钩吻，中药名。为马钱科胡蔓藤属植物胡蔓藤Gelsemium elegans（Gardn.et Champ.）Benth.[Medicia elegans Gardn.et Champ]的全株。具有祛风攻毒，散结，止痛的功效。主治疥癞，湿疹，瘰疬痈肿，疔疮，跌打损伤，风湿痹痛，神经痛。
Gou-wen, name of Chinese Medicinal Material. It refers to the whole plant of Gelsemium elegans (Gardn.et Champ.) Benth. [Medicia elegans Gardn.et Champ], a plant of the family Loganiaceae. It has the effects of dispelling wind, detoxification, promoting blood circulation, and relieving pain. It is mainly used to treat scabies, eczema, lymphadenitis, carbuncles, furuncles, bruises, rheumatism, and neuralgia.

功效作用 Efficacy and Functions

祛风攻毒，散结，止痛。
Dispelling wind, attacking toxins, dispersing masses, and relieving pain.

主治 Indications

疥癞，湿疹，瘰疬痈肿，疔疮，跌打损伤，风湿痹痛，神经痛。
Scabies, eczema, lymphadenitis, carbuncle, contusions, rheumatic pain, neuralgia.

用法用量 Dosage and Administration

外用：捣敷；或研末调敷；或煎水洗；或烟熏。
External application: pounded application; or powder mixed with water for application; or decoction for washing; or fumigation.

注意事项 Precautions

本品有剧毒，误服后极易引起中毒，出现眩晕、视物模糊、瞳孔散大、剧烈腹痛、口吐白沫、呼吸麻痹、全身肌肉松弛、胃肠出血等症状，甚至可引起死亡，故只作外用，禁作内服。
This product is highly toxic. Ingestion can easily lead to poisoning, with symptoms such as dizziness, blurred vision, dilated pupils, severe abdominal pain, foaming at the mouth, respiratory paralysis, muscle relaxation throughout the body, gastrointestinal bleeding, and even death. Therefore, it is only for external use and should not be taken internally.

化学成分 Chemical Composition

钩吻含生物碱：钩吻碱子（gelsemine），钩吻碱丑（koumine），即是钩吻碱，钩吻碱寅（koumidine），钩吻碱卯（gelsamidine），钩吻碱丙即是常绿钩吻碱（semiglabrin），钩吻碱丁（gelsenicine），钩吻碱戊（humantenine）；茎中含钩吻碱子和常绿钩吻碱，叶含钩吻碱子、丑、丁和钩吻碱辰等。胡蔓藤碱甲（rhynchophylline A），胡蔓藤碱乙，胡蔓藤碱丙，胡蔓藤碱丁，阿枯米定碱（akuammidine），16-表伏康树卡平碱（16-epi-vocamine），19-羟基二氢-1-甲氧基钩吻碱（19-hydroxydihydro-1-methoxygelsemicine），氢钩吻碱子（higenamine）等。
The plant contains alkaloids: gelsemine, koumine (also known as Gelsemium alkaloid), koumidine, gelsamidine, semiglabrin (also known as evergreen Gelsemium alkaloid), gelsenicine, humantenine; the stem contains gelsemine and semiglabrin, while the leaves contain gelsemine, koumine, gelsenicine, and gelsemicine. It also contains rhynchophylline A, rhynchophylline B, rhynchophylline C, rhynchophylline D, akuammidine, 16-epi-vocamine, 19-hydroxydihydro-1-methoxygelsemicine, higenamine, and others.

药理作用 Pharmacological Effects

1. 镇痛作用：本品全草提得之钩吻总碱有显著的镇痛作用，小鼠热板法试验腹腔注射0.5mg/kg、1.0mg/kg和2.0mg/kg均有显著镇痛效果，30min时镇痛作用的ED50为0.28mg/kg，醋酸所致小鼠扭体反应灌胃时为0.39mg/kg，腹腔注射为0.28mg/kg，光热刺激大鼠甩尾试验腹腔注射给药的ED50为0.5mg/kg。连续给药小鼠对钩吻总碱镇痛作用无耐受性。

2. Analgesic effect: The total alkaloids extracted from the whole plant have a significant analgesic effect. In the hot plate test on mice, intraperitoneal injections of 0.5mg/kg, 1.0mg/kg, and 2.0mg/kg all showed significant analgesic effects. The ED50 of the analgesic effect at 30 minutes was 0.28mg/kg; for acetic acid-induced writhing in mice, it was 0.39mg/kg by oral administration and 0.28mg/kg by intraperitoneal injection. The ED50 for the tail-flick test in rats after intraperitoneal injection was 0.5mg/kg. Continuous administration showed no tolerance in mice to the analgesic effect.

3. 镇静作用：钩吻总碱肌注或皮下注射0.5mg/kg、0.7mg/kg和1mg/kg均可显著增强阈下剂量戊巴比妥钠及水合氯醛对小鼠的中枢抑制作用，明显增加翻正反射消失鼠数；钩吻总碱还可使大鼠自发活动明显减少，外观安静，表明钩吻总碱有持久的中枢抑制作用。

4. Sedative effect: Intramuscular or subcutaneous injections of 0.5mg/kg, 0.7mg/kg, and 1mg/kg of the total alkaloids significantly enhanced the central inhibitory effects of sub-threshold doses of pentobarbital sodium and chloral hydrate in mice, increasing the number of mice losing righting reflex. The total alkaloids also significantly reduced spontaneous activity in rats, appearing calm, indicating a persistent central inhibitory effect.

5. 抗炎作用：钩吻总碱皮下或腹腔注射1mg/kg，对鹿角菜胶、蛋清所致大鼠脚肿有显著的抑制作用，皮下注射0.5mg/kg还可显著抑制大鼠棉球肉芽组织增生。由于钩吻总碱对幼年大鼠胸腺、肾上腺重量无明显影响，也不影响大鼠血浆皮质醇浓度，但可使鹿角菜胶所致肿胀大鼠鼠爪PGE含量明显降低，提示其抗炎机制不是通过垂体-肾上腺皮质系统，而是与抑制炎症部位前列腺素合成有关。

6. Anti-inflammatory effect: Subcutaneous or intraperitoneal injections of 1mg/kg of the total alkaloids significantly inhibited paw edema in rats induced by carrageenan or egg white. Subcutaneous injection of 0.5mg/kg also significantly inhibited granulation tissue formation in rats. As the total alkaloids had no effect on thymus and adrenal weights or plasma cortisol levels in young rats, but reduced PGE levels in swollen paws, the anti-inflammatory mechanism appears to involve inhibition of prostaglandin synthesis rather than activation of the pituitary-adrenal cortex system.

7. 散瞳作用：实验表明所含钩吻碱对家兔有明显散瞳作用，且恢复快。以1%钩吻碱溶液给人点眼，每次2滴，每5min一次，共3次。69例志愿者可见瞳孔迅速扩大，作用强，恢复也快，滴眼后30min即可见瞳孔直径、远视力、近视力、近点调节等均有明显改变，至6h各指标几乎恢复至给药前水平。

8. Mydriatic effect: Experiments show that the alkaloids cause significant mydriasis in rabbits, with rapid recovery. Instillation of 1% alkaloid solution into human eyes (2 drops every 5 minutes for 3 times) resulted in rapid pupil dilation in 69 volunteers. Significant changes in pupil diameter, visual acuity, near vision, and accommodation were observed within 30 minutes, and most parameters returned to baseline by 6 hours.

9. 抗肿瘤作用：钩吻碱注射液于体外对人肺腺癌细胞AGZY-83-a和胃腺癌细胞Sc-823的增殖有一定抑制作用，可使癌细胞增长速度减慢，有丝分裂指数下降，细胞膜脂流动性降低，死亡率增高。钩吻醇提物每日（以生药计）0.45g/kg、0.11g/kg连续灌胃给药14天，对小鼠移植性肉瘤S180实体型生长均有明显的抑制作用，但对小鼠移植性肝癌实体型生长抑制不明显。

10. Anti-tumor effect: The alkaloid injection inhibited proliferation of human lung adenocarcinoma cells (AGZY-83-a) and gastric adenocarcinoma cells (Sc-823) in vitro, slowing growth, reducing mitotic index, decreasing membrane fluidity, and increasing cell death. Oral administration of the alcohol extract (0.45g/kg and 0.11g/kg daily for 14 days) significantly inhibited the growth of S180 sarcoma in mice, but had no significant effect on solid hepatoma.

11. 对免疫功能的影响：本品根茎乙醇粗提取物腹腔注射0.1g/kg可使小鼠腹腔巨噬细胞对鸡红细胞的吞噬百分率及吞噬指数均明显增高，并明显拮抗环磷酰胺所致吞噬功能抑制；对小鼠溶血素抗体生成及体内淋巴细胞转化无明显影响，但可显著拮抗环磷酰胺的抑制作用。

12. Effects on immune function: Intraperitoneal injection of 0.1g/kg ethanol extract from the rhizome significantly increased phagocytosis rate and index of peritoneal macrophages in mice against chicken red blood cells, and antagonized cyclophosphamide-induced suppression. It did not affect hemolysin antibody production or lymphocyte transformation, but significantly counteracted the immunosuppressive effect of cyclophosphamide.

13. 对心脏的影响：钩吻水溶性总碱1%浓度以2ml/kg给蟾蜍淋巴囊或大鼠腹腔注射，可见蟾蜍心率明显减慢，P波时限延长，QRS波群时间延长，ST段和QT时间延长，P波、R波和T波压均降低，表明其有负性变时变力和变传导作用，并可能有心肌缺血存在；而对于大鼠，则除ST段电压降低及QT时限延长外，余无明显影响。

14. Effects on the heart: Injection of 1% aqueous total alkaloids at 2ml/kg into the lymph sac of toads or peritoneal cavity of rats caused bradycardia, prolonged P-wave, QRS complex, ST segment, and QT interval, and reduced amplitudes of P, R, and T waves in toads, indicating negative chronotropic, inotropic, and dromotropic effects, possibly with myocardial ischemia. In rats, only decreased ST voltage and prolonged QT interval were observed.

15. 对平滑肌的影响：钩吻水溶性总碱对豚鼠肺支气管灌流可显著降低流出量，表明其可使支气管平滑肌收缩，异丙肾上腺素对此有拮抗作用，但苯海拉明无拮抗效果，表明其收缩支气管平滑肌作用与组胺H1受体无关，而可能与β受体有关。

16. Effects on smooth muscle: The water-soluble total alkaloids significantly reduced outflow in guinea pig bronchial perfusion, indicating bronchoconstriction. Isoproterenol antagonized this effect, but diphenhydramine did not, suggesting the action is unrelated to histamine H1 receptors but may involve β-receptors.

17. 其他作用：钩吻总生物碱2.5-10mg/ml本身无致突变作用，但却可抑制UV和MNNG（N-甲基-N-硝基-N1-亚硝基胍）引起的大肠杆菌倾向差错修复反应（SOS），而不能抑制苯并芘（B(a)P）所致突变，也无抗突变作用。

18. Other effects: The total alkaloids (2.5–10 mg/ml) are not mutagenic but inhibit UV- and MNNG-induced SOS error-prone repair in Escherichia coli. They do not inhibit mutations induced by benzo[a]pyrene (B(a)P) and lack anti-mutagenic activity.

毒理作用 Toxic Effects

钩吻生物碱的毒性（小鼠腹腔注射）LD50（mg/kg）：钩吻素甲56.2，N1-甲基钩吻素甲63.1，钩吻素丁＞125，钩吻素戊>125，钩吻素子100，钩吻素已0.165，钩吻素庚2.83，胡蔓藤碱甲0.21。钩吻总碱注射液给麻醉大鼠静注，0.9mg/kg对大鼠呼吸、血压、心电及脑电四项指标均无明显影响；1.8mg/kg（相当于人用药10倍），对大鼠呼吸、脑电无明显影响，但给药后20-40min期间出现血压下降、心率减慢，60min后逐渐恢复正常；3.6mg/kg（相当于人用量20倍）对大鼠呼吸、血压、心电和脑电指标均有明显抑制作用，在动物死亡过程中首先是表现为呼吸停止，然后脑电、心电消失，说明大鼠死亡的主要原因是呼吸中枢麻痹。该药随着剂量的加大，上述四项指标中的抑制过程呈正变量效关系，提示临床使用该药时要严格控制剂量。
Toxicity of Gelsemium alkaloids (intraperitoneal injection in mice) LD50 (mg/kg): gelsemine 56.2, N1-methylgelsemine 63.1, gelsenicine >125, humantenine >125, koumine 100, koumine H 0.165, koumine G 2.83, rhynchophylline A 0.21. Intravenous injection of total alkaloids in anesthetized rats: 0.9 mg/kg had no significant effect on respiration, blood pressure, ECG, or EEG; 1.8 mg/kg (10× human dose) had no effect on respiration or EEG, but caused transient hypotension and bradycardia (20–40 min post-injection), recovering by 60 min; 3.6 mg/kg (20× human dose) significantly suppressed all four parameters. Death was primarily due to respiratory center paralysis. The dose-dependent suppression indicates the need for strict dosage control in clinical use.

相关论述 Relevant Discussion

1. 治痈疮肿毒：生断肠草120g，黄糖15g。共捣敷患处。

2. 治风湿关节痛：干断肠草30g，防风6g，独活3g，共研粗末，用纸卷烧烟熏患处。（1、2方出自《广西药用植物图志》）

3. 治远年臁疮：鲜大茶药500g。煎水洗患处，日洗数次，洗后将药叶一张贴疮口。

4. 治瘭疽：大茶药叶、石灰。二味捣烂，贴患指第三节，有脓即溃，无脓即消。（3、4方出自《岭南草药志》）

5. Treatment for abscess and swelling: 120g fresh Gelsemium elegans, 15g brown sugar. Crush and apply to affected area.

6. Treatment for rheumatic joint pain: 30g dried Gelsemium elegans, 6g Saposhnikovia divaricata, 3g Angelica pubescens. Grind into coarse powder, roll in paper, burn and fumigate the affected area. (Prescriptions 1 and 2 from Guangxi Medicinal Plant Illustrated Handbook.)

7. Treatment for chronic ulcers: 500g fresh Gelsemium elegans. Boil and wash affected area several times daily; after washing, apply one leaf directly to the ulcer.

8. Treatment for carbuncle: Gelsemium elegans leaves and lime. Crush and apply to the third joint of the affected finger; if pus is present, it will drain; if not, the lesion resolves. (Prescriptions 3 and 4 from Lingnan Herbal Medicine Treatise.)

临床应用 Clinical Application

1. 治痈疮肿毒：生断肠草120g，黄糖15g。共捣敷患处。

2. 治风湿关节痛：干断肠草30g，防风6g，独活3g。共研粗末，用纸卷烧烟熏患处。（1、2方出自《广西药用植物图志》）

3. 治远年臁疮：鲜大茶药500g。煎水洗患处，日洗数次，洗后将药叶一张贴疮口。

4. 治瘭疽：大茶药叶、石灰。二味捣烂，贴患指第三节，有脓即溃，无脓即消。（3、4方出自《岭南草药志》）

5. Treatment for abscess and swelling: 120g fresh Gelsemium elegans, 15g brown sugar. Crush and apply to affected area.

6. Treatment for rheumatic joint pain: 30g dried Gelsemium elegans, 6g Saposhnikovia divaricata, 3g Angelica pubescens. Grind into coarse powder, roll in paper, burn and fumigate the affected area. (Prescriptions 1 and 2 from Illustrated Handbook of Medicinal Plants in Guangxi.)

7. Treatment for chronic leg ulcers: 500g fresh Gelsemium elegans. Boil and wash affected area multiple times daily; after washing, apply one leaf to the ulcer.

8. Treatment for carbuncle: Gelsemium elegans leaves and lime. Crush and apply to the third joint of the affected finger; promotes drainage if pus is present, otherwise resolves inflammation. (Prescriptions 3 and 4 from Compendium of Southern Medicinal Herbs.)

加工炮制 Processing and Preparation

采收加工：全年均可采，切段，晒干或鲜用。
Harvesting and processing: Can be harvested year-round, cut into sections, sun-dried or used fresh.

药材鉴别 Medicinal Material Identification

药材性状：茎呈圆柱形，外皮灰黄色至黄褐色，具深纵沟及横裂隙；幼茎较光滑，黄绿色或黄棕色，具细纵纹及纵向椭圆形突起的点状皮孔。节稍膨大，可见叶柄痕。质坚，不易折断，断面不整齐，皮部黄棕色，木部淡黄色，具放射状纹理，密布细孔，髓部褐色或中空。气微，味微苦，有毒。叶不规则皱缩，完整者展平后呈卵形或卵状披针形，先端渐尖，基部楔形或钝圆，叶脉于下面突起，侧脉4-5对，上面灰绿色至淡棕褐色，下面色较浅。气微，味微苦。
Characteristics: Stem is cylindrical, outer skin gray-yellow to yellow-brown, with deep longitudinal grooves and transverse fissures; young stems are smoother, yellow-green or yellow-brown, with fine longitudinal lines and elliptical raised lenticels. Nodes slightly swollen with visible leaf scars. Texture hard, difficult to break, uneven fracture; bark yellow-brown, wood light yellow with radial pattern and fine pores, pith brown or hollow. Slight odor, slightly bitter taste, toxic. Leaves irregularly wrinkled; when flattened, ovate or ovate-lanceolate, apex gradually pointed, base cuneate or rounded, veins prominent beneath, 4–5 pairs of lateral veins, upper surface gray-green to pale brown, lower surface lighter. Slight odor, slightly bitter taste.

植物学信息 Botanical Information

植物种属：马钱科胡蔓藤属植物胡蔓藤。
Species: Gelsemium elegans (Benth.) A. Gray, family Loganiaceae (previously classified under Menispermaceae).

形态特征 Morphological Characteristics

常绿藤本，长约12m。枝光滑，幼枝具细纵棱。单叶对生；具短柄；叶片卵状长圆形至卵状披针形，长5-12cm，宽2-6cm，先端渐尖，基部楔形或近圆形，全缘。聚伞花序多顶生，三叉分枝，苞片2，短三角形；萼片5，分离；花小，黄色，花冠漏斗形，先端5裂，内有淡红色斑点，裂片卵形，先端尖，较花筒短；雄蕊5；子房上位，2室，花柱丝状，柱头4裂。蒴果卵状椭圆形，下垂，基部有宿萼，果皮薄革质。种子长圆形，多数，具刺状突起，边缘有翅。花期5-11月，果期7月至翌年2月。
Evergreen woody vine, up to 12 meters long. Stems smooth, young stems with fine longitudinal ridges. Leaves opposite, short-petioled; blades ovate-oblong to ovate-lanceolate, 5–12 cm × 2–6 cm, apex acuminate, base cuneate or nearly round, margins entire. Inflorescences terminal cymes, trichotomously branched, with 2 small triangular bracts; sepals 5, free; flowers small, yellow, funnel-shaped corolla with 5 lobes, pale red spots inside, ovate acute lobes shorter than tube; stamens 5; superior ovary, 2-celled, filiform style, 4-lobed stigma. Capsule ovoid-ellipsoid, pendulous, base with persistent calyx, thin leathery pericarp. Seeds oblong, numerous, spiny, winged at margins. Flowering from May to November, fruiting from July to February next year.

分布区域 Distribution Area

分布于浙江、福建、江西、湖南、广东、广西、海南、贵州、云南、台湾等地。
Distributed in Zhejiang, Fujian, Jiangxi, Hunan, Guangdong, Guangxi, Hainan, Guizhou, Yunnan, Taiwan and other regions.

生长环境 Growing Environment

生于海拔500-2000m的向阳山坡、路边草丛或灌丛中。
Found on sunny slopes, roadside grasslands, or shrublands at altitudes of 500–2000 meters.