from Herba Patriniae Scabiosaefoliae, Herba Patriniae, Radix Bupleuri, Herba Euphorbiae Humifusae, Radix Lamiophlomidis R

27、otatae, Rhizoma Alpiniae Officinarum, Herba Hyperici, Herba Lagotidis, Cannabis Sativa L., TCM herbal ingredient pairs displaying pharmacodynamic synergism Radix Astragali, Fructus Ligustri Lucidi, Herba Artemisiae Annuae, Radix Artemiiae Annua, Semen Artemisiae, Herba Taxilli, Fructus Quisqualis, R

28、adix Quisqualis Indica, Herba Pyrolae Chinensis, Herba Ephedrae) exerts an anti-allergic and anti-inflammatory effect that alleviates allergic rhinitis, which is congruous to the therapeutic effect of the TCM herbal pair, Herba Asari and Herba Ephedrae, containing eugenol and quercetin respectively.

29、 This TCM herbal pair has been used to treat allergic rhinitis. The similarity in therapeutic effect of the TCM herbal ingredient pair and the TCM herbal pair can be a sign of possible synergism between the ingredients in the TCM herbal ingredient pair. Mechanism of synergistic actions of eugenol an

30、d quercetin (low concentration)Case study 1: Antidepressant activity of St. Johns WortSt. Johns Wort (SJW) is an extract from the plant Hypericum perforatum L. Numerous clinical trials have shown that SJW had significant antidepressant efficacy and lower side effects than standard antidepressants. I

31、n many countries, it has been widely used for the treatment of mild to moderate forms of depression. SJW has been included in the pharmacopoeias of Germany and the US.The main active ingredients of SJW are hyperforin (HP), hypericin (HY), pseudohypericin (PH), amentoflavone (AF), and several flavono

32、ids (FL)Case study 1: Antidepressant activity of St. Johns WortCase study 1: Antidepressant activity of St. Johns WortCase study 2: The effect of Realgar-Indigo naturalis formula (RIF) on acute promyelocytic leukemia (APL)TCM formula RIF has been used in China to treat APL since 1980s. RIF consists

33、of four herbs, realgar, Indigo naturalis, Salvia miltiorrhiza, and Radix pseudostellariae. In TCM theory, multiple agents contained in one formula must work synergistically. Realgar is regarded as the principal component of the formula RIF, and the other three are adjuvant components to assist the e

34、ffect of realgar. The main active compounds of realgar, Indigo naturalis and Salvia miltiorrhiza are tetraarsenic tetrasulfide (As4S4, A), indirubin (I) and tanshinone IIA (T), respectively.Case study 2: The effect of Realgar-Indigo naturalis formula (RIF) on acute promyelocytic leukemia (APL)A) Protein interaction network. (B) Protein-pathway association network.Case study 2: The effect of Realgar-Indigo naturalis formula (RIF) on acute promyelocytic leukemia (APL)Comparison with combination therapy in Wes