The clinical difference between ginger and dried ginger-生姜与干姜的临床区别

Ginger is well known in our lives. It is not only a food, but also an important medicine. I mistakenly used dried ginger as ginger in clinical practice, and I personally experienced the difference in the efficacy of the two in drinking warm water.

The patient, a 53-year-old female with asthma and cough, went to the doctor for 1 year. The patient had a cough with no obvious cause a year ago. The condition was mild and severe with medication. In the past month, the cough has worsened, chest tightness, shortness of breath, asthma at night affecting sleep, and asthma attacks. I sometimes cough a lot of thin white foamy sputum, neutralize the mouth, fear cold, fear cold on the chest and back, have normal stool, drink less urine and drink a little bit astringent pain, fat tongue, large fur and white teeth marks. Differentiating the six meridians is the syndrome of Taiyin and Taiyin, and the syndrome is Xiaoqinglong Decoction.

At the second visit 5 days later, he was informed that the cough was relieved and the amount of sputum decreased slightly after taking the upper part. When I looked at the record of the last visit, I found that the dry ginger in Xiaoqinglong Decoction was written as ginger by mistake, so I changed it. The patients of the third consultation reported that the effect was very good this time, the sputum volume was significantly reduced, and the cough was also relieved.

“Shen Nong’s Materia Medica” does not record ginger, only the dried ginger is born in Youliang, ginger “Famous Doctors”: [Ginger] tastes pungent. Lukewarm. Indications of typhoid fever, headache and nasal congestion. Cough up breath. Stop vomiting. Sheng Qianwei and Jingzhou Yangzhou. Picked in September. It was warm again. Xin. Go to Five Zang. Go light. Get angry. Stop vomiting. In addition to wind and heat. Jiufu Xiaozhi Shaozhi. Sad.

Dried ginger “Shen Nong’s Materia Medica”: [Dried ginger] is pungent. temperature. Indications full of chest. Cough up breath. Wenzhong. Stop bleeding. Sweating. By rheumatism. Intestinal diarrhea. The survivor Youliang. Take a long time to get rid of the odor. Divine. Sheng Qian is Chuan Gu.

“Famous Doctors”: [Dried Ginger] is hot. Non-toxic. Indications of cold abdominal pain. Evil. cholera. Fullness. Wind evil all poisons. Gas between the skin. Stop saliva.

Reading books or listening to teachers often talk about dry ginger Wenzhong Huayin, ginger sweats stomach to relieve vomiting, clinical use is based on the composition of the original prescription and the teacher’s experience to learn to apply, I did not really appreciate the difference of the drug.

Although these two medicines are used to treat wet phlegm and drinking water, dry ginger is mainly used for warming thin water, such as Xiaoqinglong Decoction, Linggan Wuwei Jiangxin Decoction, Ganjiang Lingshu Decoction, etc. Xiaoqinglong Decoction treats white phlegm cough Foamy and thin sputum, these symptoms are caused by drinking, drinking evil is relatively thin, fluid and diffusive, people’s symptoms are severe, or the secretion is thin.

Ginger is mainly used to reduce the thick phlegm, such as Xiaobanxia Decoction, Banxia Houpu Decoction, etc., Banxia Houpu Decoction treats chest tightness. Phlegm in the pharynx, sticky phlegm, or foreign body sensation in the pharynx, this is the texture is relatively heavy Muddy viscous or invisible sputum.

Author: Zheng Jun

Unit: Weihai Third Hospital

姜在我们生活是人人皆知,它不仅是食物,也是一味重要的药物,我在临床中误把干姜用成生姜,亲身体会到了二者在温化水饮功效上的区别。

患者,女53岁,哮喘咳嗽1年就诊,患者1年前无明显诱因出现咳嗽,用药物治疗病情时轻时重,近一个月来咳嗽加重,出现胸闷气短,夜晚发哮喘影响睡眠,哮喘发作时咳大量稀白色泡沫痰,口中和,怕冷,前胸后背怕凉,大便正常,小便饮水少略涩痛,舌胖大苔白齿痕。辨六经为太阳太阴合病,辨方证为小青龙汤方。

5天后二诊,告知服上方后咳嗽减轻,痰量略减少,看上次就诊记录时发现误把小青龙汤中的干姜写成了生姜,遂改之。三诊患者反馈,这次效果非常好,痰量明显减少,咳嗽也减轻。

《神农本草经》未录生姜,仅于干姜条言生者尤良,生姜《名医别录》:【生姜】味辛。微温。主治伤寒头痛鼻塞。咳逆上气。止呕吐。生犍为及荆州扬州。九月采。又云微温。辛。归五藏。去淡。下气。止呕吐。除风邪寒热。久服小志少智。伤心气。

干姜《神农本草经》:【干姜】味辛。温。主治胸满。咳逆上气。温中。止血。出汗。逐风湿痹。肠澼下痢。生者尤良。久服去臭气。通神明。生犍为川谷。

《名医别录》:【干姜】大热。无毒。主治寒冷腹痛。中恶。霍乱。胀满。风邪诸毒。皮肤间结气。止唾血。

看书或者听老师经常讲干姜温中化饮,生姜发汗健胃止呕,临床使用时就是按照原方的组成和老师的经验学着应用,没能真正的体会到药物的差别。

虽然这两个药都是治疗痰饮水湿的,但干姜以温化稀薄水饮为主,如小青龙汤、苓甘五味姜辛汤、甘姜苓术汤等,小青龙汤治疗的咳白痰泡沫样稀痰,这些症状是饮为患,饮邪相对稀薄流动和弥散性比较强,人的症状反应重,或者分泌物清稀。

生姜是以化粘稠的痰浊为主,如小半夏汤,半夏厚朴汤等,半夏厚朴汤治疗胸闷咽中有痰、痰粘咳不出来或是咽中有异物感,这就是质地比较重浊粘稠或是无形的痰饮。

作者:郑军

单位:威海市立三院

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