右归丸临床应用解析

右归丸临床应用解析 主治功效 功能主治:温补肾阳，填精止遗。用于肾阴不足，命门火衰，腰膝酸冷，精神不振，怯寒畏冷，阳痿遗精，大便溏薄，尿频而清。 阳痿 证属命门火衰。症见阳痿阴冷，腰膝酸软，耳鸣脱发，牙齿松动，畏寒肢冷，形体瘦弱，短气乏力，头晕目眩，面色挑白，舌淡胖润有齿痕，脉沉细尺弱。 浮肿 证属肾阳不足。症见全身水肿，肿势多由腰足始，腰以下肿明显，两内踝尤剧，腰膝酸软疼痛，阴囊湿冷，畏寒肢冷，小便量少色清，舌淡体胖，苔薄白，脉沉细弱。 腰膝酸痛 证属肾阳不足，阴寒内盛。症见腰膝酸痛，少腹不仁，神疲气怯，畏寒肢冷，舌淡苔白，脉沉迟。 应用鉴别 功能类同药物鉴别 ?与桂附地黄丸的鉴别:两药同属补阳剂，均有补益肾阳之功。但桂附地黄丸以桂、附加入六味丸中，温养阴中之阳，全方有补有泻，补而不滞，补中有泻，常用于腰膝酸软、四肢厥冷、少腹拘急冷痛、小便不利或夜尿清长等肾阳不足之证。右归丸方名“右”，指命门之意，即肾阳，较桂附地黄丸少了丹皮、茯苓和泽泻，多了菟丝子、鹿角胶、枸杞子、当归和杜仲，故而补肾填for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 精壮阳的力量增强，功专于补，常用于阳痿、浮肿等命门火衰之证。?与济生肾气丸的鉴别:两药均为治疗肾阳不足所致的阴水水肿的常用方剂。但右归丸以补为用，温壮肾阳，填精益髓，并无专门的利水药，所以其治疗的水肿病情较轻，只需温补使肾阳得充，就可以达到利水的目的，西医的慢性肾炎见有肾阳虚现的可用本方。而济生肾气丸方中有车前、牛膝利水消肿，所治之水肿病情较重，常用于西医之慢性肾炎、肾功能不全、心源性水肿、内分泌失调、营养障碍等疾病。?与龟龄集的鉴别:两药同属补阳剂，均有补益肾阳之功，主治阳痿遗精等肾阳亏虚诸证。但龟龄集其中有参、茸补益气血，海马、雀脑、淫羊藿、补骨脂、肉苁蓉、锁阳、菟丝子等温肾壮阳，益精强骨，为治疗气血不足、肾阳虚衰证的良药。而右归丸则为温壮肾阳之剂，取“善补阳者必于阴中求阳”之意，诸药合用，刚柔相济，共奏温肾壮阳之功，并无补益气血之力，且温肾壮阳之力弱于前方，常用于阳痿、遗精等肾阳不足、阴寒内盛之证。?与青娥丸的鉴别:两药同属补阳剂，均有补益肾阳之功，主治腰膝酸痛之证。但右归丸取意于“善补阳者，必于阴中求阳”，有熟地、鹿角、菟丝子、枸杞等药，故而除了有温补肾阳的作用外，还有填补精血之功，使得阳得阴助而生化无穷。而青娥丸中有杜仲、胡桃仁、补骨脂、大蒜四味温肾壮阳、强健腰膝，补益肝肾，仅有温补肾阳之功，并无填补精血的作用，功专于补阳。 主治类同药物鉴别 阳痿早泄。与强阳宝肾丸的鉴别:两药均可治疗阳痿早泄。但右归丸所治之阳痿早泄，为肾阳不足，或先天秉for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 衰，或劳伤过度，以致命门火衰之证，兼有畏寒肢冷，阴寒内盛之证，可见腰膝酸软，面色白光白，精神不振，食少便溏，或全身浮肿等症状。而强阳宝肾丸除了有温补元阳之功外，还有固精涩遗之力，所治之阳痿早泄为肾阳不足，肾气衰微之证其病情比前者更严重，所以需要固涩与补益并进。 现代研究 药理作用药理作用 本方具有增强免疫、保护和调节脏器机能、抗衰老，调节激素含量、抑制自发性放电等作用。 1(增强机体免疫功能:用氢化考的松造成“阳虚”小鼠模型，致使出现免疫功能低下。右归丸能部分对抗激素对脾脏淋巴细胞的作用，对胸腺淋巴细胞有轻度作用。能使降低的溶血空斑数明显提高，延长体外脾细胞存活率。说明右归丸能改善和调节B淋巴细胞功能，促进体液免疫。此外，附子、肉桂、仙灵脾、熟地黄、党参及鹿角的水煎液，能使降低的小鼠腹膜细胞总数，?型细胞(淋巴细胞)、?型细胞(未成熟巨噬细胞)和?型细胞(巨噬细胞)的数目均明显提高。说明此药有扶正作用。 2(对实验性“肾阳虚”动物重要脏器的保护和机能调节作用:实验性“肾阳虚”模型的建立有多种方法，其中“氢考模型”为最常用。即长期注入大剂量氢化考的松，造成实验动物垂体-肾上腺皮质系统功能抑制及机体“耗竭”，使多系统、器官受到损伤，其重要脏器(如肝、肾上腺、胸腺、脾脏)重量、结构和所含的部分酶系统活性RNA、糖原for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 量等发生变化。右归丸对肾阳虚小鼠重要脏器有保护和机能调节作用:(1)右归丸使阳虚小鼠重要脏器重量增加。(2)右归丸能保护肝细胞核的亚微结构，使RNA及葡萄糖-6-磷酸脱氢酶(G-6-PH)成分增多，故有调整DNA、RNA及蛋白质的合成作用。线粒体是细胞氧化产生能量的主要机构。右归丸也有保护线粒体亚微结构的作用，并能使线粒体膜上的琉璃酸脱氢酶(SDH)、谷氨酸脱氢酶(GDH)、单胺氧化酶(MAO)成分增多，提示本方对线粒体有恢复和再生作用，从而提高细胞氧化供能的能力，这可能是纠正虚证的机制之一。右归丸使乳酸脱氢酶(LDH是糖原分解酶)和葡萄糖-6-磷酸酶(G-6-P)增多，可能有促进糖代谢的作用;使MAO活性恢复，有促进机体代谢及解毒作用。此外，右归丸使肝枯否细胞增多、变大、酸性磷酸酶(ACP)反应增强，ACP是溶酶体内主要的酶，故本方可能有增强吞噬细胞的作用。(3)有归丸对脾脏淋巴细胞有一定保护作用，对胸腺有轻度作用，说明本方对提高机体免疫有一定作用。(4)右归丸可使肾上腺非特异性酯酶(N-Ease)轻度增高。由于右归丸能保护肝、脾等器官，使受氢化考的松影响而变化的肝细胞中多种成分得到调整，使之接近正常，从而消除“阳虚”证候。 3(调节性激素含量:右归丸对男性阳虚的血清睾丸素含量降低者使之升高，血清雌二醇含量升高者使之降到正常水平;女性肾阳虚的血清睾丸素值无明显变化，而血清雌二醇低于正常者能明显上升。说明右归丸的作用机制与外源性性激素不同，重在改善机体功能，恢复下丘脑-垂体-性腺系统的正常分泌。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 4. 抗衰老:(1)对脑内单胺氧化酶的影响:人体衰老最重要的是中枢神经系统及心血管系统的衰老，已知脑内单胺氧化酶活力在老年呈增龄性线性升高，降低胞内单胺氧化酶活力则可起到防老抗衰作用。单胺氧化酶分A、 B两型，单胺氧化酶B(MAO-B)活性与衰老关系密切，脑内单胺类神经调节作用下降与MAO-B活性上升是引起脑功能衰老的主要原因之一。右归丸能使青、中、老龄的小鼠脑线粒体MBO-B活性明显降低，并使老龄组的酶活性降到青年组水平。另外，能使25月龄老龄大鼠脑干的MAO-B活性降至4月龄青年大鼠的水平，与老龄对照组比较差异显著，但对大脑皮质MAO-B的活性无明显作用。(2)对组织中羟脯氨酸、血清微量元素、尿生化的影响:目前认为，衰老时，心、肾组织的胶原蛋白含量增多，而胶原蛋白中羟脯氨酸含量高。右归丸使老龄小鼠肾羟脯氨酸降低，并使老龄大鼠心羟脯氨酸含量降至中年水平。并可使老龄大鼠的尿蛋白降至青年期水平。由此可见，右归丸对心、肾组织老化有延缓作用。另外，使羟基脲造成“阳虚”小鼠的血清镁含量升高，对血清铜、锌含量无明显影响。 5(调节环核苷酸含量:(1)与同龄对照组比较，右归丸能使青年组( 5月龄)小鼠肝组织cAMP含量降低，使中年组(8月龄)含量增高，老年组(16月龄)保持不变。右归丸组内的青、老年组含量相近似，而低于中年组含量。对cGMP含量右归丸影响不明显。(2)右归丸对小鼠肺组织cAMP含量影响不明显。与同龄对照组比较，右归丸能使青年组cGMP含量降低，老年组的含量升高，而中年组的含量变化不明显。右归丸通过影响肝、肺组织环核苷酸含量，来调节不同月龄小鼠for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 的代谢水平，从而影响其肝、肺功能。此外，对阳虚小鼠血浆环核苷酸含量也有明显影响，用氢化考的松造成阳虚小鼠动物模型，灌服右归饮煎液，连续10日，结果，服右归饮煎液组cAMP升高，cGMP降低，cAMP/cGMP比值升高，与对照组相比有显著性差异。 6. 调节血浆肾素活性和醛固酮含量:大鼠血浆肾素活性和血浆醛固酮含量随月龄增加而降低。右归丸使老年组血浆肾素活性明显提高，对醛固酮无明显作用。右归丸可能提高β-肾上腺素受体敏感性，使肾素活性增加，醛固酮含量略有增加。 7. 对肾阳虚大鼠中脑中央灰质(CG)单位自发放电的影响:分别给肾阳虚大鼠以伤害性刺激、性刺激和VMN(下丘脑腹内侧核)电刺激，以观察各组动物CG放电对三种刺激的反应。结果，肾阳虚大鼠CG放电频率显著升高，而对刺激的反应性降低，用右归丸治疗后，CG自发放电频率及其对刺激的反应均有恢复趋势。显示右归丸对肾阳虚大鼠脑内儿茶酚胺(CA)、性激素和促性腺激素释放激素(LHRH)及内源性阿片肽类的含量和活性具有特异性调节作用。 临床新用 近年来通过临床验证，该药还可用于治疗肾阳不足的性功能减退、精子缺乏症、骨质疏松症、慢性支气管炎、坐骨神经痛、假肥大型进行性肌营养不良、老年型赤白带过多症以及遗传性小脑共济失调、乳腺囊肿、白细胞减少症、红斑性狼疮、慢性腹泻、胃溃疡合并大出血、人工流产后月经过多、腰肌劳损、哮喘持续发作、产后不明原因发热、慢性肾功能衰竭、慢性胃炎、肾病综合征等疾病。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 临床应用 1.男性不育症:应用本方加减:熟地30g，山药30g，紫河车粉30g，山萸肉18g，枸杞18g，菟丝子18g，杜仲15g，巴戟15g，鹿角胶15g，陈皮15g，海狗肾10g(冲服)。水煎服。另外，自备狗、猪、羊等动物睾丸、阴茎、肾脏等不限，将其焙干研细末服用，每次10g，每日2次。共治疗本病11例，结果:全部治愈:女方受孕。 2.肾阳虚:应用本方治疗22例肾阳虚患者，测定治疗前后血清睾丸素(T)和雌二醇(E2 )的浓度。结果:男性患者血清T值低于正常组，E2 值高于正常组，右归丸可使其T值升高，E2 值下降;女性患者E2 值低于正常组，右归丸可使其升高。 3.坐骨神经痛:许继祥用本方去吴茱萸，加川牛膝、麻黄、炒白芍、甘草为基本方，刺痛明显加丹参、制乳香没药;麻木重加鸡血藤;夜间痛甚加首乌;夹湿者去枸杞加苍术、便纳差溏加砂仁、山楂;自汗去麻黄加黄芪。治疗本病48例，其中原发性41例，继发性7例。结果:治愈32例;显效12例;无效4例。 4.肥大性脊椎炎:喻峰用本方减鹿角胶、菟丝子、当归，加威灵仙、枣皮、甘草为基本方，痛甚加乳香、甲珠;寒甚加川乌、草乌;肢体麻木加全蝎或蜈蚣;便秘加熟大黄;气血亏虚加黄芪，当归;寒痰加白芥子或生南星。同时用10%葡萄糖注射液250ml中加川芎嗪注射液120ml静脉滴注，每日1次，10-15日为1疗程。治疗本病48例。结果:临床痊愈31例，显效17例。服药10-42日，一般于用药后2-3日疼痛或轻，10日左右症状消失。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 5.乳糜尿:张达旭用本方去鹿角胶5g，菟丝子5g，枸杞子5g，加升麻5g，陈皮5g，柴胡5g，白术10g，黄芪15g，党参15g，甘草6g，治疗本病15例。结果:痊愈14例，无效1例(治疗1个月后，乳糜尿试验未转阴性)。 毒性试验 急性毒性:选健康Swiss小鼠，体重19?1g灌服右归丸煎液，每鼠给药量按体表面积折算为临床用药量的180倍，给药后连续观察7日，动物的进食、活动及一般状况未见异常改变。 用药禁忌 忌生冷饮食，阴虚火旺者忌用。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet