重用甘草為君論治頑固怔忡之病例報告

本論文探討病例苦於心律不整、經常出現陣發性心房纖維顫動（Paroxysmal atrial fibrillation）已超過十年，發作時伴隨嚴重恐慌、怔忡等症狀，經服用抗心律不整藥物及心導管射頻燒灼術（RFCA, Radiofrequency catheter ablation）治療但療效不足以緩解，現以中藥治療，其怔忡、心悸已獲控制，患者對療效相當滿意。筆者以少陰君火、離火之概念，重用甘草為君藥以安少陰君火，得到滿意療效，其法仿效李東垣《脾胃論》甘溫益元氣之法、及張仲景《傷寒論》中之少陰證，文中將分析其理法方藥，並討論甘草在歷代本草典籍中之相關論述，以期找出療效顯著且力專之治法來處理較為急重之症。

關鍵字

甘草；少陰病；心悸；怔忡

並列摘要

We present a case of 71-year-old woman who had suffered from cardiac arrhythmia with paroxysmal atrial fibrillation for more than ten years. The symptom of palpitation often accompanied with severe anxiety and panic attack. She had taken antiarrhythmic drugs, even performed Radiofrequency catheter ablation (RFCA), but all in vain. In contrast, after prescribing traditional Chinese medicine, the cardiac arrhythmia and all symptoms of palpitation and panic had been well controlled. The patient was quite satisfied with the efficacy of our medical treatment. In this study, the concept of Shao-Yin-Jun-Huo (少陰君火) and Li-Huo (離火) has been applied to prescribe large amount of Licorice (Gan-Cao甘草) as the main drug within the formula. The methods were referred to the theories of ＂Gan-Wen (甘溫)＂ medications to elevate body energy in the books of Pi-Wei-Lun (脾胃論), and Shao-Yin disease in Shang-Han-Lun (傷寒論). The theory, method, prescriptions, and applications of Licorice in the ancient herbal classics were clearly documented as well. Based on this successful treatable case, further application of traditional Chinese medical theory to critical illness with the similar diseases will be expected clinically.

並列關鍵字

Licorice (Glycyrrhiza uralensis) ； Shao-Yin disease ； Palpitation

參考文獻

Chao, TF,Wang, KL,Liu, CJ,Lin, YJ,Chang, SL,Lo, LW,Hu, YF,Tuan, TC,Chung, FP,Liao, JN,Chen, TJ,Chiang, CE,Lip, GY,Chen, SA(2015).Age threshold for increased stroke risk among patients with atrial fibrillation: a nationwide cohort study from taiwan.J Am Coll Cardiol..66,1339-1347.