主條目:Drugs for alimentary tract人類胃腸道用藥

- 中藥中常常稱作瀉下藥,多有毒性,性味通常"寒涼苦,"能引起腹瀉及滑利大腸而通利大便促使排便,排除積滯水飲及其他也害物質,有ㄉ還能使實症下瀉.適用於大便結密,腸道積滯,實熱內結及水腫停飲等裏實症,此類藥易傷胃氣。分成三種等級:
- (3峻(ㄐㄩㄣˋ)下逐水藥)
- 潤下藥
- 攻下藥
- 強度:(1攻下藥)<(2.潤下藥)<(3峻下逐水藥)
- PS. (大戟科)常常是(3峻(ㄐㄩㄣˋ)下逐水藥)
- 醫學上對便秘的定義是指每週解便次數少於三次或排便用力且排出乾硬的糞便。
classification[]
成藥基準表甲類成藥(四)緩下劑(瀉藥):便秘、習慣性便秘、慢性便秘。[]
成藥基準表甲類成藥(九)浣腸劑:便秘、習慣性便秘、慢性便秘。[]
西藥[]
滲透性瀉劑(Hyperosmotic agents)[]
- 滲透性瀉劑(Hyperosmotic agents)(Site of action: colon): glycerin suppositories (Hallens), sorbitol, lactulose乳果糖, and PEG聚氧乙烯 (Macrogol)(Colyte, MiraLax)聚乙二醇4000[1]
- 鹽類瀉劑(Saline Hyperosmotic laxative)(Site of action: small and large intestines):sodium phosphate(and variants) , potassium sodium tartrate, magnesium citrate, magnesium hydroxide (milk of magnesia), and magnesium sulfate (Epsom salt)硫酸鎂
- 開塞露(含硫酸鎂、甘油、丙二醇):能潤滑並刺激腸壁,軟化大便,使其易於排出,成人20ml/次,主要適用於硬結便患者,尤其是老年症患者。
- Chloride channel activators
Lubiprostone is used in the management of chronic idiopathic constipation and irritable bowel syndrome. It causes the intestines to produce a chloride-rich fluid secretion that softens the stool, increases motility, and promotes spontaneous bowel movements.
刺激性瀉劑(Stimulant agents)[]
蕃瀉葉、鼠李、酚酞、篦麻油等
Preparation(s) | Type | Site of action | Onset of action |
---|---|---|---|
Cascara (casanthranol) | Anthraquinone | colon | 6–8 hours |
Buckthorn | Anthraquinone | colon | 6–8 hours |
Senna extract(蕃瀉葉) (senna glycoside) | Anthraquinone | colon | 6–8 hours |
Aloe vera(蘆薈) (aloin) | Anthraquinone | colon | 8–10 hours |
Phenolphthalein | Triphenylmethane | colon | 8 hours |
Bisacodyl(比沙可啶) (oral) | Triphenylmethane | colon | 6–12 hours |
Bisacodyl (suppository) | Triphenylmethane | colon | 60 minutes |
Castor oil(蓖麻子油) | Ricinoleic acid | small intestine | 2–6 hours |
Castor oil is a glyceride that is hydrolyzed by pancreatic lipase to ricinoleic acid, which produces laxative action by an unknown mechanism.Long-term use of castor oil may result in loss of fluid, electrolytes, and nutrients.[4]
容積性瀉藥(Bulk-forming agents):懷孕只能用這種[]
- (不可溶性)纖維素(Dietary fiber)
- Fruits, such as bananas,[5] though this depends on their ripeness,[6] kiwifruits,[7] prunes,[8] apples (with skin), pears (with skin), and raspberries[9]
- Vegetables, such as broccoli, string beans, kale, spinach,[10] cooked winter squash, cooked taro and poi, cooked peas, and baked potatoes (with skin)[9]
- Whole grains
- Bran products[9][10]
- Nuts
- Legumes, such as beans, peas, and lentils[9]
- Psyllium Husk(車前子殼)(Metamucil 水溶性纖維粉)、Calcium Polycarbophil、Polyethylene Glycol、樂瑪可Normacol plus(Sterculia 62% +Frangula 8%)、Citrucel(methylcellulose )、polycarbophil
潤滑性瀉劑(Lubricant agents)[]
液狀石蠟(Mineral oils, such as liquid paraffin)、中醫的口服麻仁丸
軟便劑Emollient agents (stool softeners)[]
Docusate (Colace, Diocto), Gibs-Eze[4]Emollient agents prevent constipation rather than treating long-term constipation.[4]
5-HT4受體激動劑(Serotonin agonist)[]
5-HT4受體激動劑
Tegaserod (brand name Zelnorm).
Prucalopride (brand name Resolor).
婦科[]
懷孕禁用 | 懷孕小心使用 | 哺乳禁用 | 哺乳小心使用 |
瀉下藥 | |||
膨脹性瀉下劑、Magnesium Sulfate(B)、Lactulose(BM)、Tegaserod(BM) | senna、bisacodyl可建議 | ||
止瀉藥 | |||
孕期常用的止瀉藥可分為輕度的「Kaopectin(C)」和強度的「Imodium(Loperamide)(BM)」兩種,這兩種藥物的等級在B~C之間,孕婦服用相對安全。(懷孕拉肚子怎麼辦?4大護理原則學起來!) | loperamide可建議 |
中藥[]
機轉 | 例子 |
多有毒性,性味通常"寒涼苦 | *瀉藥(瀉下藥)多有毒性,性味通常寒涼苦(性味寒涼苦ㄉ助瀉),科學映證:Mg會苦會瀉、MgO稱做苦土、MgCl2等海鹽ㄉ成分稱作為苦滷、MgSO4*7H2O 硫酸鎂帶7個結晶水俗稱瀉鹽(性味為苦)PS.NaNO3俗稱芒硝亦有瀉下作用。大黃寒苦 |
(1攻下藥)大腸經<
(2.潤下藥)大腸經+<
(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
大黃(蓼(ㄌㄧㄠˇ)科)寒苦(1攻下藥)
蘆薈(百合科)寒苦(1攻下藥)
商陸(商陸科)寒苦毒(3峻(ㄐㄩㄣˋ)下逐水藥)
牽牛子(旋花科)寒苦毒(3峻(ㄐㄩㄣˋ)下逐水藥)
芒硝(NaNO3)寒苦鹹(1攻下藥)
番瀉葉(豆科)寒苦甘(1攻下藥)
甘遂(大戟科)寒苦甘毒(3峻(ㄐㄩㄣˋ)下逐水藥)
大戟(大戟科)寒苦辛毒(3峻(ㄐㄩㄣˋ)下逐水藥)
巴豆(大戟科)辛熱大毒(3峻(ㄐㄩㄣˋ)下逐水藥)
千金子(大戟科)辛溫毒(3峻(ㄐㄩㄣˋ)下逐水藥)
芫(ㄩㄢˊ)花(瑞香科)苦辛溫毒(3峻(ㄐㄩㄣˋ)下逐水藥)
郁李仁(薔薇科)苦辛平(2.潤下藥)
火麻仁(桑科)甘平(2.潤下藥)
............................
大黃(科)寒苦(1攻下藥)大腸經+胃+脾+心肝*****
蘆薈(百合科)寒苦(1攻下藥)大腸經+肝***
商陸(商陸科)寒苦毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
牽牛子(旋花科)寒苦毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
芒硝(NaNO3)寒苦鹹(1攻下藥)大腸經+胃****
番瀉葉(豆科)寒苦甘(1攻下藥)大腸經+0****
甘遂(大戟科)寒苦甘毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
大戟(大戟科)寒苦辛毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
巴豆(大戟科)辛熱大毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+胃+肺
千金子(大戟科)辛溫毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肝
芫(ㄩㄢˊ)花(瑞香科)苦辛溫毒(3峻(ㄐㄩㄣˋ)下逐水藥)大腸經+腎+肺
郁李仁(薔薇科)苦辛平(2.潤下藥)大腸經+小腸經
火麻仁(桑科)甘平(2.潤下藥)大腸經+脾*****
泻下药 | |||||||||
攻下藥 | |||||||||
大黃(寒性藥) | 泻下攻积 | 攻下力峻 | |||||||
涼膈散:清熱解毒、瀉火通便
|
(上下兩焦,即陽明、少陽) | 清热 | 泻火解毒,凉血止血 | ||||||
大承氣湯(三焦):峻下熱結、消痞除滿
小承氣湯(不犯下焦):瀉熱通便、消痞除滿 調胃承氣湯(不犯上焦):通便軟堅、和胃瀉熱 |
皆可治陽明實熱症 | 活血祛瘀, | |||||||
利湿退黄 | |||||||||
芒硝(寒性藥) | 泻下攻积 | ||||||||
清热 | (外用)清热消肿止痛 | ||||||||
桃核承氣湯:通便下瘀 | 润燥软坚, | ||||||||
番瀉葉(寒性藥) | 泻下通便 | (热结便秘) | |||||||
蘆薈(寒性藥) | 瀉下 | 清肝 | 殺蟲 | ||||||
潤下藥 潤腸湯:潤腸通便 | |||||||||
火麻仁 | 润肠通便 | 麻子仁丸:潤腸通便 | |||||||
兼补虚之功 | |||||||||
郁李仁 | 润肠通便 | ||||||||
兼行气滞 | 利水消腫 | ||||||||
峻下逐水藥 | |||||||||
甘遂 | 峻下逐水
(瀉水逐飲 ) |
(用于水湿壅盛之实证) | |||||||
消肿散结 | |||||||||
大戟 | 峻下逐水
(瀉水逐飲 ) |
(用于水湿壅盛之实证) | |||||||
消肿散结 | |||||||||
巴豆(熱性藥)(促癌藥) | 峻下冷积、逐水退肿、 | 祛痰利咽、 | 芫花 | 峻下逐水
(瀉水逐飲 ) |
(用于水湿壅盛之实证) | 祛痰止咳 | |||
外用蚀疮 | 外用杀虫、疗疮 | ||||||||
牵牛子(别名:二丑) | 泻下逐水、 | ||||||||
祛积杀虫 | |||||||||
商陸 | 瀉下利水 | ||||||||
消腫散結 | |||||||||
千金子 | 逐水退腫 | ||||||||
破血消癥 |
參考資料[]
- ↑ 引用錯誤:無效的
<ref>
標籤,未定義名稱為Handbook22
的參考文獻內容文字。 - ↑ 模板:Cite web
- ↑ 模板:Cite web
- ↑ 4.0 4.1 4.2 引用錯誤:無效的
<ref>
標籤,未定義名稱為Handbook
的參考文獻內容文字。 - ↑ 模板:Cite journal
- ↑ 模板:Cite news
- ↑ 模板:Cite journal
- ↑ 模板:Cite journal
- ↑ 9.0 9.1 9.2 9.3 引用錯誤:無效的
<ref>
標籤,未定義名稱為NIDDK
的參考文獻內容文字。 - ↑ 10.0 10.1 引用錯誤:無效的
<ref>
標籤,未定義名稱為AICR
的參考文獻內容文字。