登革熱的中醫治療－文獻回顧與研究

背景：登革熱目前是世界上嚴重的蟲媒傳染病之一，目前西醫的治療方式主要為支持性療法例如輸液及輸血治療，尚未發展出抗病毒藥物。本文目的為探討登革熱的古今中醫藥治療，希望給登革熱的病患更全面的醫療照護。材料與方法：我們收錄2008－2018年間出版的文獻：八篇台灣本土疫情資料及疫區當地中醫院治療經驗、十七篇大陸當代醫家期刊論文及五篇現代研究關於中藥對抗登革熱的有效成份報導，統計登革熱的相關古籍文獻指引、常見證型、治則方藥等，總結了登革熱的中醫治療進展。結果：在三十篇中外的文獻中，有十七篇提及登革熱的中醫治療。根據統計結果，最常被引用為治療指引的中醫理論為「溫病學說」。登革熱最常出現的四種證型為衛氣同病、濕熱中阻、氣營（血）同燔及氣分熱盛。最常用的處方分別為銀翹散、三仁湯與達原飲、清瘟敗毒飲及白虎湯。在現代藥理研究中，有一些從清熱類、芳香開竅類中藥衍生的化合物，像是黃芩素、Diasarone-1、木犀草素、甘草次酸、金銀花的水萃取物等，能藉由抑制病毒複製、成熟與突變等作用，減少登革熱病毒的感染致病能力。關於中醫藥治療登革熱的臨床療效，值得進一步研究。

關鍵字

登革熱；中醫藥治療；溫病

並列摘要

Background: Dengue fever is currently one of the world's major insect vector epidemic disease, it reaches peak season during July to September in Taiwan. At present, the conventional treatment of dengue fever is supportive care, anti-viral drug or vaccination is still lack. This article aims to explore the syndrome / pattern characteristics and management of dengue fever in Chinese herbal medicine (CHM). Materials and Methods: This paper collected and analyzed eight articles of Taiwan endemic disease treatment experience, as well as seventeen articles related to CHM management of dengue fever from Chinese Journal Full-text Database and five articles from PubMed which majorly published between 2008 and 2018. Results: Mentioned in the seventeen of the above thirty articles, dengue fever belongs to ＂warm diseases＂ in traditional Chinese medicine (TCM) according to its clinical manifestations. The most common syndrome / pattern types and most popular treatment formula are ＂dual disease of defense and qi＂ managed by Yin-Qiao-San, ＂blockage of damp-heat＂ managed by Da-Yuan-Yin and San-Ren-Tang, ＂dual blaze of qi, construction and blood＂ managed by Qing-Wen-Bai-Du Decoction,＂ exuberant heat in the qi aspect＂ managed by Bai-Hu-Tang. In modern pharmacological research, some pure compound such as Baicalein, Luteolin, Carbenoxolone disodium and Diasarone-1extracted from single herbal medicines belonged to classes of ＂heat clearing＂ and ＂to open the orifices with aroma＂, were potential therapeutic intervention against dengue virus. Conclusions: Dengue fever has its own particular evolution with obvious seasonal and epidemic characteristics, CHMs have potential in treating dengue fever.