2 English reference heat-clearing formula [Chinese medicine terminology examination and approval Committee. Terminology of Traditional Chinese Medicine (2004)]
3 Overview Qingre Prescription [1] refers to a prescription mainly composed of heat-clearing drugs, which has the functions of clearing away heat and purging fire, cooling blood and relieving summer heat, detoxifying and clearing away heat and deficiency heat. , is the general name for treating internal heat syndrome [2][ 1]. Distinguish between qi-activating and heat-clearing agents, camp-clearing and blood-cooling agents, heat-clearing antidote, fu-clearing and heat-clearing agents, heat-clearing and summer-clearing agents and heat-clearing agents [1].
4 Indications of heat-clearing agent Heat-clearing agent is suitable for internal heat syndrome with exterior syndrome resolved, heat entering the interior, or internal heat full but not yet full [2]. The etiology of internal heat syndrome is nothing more than internal injury and exogenous pathogen [2]. Because exogenous pathogens, or exogenous pathogens turn into heat, or warm fire and poison are all diseases; Because of internal injuries, most of them are caused by excessive viscera and excessive polarization of five emotions [2]. Because the internal heat syndrome is divided into qi-blood heat, excess heat and deficiency heat, and the zang-fu organs are superior, the heat-clearing agents can be divided into six categories, namely, heat-clearing agents that clear qi and separate heat, which are suitable for qi-heat syndrome; Clearing camp and cooling blood is suitable for the syndrome of heat entering camp blood; Clearing heat and detoxicating is suitable for the syndrome of excessive heat toxin; Qingfu Qingre agent is suitable for heat syndrome caused by excessive heat in a certain viscera. Heat-clearing and summer-heat relieving agent is suitable for summer-heat syndrome; Clearing deficiency-heat agent is suitable for deficiency-heat syndrome [2].
5 Pay attention to the following aspects when using heat-clearing agents: heat-clearing agents are mostly cold products, which are easy to hurt the spleen and stomach, and cannot be taken in excess, which can hurt the yang [2]. For those who are usually deficient in cold, even if they have internal heat syndrome, they should be used with caution to avoid damaging Yang Qi [2]. Clearing deficiency and clearing heat mostly contains nourishing yin, which is greasy and astringent. Early use can leave evil spirits, and it is not advisable to use it too early [2]. Pay attention to distinguish the true and false of heat syndrome from the false and true [2]. Real winter vacation heat card holders should not misuse this kind of prescription [2]. Patients with excess heat syndrome should use cold and heat-clearing prescription to directly break their heat; If it is deficiency-heat syndrome, it is necessary to use sweet and cool nourishing yin to clear away heat [2]. In the process of treating fever patients with heat-clearing agents, we should pay attention to the compatibility of nourishing yin drugs according to the condition, so as to achieve the purpose of caring for vaginal fluid [2]. Heat-clearing agent is a cold product, which is easy to spoil stomach qi and damage spleen yang after long-term repeated use, so it should be used moderately, not excessively and not excessively [2]. If necessary, it can be combined with spleen-invigorating and stomach-regulating products to eliminate evil without hurting the spleen and stomach [2].
6 Classification of heat-clearing agents 6. 1 Heat-clearing agents Heat-clearing agents are suitable for heat in the qi, excessive heat impairing body fluids, or residual heat after heat impairing both qi and yin, with symptoms such as high fever, polydipsia, hyperhidrosis and pulse sinking [2]. Commonly used drugs for clearing heat and regulating qi, such as gypsum, Anemarrhena asphodeloides, bamboo leaves, gardenia, etc. , mainly composed of prescription [2]. Because pathogenic heat is easy to damage body fluids and consume qi, it is often combined with qi-invigorating and fluid-promoting herbs, such as Ginseng and Ophiopogon japonicus [2]. Representatives include White Tiger Decoction and Bamboo Leaf Gypsum Decoction [2].
6.2 Heat-clearing and detoxicating drugs are suitable for the symptoms of stomach heat, such as fever, upset, typo, macula, vomiting, or redness due to body heat, dysphoria in chest and diaphragm, red urine, constipation, ulcers and furuncles [2]. Commonly used drugs for clearing away heat and toxic materials and purging fire, such as Scutellaria baicalensis Georgi, Coptidis Rhizoma, Flos Lonicerae, Fructus Forsythiae, Herba Taraxaci, Herba Violae, Radix et Rhizoma Rhei, etc. , mainly composed of prescription [2]. If the epidemic virus occurs on the head and face, it can be combined with spicy and cool products, such as Fructus Arctii, Herba Menthae and Bombyx Batryticatus. Hot air inlet emits explosive powder, such as gypsum and Anemarrhena asphodeloides; Heat entering the blood is combined with blood-cooling drugs, such as buffalo horn, peony bark and rehmannia root [2]. Representatives include Huanglian Jiedu Decoction, Puji Disinfection Drink, Xianfang Huoxue Drink and Geliang Powder [2].
6.3 Qingying Cooling Blood Agent Qingying Cooling Blood Agent is suitable for the syndrome of pathogenic heat spreading to the camp or heat entering the blood. The symptoms are: body heat is very hot at night, sometimes unconsciousness, or faint with macula, mental distress, vomiting blood, bleeding, macula, or hemomania, and red tongue [2]. Commonly used drugs such as buffalo horn, Radix Rehmanniae and Radix Scrophulariae. Mainly used for prescription, or honeysuckle, forsythia suspensa and bamboo leaves, to clear heat and regulate qi; Or use Cortex Moutan and Radix Paeoniae Rubra to cool blood and dissipate blood stasis, so as to stop bleeding without leaving blood stasis [2]. Represented by Qingying Decoction and Rhinoceros Horn Dihuang Decoction [2].
6.4 Qingzang-fu heat-clearing agent Qingzang-fu heat-clearing agent is suitable for the fire syndrome caused by excessive pathogenic heat of a certain zang-fu organ [2]. Its clinical manifestations are different due to different viscera of heat syndrome [2]. The main clinical manifestations are irritability, thirst, redness, sores on the mouth and tongue, and red and astringent urine. Headache, red eyes, bitter taste, hypochondriac pain, or itching and swelling, turbid urine with yellow color; Fever, asthma and cough, yellow and thick phlegm or foul purulent blood phlegm, chest tightness and pain; Or toothache, gum swelling and pain, halitosis, loose teeth, toothache; Or abdominal pain, acute diarrhea, bloody stool and purulent blood [2]. According to the different syndromes of visceral heat, this kind of prescription is mainly composed of corresponding heat-clearing drugs [2]. For example, Rhizoma Coptidis, bamboo leaves and plumula Nelumbinis, Scutellariae Radix, Cortex Mori and Rhizoma Phragmitis, Radix Gentianae, Prunellae Spica, Fructus Gardeniae, Pulsatilla and Cortex Phellodendri are commonly used drugs for clearing away heat and stomach respectively [2]. Representative prescriptions include Daochi Powder, Longdan Xiegan Decoction, Bulbus Allii Macrostemon Powder, Wei Qing Powder, Shaoyao Decoction and Pulsatilla Decoction [2].
6.5 Heat-clearing and summer-relieving agent Heat-clearing and summer-relieving agent is suitable for Xia Yue summer-heat syndrome [2]. Summer heat is one of the six evils, which has specific seasonality [2]. Summer sickness is often manifested as body heat, polydipsia, hyperhidrosis, fatigue, dysuria, and rapid pulse [2]. Commonly used are lotus leaves, gypsum, talc, watermelon and Cui Yi. , good at clearing away heat and relieving summer heat, mainly composed of prescriptions [2]. Summer heat is often accompanied by humidity. If summer heat is accompanied by dampness, the method should be to clear summer heat and promote diuresis, and it should be used together with Poria, Alisma orientalis and Polyporus. Summer heat consumes energy easily. If the summer heat is accompanied by qi deficiency, it is advisable to clear the summer heat and benefit the vitality. It is compatible with Radix Pseudostellariae and Radix Astragali [2]. The representative prescriptions are Liuyisan and Qingshu Yiqi Decoction [2].
6.6 Qingxu Fever is suitable for the later stage of fever. When the pathogenic heat is not exhausted and the vaginal fluid has been injured, there will be low fever in the afternoon or evening, and the heat will subside in the morning; Or liver and kidney yin deficiency, so that bone steaming hot flashes or low fever lasts for a long time [2]. Radix Rehmanniae, Radix Scrophulariae, Radix Ophiopogonis, Carapax et Plastrum Testudinis and Carapax Trionycis are commonly used for nourishing yin. Artemisia annua, Anemarrhena asphodeloides, Cortex Moutan, Cortex Lycii and Radix Bupleuri penetrate their heat [2]. Representative prescriptions such as Artemisia annua Biejia Decoction, Qinggu Powder and Danggui Huang Liu Decoction [2].
Table 3 1? Comparison of commonly used heat-clearing agents (from Yi Ben Tong)
classify
Common prescription
Drug compatibility
function
therapy
Clearing qi and separating heat
baihu tang
Gypsum is king and Anemarrhena asphodeloides is minister.
clear heat and promote saliva
Yangming qi divides into excess heat.
Clearing camp and cooling blood
Qingying decoction
Rhinoceros horn Dihuang decoction
The rhinoceros horn is king, and Xuan Shengmai is minister.
The rhinoceros horn is king, and the birthplace is minister.
Clearing camp, detoxifying and penetrating heat
Clearing heat, cooling blood and removing blood stasis
Heat enters the camp
Heat entering the blood
clear heat and detoxicate
Five-flavor disinfectant beverage
Yin Hua is the king and Di Ding Tiankui is the minister.
Clearing heat, detoxicating and eliminating sores
All kinds of furuncle and heat toxin
Clearing viscera heat
Weijing decoction
Pulsatilla decoction
Decoction of Gentian to Purge the Liver
Reed stems are king, and wax gourd kernels are ministers.
Pulsatilla is king, even cypress is minister.
Gentiana is the king and Qin Zhi is the minister.
Clearing lung, resolving phlegm and expelling pus
Clearing heat and cooling blood to stop dysentery
Clearing damp-heat in liver and gallbladder
Heat toxin accumulates in lung (lung carbuncle)
Heat toxin accumulating in intestine
Excess heat in liver and gallbladder and damp-heat
Clearing heat and dispelling summer heat
Qingshu Yiqi decoction
Lotus stems and green clothes are kings, and winter is ministers.
Clearing heat and relieving summer-heat, benefiting qi and nourishing yin
Summer heat hurts qi and yin.
Clearing deficiency-heat
Artemisia annua Biejia decoction
Artemisia annua Turtle is king and the land is minister.
Nourishing yin and penetrating heat