Status

Current conditions ICD-9-CM:
2003
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
2010
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
2012
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
729.1 MYALGIA AND MYOSITIS, UNSPECIFIED
719.39 PALINDROMIC RHEUMATISM,MULTIPLE SITES
680.0 CARBUNCLE AND FURUNCLE, FACE
378.41 ESOPHORIA
311 DEPRESSIVE DISORDER, NOT ELSEWHERE CLASSIFIED
523.8 OTHER PERIODONTAL DISEASES(PERIODONTAL POCKET,GINGIVAL POLYP)
681.02 ONYCHIA AND PARONYCHIA OF FINGER
2013
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
704.8 OTHER DISEASES OF HAIR AND HAIR FOLLICLES
706.1 OTHER ACNE
444.22 ARTERIAL EMBOLISM AND THROMBOSIS OF LOWER EXTREMITY
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
378.41 ESOPHORIA
728.85 (728.850) SPASM OF MUSCLE
353.4 LUMBOSACRAL ROOT LESIONS,NOT ELSEWHERE CLASSIFIED
780.52 (780.520) OTHER INSOMNIA
788.43 NOCTURIA
2014
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
374.05 TRICHIASIS WITHOUT ENTROPION
372.72 CONJUNCTIVAL HEMORRHAGE
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
378.41 ESOPHORIA
2015
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
705.83 HIDRADENITIS
698.8 OTHER PRURITIC CONDITIONS
686.9 UNSPECIFIED LOCAL INFECTIONS OF SKIN AND SUBCUTANEOUS TISSUE
686.09 OTHER PYODERMA
272.0 PURE HYPERCHOLESTEROLAEMIA (FAMILIAL HYPERCHOLESTESTEROLEMIA)
729.1 MYALGIA AND MYOSITIS, UNSPECIFIED
719.39 PALINDROMIC RHEUMATISM,MULTIPLE SITES
377.61 ASSOCIATED WITH NEOPLASMS
311 DEPRESSIVE DISORDER, NOT ELSEWHERE CLASSIFIED
307.48 REPETITIVE INTRUSIONS OF SLEEP
705.81 DYSHIDROSIS
372.72 CONJUNCTIVAL HEMORRHAGE
680.2 CARBUNCLE AND FURUNCLE, TRUNK
523.3 ACUTE PERIODONTITIS(ACUTE PERICORONITIS)
Current conditions ICD-10-CM:
2016

E780 Pure hypercholesterolemia
G40.909 Epilepsy, unspecified, not intractable, without status epilepticus
L301 Dyshidrosis [pompholyx]
F32.9 Major depressive disorder, single episode, unspecified
D33.2 Benign neoplasm of brain, unspecified
H04.123 Dry eye syndrome of bilateral lacrimal glands
H47.529 Disorders of visual pathways in (due to) neoplasm, unspecified side
H02.052 Trichiasis without entropian right lower eyelid
H11.31 Conjunctival hemorrhage, right eye
H52.6 Other disorders of refraction
H50.51 Esophoria
H02.055 Trichiasis without entropian left lower eyelid
H47.099 Other disorders of optic nerve, not elsewhere classified, unspecified eye
F51.8 Other sleep disorders not due to a substance or known physiological condition
G40.901 Epilepsy, unspecified, not intractable, with status epilepticus
L0881 Pyoderma vegetans
B009 Herpesviral infection, unspecified
J069 Acute upper respiratory infection, unspecified
M79.1 Myalgia
M12.39 Palindromic rheumatism, multiple sites

Current treatment centers:
GP/ The department of Neurosurgical emergency & Critical Care of Chang Gung Memorial Hospital Linkou Branch/ TCM oncology of China Medical University Hospital Cancer Center/ and Taichung Hospital, Ministry of Health and Welfare

Contents of reference sources:
MIMS- Search drug information/ interaction/ images & medical diagnosis.
Complementary and Alternative Healing University- Dictionary of Chinese Herbs. http://alternativehealing.org
Database 醫砭‧沈藥子 http://yibian.hopto.org
Traditional Chinese Medicine (TCM) Wiki http://www.tcmwiki.com/

Saturday, November 5, 2011

tian ma 天麻

Pharmaceutical name 英文药名:
Rhizoma Gastrodiae Elatae
Latin botanical name 拉丁學名:
Gastrodia elata Bl.,  
Other Names 別名﹕
ming tian ma 明天麻﹐ming chi jian 名赤箭﹐ding feng cao定風草﹐shui yang yi 水洋芋,  chi jian zhi 赤箭芝, du yao zhi独摇芝  ,  ding feng cao 定風     草  ,  li mu 离母  ,  he li cao 合离草  ,  shen cao 神草  ,  gui tu you 鬼督邮, chi jian 赤箭 。
處方名:天麻  ,  明天麻  ,  天麻片  ,  炒天麻  ,  煨天麻  ,  薑天麻等
Common Name 英文名﹕
Gastrodia Tuber
Distribution 分佈﹕
It is mainly produced in Sichuan, Yunnan and Guizhou provinces.  Other producing regions include Northeast China and North China.
主產於四川﹐ 云南﹐ 貴州等省。東北部與北部亦有出產。
Properties (characteristics) 性味﹕
Sweet in taste and neutral in nature.
味甜﹐性平。
Channels (meridians) entered:
Liver.

Actions & Indications 主治:
1. Calming the internal wind and relieving convulsion and spasm. For suppressing symptoms of liver-wind, no matter if cold type or heat type.
2. Calming the liver and suppressing liver yang ascending 肝陽上亢. For such symptoms as vertigo and headache.
3. Removing obstruction in the channels to relieve pain. For arthralgia due to the wind, cold and dampness, or for numbness and paralysis caused by liver and shenxu (kidney deficient) 腎虛
4. For neurasthenia and insomnia
有息寒 型 或 熱 型 之 肝 風   ,  有 止痙 的功能。
主治:
1. 四肢拘挛  ,  小兒 驚 風 ,
2. 肝 陽 上 亢 之 眩暈  ,  頭 痛  ,
3. 麻木  ,  風濕疼痛 ,
4. 神經衰弱  ,  失眠 。
Medical Function:
1. Effect on the CNS: sedation, anti-seizure, painkilling effect.
2. Effect on heart and blood vessels: protects the heart muscle from lacking circulation, improves blood flow in the coronary artery,
3. Improves blood flow to the brain,
4. mitigate the effect of adrenalin on blood vessel constriction, lower blood pressure.
5. Effect on tolerance of lack of oxygen.
6. Improve the immune system.
7. Other effects: increase the skin temperature; increase the expansion and contraction ability of the smooth muscle of the intestine; improve the secretion of the bile in the gall bladder (vanillyl alcohol); slow down breathing; inhibits 5-HT, PGE2;
8. Vanilline can be absorbed in the small intestine rapidly and shows up in the liver and the brain, especially the cerebrum, and the medication quickly permeates the blood-brain barrier. Vanilline is excreted through the urine within 10-12 hours.
9. Toxicity: Relatively safe.
药理:
1. 鎮痛、 鎮靜、惊厥、
2. 抑 制 腎 上 腺 素 而 降 低 血 管 收 縮 而 降 低血壓
3. 增 進 腦 血 液 循 環
4. 香莢蘭醛  容 易 被 小 腸 吸 收 ﹐ 很 快 到 達 肝 臟 與 腦 部﹐ 特 別 是 在 大 腦
5. 明目
6. 增强記 憶 力
Chemical ingredients 化學成份:
vanilline 香莢蘭醛
vanillic acid 香莢蘭酸
vanillyl alcohol 香莢蘭醇
gastrodin 天麻甙
p-hydroxymethylphenyl-β-D-glucopyranoside 對- 羥甲基苯-β-D-吡喃葡萄糖甙
p-hydroxybenzyl alcohol 對-羥基苯甲醇
β-sitosterol β-谷甾醇
daucosterol 胡蘿蔔甙
citric acid 檸檬酸
citric acid monomethyl ester 檸檬酸獨甲酸酯
palmitic acid 棕榈酸
p-hydroxybenzaldehyde 對-羥基苯甲醛
sucrose 蔗糖
succinic acid 琥珀酸
bis (4-hydroxybenzyl) ether mono-β-D-glucopyranoside 酯酶荧光底物
4-hydroxybenzyl methyl ether, 4-(4'-hydroxybenzyloxy) benzyl methyl ether
bis (4-hydroxybenzyl) ether 雙(4-羥芐基)醚
4-(β-D-glucopyranosyloxy) benzyl alcohol  
tris [4-(β-D-glucopyranosyloxy) benzyl] citrate  
parishin 檸檬酸酯
3, 4-dihydroxybenzyl aldehyde  3,4-二羥基二苯 乙醛
4, 4'-dihydroxydiphenyl methane  4,4'-二羥基二苯甲烷
p-hydroxybenzyl ethyl ether 對-羥基苯甲基乙醚
4, 4'-dihydroxydibenzyl ether 4,4'-二羥基二苯 醚
4-ethoxy methyl phenyl-4'-hydroxy benzyl ether  
iron 鐵
fluorine 氟
manganese 錳
zinc 鋅
iodine
anti-fungus protein 抗真菌蛋白質
vitamin A 維 生 素 甲
Dosage 用量﹕
As a decoction, 3 -10 g daily.
As powder, 1 - 1.5 g each time.
煎劑 ﹕ 3~10 克。
粉劑﹐每次服﹕1~1.5 克
Samples of formulae 處方舉例﹕
Use for paralysis after stroke; also for spastic muscles: tian ma, 3 portions; niu xi , 3 portions; du zhong, 3 portions; dang gui, 2 portions; qiang huo, 2 portions. Grind into fine powder. Mix with cooked honey to make into cubes. Take 5g each time 3x day with warm boiled water.   (Source of formula: Long Xiang Fei)
Traditionally, tian ma is being used with the combination of gou teng, ban xia, chuan xiong, fang feng etc.
症狀﹕肌肉肢體 拘挛;中風癱瘓
處方﹕天麻 3份﹐牛膝 3份﹐杜仲 3份﹐當歸 2份﹐羌活 2份。磨成細末。煉蜜為丸。每次服 5克。每日3次﹐開水送服。處方來源﹕龍翔飛。
tian ma wan 天麻丸
傳統上 ,天麻常與鉤藤、半 夏 、 川 芎、 防風等配伍使用。
Differentiation 鑒 別 ﹕
Tian ma is long and elliptical, shrunk, crooked and slightly flat, 3-15 cm long, 1.5-6 cm wide, and 0.5-2cm thick. At one end of the tuber, there is a reddish-brown withered bud or a remaining stem. At the other end, there is an umbilicate scar. Tian ma ( Gastrodia) tuber is usually peeled. Its surface is yellowish white or yellowish brown with longitudinal wrinkles and some spotted segmental rings. It is hard and semi-transparent. It does not break easily.  Its cross-section is smooth and lustrous. It has a peculiar odor and a sweet, slightly pungent taste.   Fakes are the roots of Mirabilis jalapa L. and Dahlia pinnata Cav., or the tuber of potato, Solanum tuberosum L. They do not have the spotted segmental rings and longitudinal wrinkles on the surface, and the cross-section has no resin-like luster.
天麻偽 品常见者有 大麗 菊Dahlia pinnata cav.(菊科)  ,  紫茉莉 Mirabilis jalapa L.(紫茉莉科)  ,  馬 鈴 薯 Solanum tuberosumL(茄科)  ,  羽裂蟹甲草 Cacalia tangutica Hand.(菊科)  ,  芭蕉芋Canna edulis Ker.(美人蕉科)  ,  芋頭 Colocasia esculenta Sch.(天南星科)  ,  大九股牛Dobinea delavayi Engl. (槭 樹 科)等十餘種 植物的根或塊 茎的仿製 品。
Cautions 禁忌﹕
Should not be used in case of yinxu (yin deficient)
陰虛者忌 用。


The earliest writing that described tian ma is "Shen Nong Ben Cao Jing", a medical material book, written during Qin and Han dynasties of China, about 2,200 years ago. The book classified herbs into 3 categories: top, middle, and lower. Tian ma was listed as top quality herb.
Tian ma was mentioned in the work of Ge Hong in the work entitled "Bao Po Zi." He lived between 283-343 A.D. during the Jin dynasty of China. He was a medical and Dao writer.
Other early classical works also described tian ma and its usage, include:
Tang Ben Cao, completed in 659 A.D.
Tu Jing Ben Cao completed in 1061 A.D.
其記述最早見于《神農本草經 》。
以 下 著 作 亦 有 報 導 天 麻 形 態 與 性 質 。 列為上品
葛 洪 (283 AD - 363 AD)《 抱 朴 子》
《唐本草》亦稱《唐新修本草》,有時簡稱《新修本草》,是唐高宗顯慶四年(公元659年)編修成功的,由唐朝政府頒行,這是國家頒定藥典的創始。
《圖經本草》 公元1061年編成.
This herb belong to controlled material of CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora),  under append. II (permit required for import and export trade): 天麻 屬 於 《華約》附錄二品種 管制的藥材種類。  須 按 預先申請的許可証進行貿易 。

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