龍膽瀉肝湯的臨床驗案解析

目前中醫臨床習用的龍膽瀉肝湯出自《醫方集解》，由酒炒龍膽草、炒黃芩、酒炒梔子、澤瀉、木通、車前子、酒洗當歸、酒炒生地黃、柴胡、生甘草所組成。吾等經驗認為臨床上運用此方劑，宜把握肝火上炎與肝經濕熱兩大主要病機，依疾病特質靈活加減其他藥物，可以治療多種疾病，例如：配合滋陰養血藥物可以治療頭面部的帶狀皰疹合併頭痛；配合滋陰清熱和燥濕殺蟲藥物可以治療念珠菌陰道炎；配合養腎陰涼血藥物可以治療乾癬合併心律不整；配合宣肺清熱、涼血養血藥物可以治療慢性蕁麻疹；配合使用滋陰清熱與活血化瘀藥物可以治療精索靜脈曲張合併不明熱。

關鍵字

龍膽瀉肝湯；帶狀皰疹；念珠菌陰道炎；乾癬；慢性蕁麻疹

並列摘要

The Long-Dan-Xie-Gan-Tang (LDXGT) decoction frequently used in clinical situation is derived from the ancient works of Yi-Fang-Ji-Jie，and consists of Gentian, Scutellaria, Gardenia, Alisma, Mutong, Plantago seed, Tangkuei, dried Rehmannia, Bupleurum, Licorice. When we use LDXGT decoction, we should focus on the two main pathogenesis of and the dampness-heat syndrome of liver meridian and liver Upflaming of liver fire. And then by properly adding some other drugs with LDXGT decoction, we can treat many other different disease. For example, we can add drugs that clear Qi heat, supplement the blood in LDXGT decoction to treat herpes zoster of head; we can add drugs that clear dampheat and nourishing Yin in LDXGT decoction to treat candida vaginitis; we can add drugs that clear blood heat and supplement kidney yin in LDXGT decoction to treat psoriasis with cardiac arrhythmia; we can add drugs that clear lung heat and supplement blood in LDXGT decoction to treat chronic urticaria; we can add drugs nourishing Yin and clear lung heat in LDXGT decoction to treat varicocele with unknown fever.