山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (5): 68-73.doi: 10.6040/j.issn.1673-3770.0.2022.469
姚钰宁1,张龙生2,孙静2,曹克刚3
YAO Yuning1, ZHANG Longsheng1, SUN Jing2, CAO Kegang3
摘要: 目的 报道《伤寒论》苦酒汤治疗难治咽部溃疡1例,学习苦酒汤治疗咽部溃疡的适应证候以及临床应用的具体方法。 方法 回顾、总结1例苦酒汤治疗难治咽部溃疡的诊疗过程,通过数据库检索、著作阅读的方式,从苦酒汤方证、煎服法及相关现代研究方面进行文献复习。 结果 苦酒汤多用于治疗少阴虚火灼咽所致咽痛、溃疡、失音。其中可以醋可代苦酒,用以解毒敛疮,鸡子白止痛润咽,半夏豁痰开痹。煎服法上多改良仲景之法,通过后下鸡子白的方法存其凉润之性。在临床上,苦酒汤可应用于急慢性咽喉炎、失音、喉源性咳嗽、梅核气以及放疗后口腔溃疡等疾病的治疗。 结论 苦酒汤对治疗咽部溃疡等咽部疾病具有确切临床疗效,但其药物选用、煎服法考证及改良、机制探索均有待进一步研究。
中图分类号:
[1] 刘锦, 王江娇, 刘静. 刘静从阳虚论治难治性咽部溃疡经验[J]. 辽宁中医杂志, 2019, 46(6): 1158-1160. doi:10.13192/j.issn.1000-1719.2019.06.011 LIU Jin, WANG Jiangjiao, LIU Jing. Liujing's experience in treating refractory pharyngeal ulcer from Yang deficiency[J]. Liaoning Journal of Traditional Chinese Medicine, 2019, 46(6): 1158-1160. doi:10.13192/j.issn.1000-1719.2019.06.011 [2] 艾思南, 王耀献, 王珍, 等. 《伤寒论》中“阴阳自和”概念浅析[J]. 北京中医药, 2021, 40(4): 399-401. doi:10.16025/j.1674-1307.2021.04.018 AI Sinan, WANG Yaoxian, WANG Zhen, et al. Analysis of “Yin and Yang self-harmony” in treatise on febrile diseases[J]. Beijing Journal of Traditional Chinese Medicine, 2021, 40(4): 399-401. doi:10.16025/j.1674-1307.2021.04.018 [3] 柯琴. 伤寒附翼[M].李顺保,程卫东校注. 北京: 学苑出版社, 2013 [4] 李中梓.李中梓医学全书·伤寒括要[M].2版,北京:中国中医药出版社,2016 [5] 钱潢. 伤寒溯源集[M].谢忠礼,陈素美校注. 北京: 中国中医药出版社, 2015 [6] 王叔和. 注解伤寒论[M].北京: 人民卫生出版社, 2012 [7] 刘渡舟. 刘渡舟伤寒论讲稿[M]. 王庆国,李宇航,陈萌 整理.北京: 人民卫生出版社, 2008 [8] 胡希恕. 伤寒论通俗讲话[M].冯世纶整理. 北京: 中国中医药出版社, 2008: 90 [9] 黄元御. 长沙药解[M].伍悦点校. 北京: 学苑出版社, 2011 [10] 危亦林. 世医得效方[M].戴铭校注. 2版. 北京: 中国中医药出版社, 2009 [11] 闫敏敏, 李天昊, 杨舒佳, 等. 医用“苦酒”文献源流考辨[J]. 中华中医药杂志, 2021, 36(7): 3900-3903 YAN Minmin, LI Tianhao, YANG Shujia, et al. Textual research on the origin and development of medical’Kujiu’ literature[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2021, 36(7): 3900-3903 [12] 卢之颐. 本草乘雅半偈[M].张永鹏校注. 北京: 中国医药科技出版社, 2014 [13] 陈亦人. 《伤寒论》求是(修订版)[M]. 上海: 上海科学技术出版社, 2012 [14] 巩颖, 顾媛媛, 刘文亚, 等. 基于临床中药学思维的半夏泻心汤临床用药探析[J]. 北京中医药, 2018, 37(10): 996-998. doi:10.16025/j.1674-1307.2018.10.024 GONG Ying, GU Yuanyuan, LIU Wenya, et al. Analysis of clinical medication of Banxia Xiexin Decoction based on clinical thinking of traditional Chinese medicine[J]. Beijing Journal of Traditional Chinese Medicine, 2018, 37(10): 996-998. doi:10.16025/j.1674-1307.2018.10.024 [15] 贺华, 刘闯, 王保华, 等. 论《伤寒杂病论》中半夏当为鲜半夏[J]. 亚太传统医药, 2019, 15(12): 63-65. doi:10.11954/ytctyy.201912021 HE Hua, LIU Chuang, WANG Baohua, et al. Pinelliae rhizome in treatise on cold pathogenic and miscellaneous diseases should be fresh pinelliae rhizoma[J]. Asia-Pacific Traditional Medicine, 2019, 15(12): 63-65. doi:10.11954/ytctyy.201912021 [16] 刘敏, 郭明章, 李宇航, 等. 仲景方中半夏用药剂量及配伍比例研究[J]. 北京中医药大学学报, 2010, 33(6): 365-368 LIU Min, GUO Mingzhang, LI Yuhang, et al. Dosage and combination proportion of Banxia(Rhizome Pinelliae)in ZHANG Zhongjing's formulas[J]. Journal of Beijing University of Traditional Chinese Medicine, 2010, 33(6): 365-368 [17] 左季云. 伤寒论类方汇参: 李可批注版[M]. 北京: 中国医药科技出版社, 2017 [18] 张锦, 王克穷. 苦酒汤治疗放疗后口腔溃疡体会[J]. 实用中医药杂志, 2015, 31(9): 866 ZHANG Jin, WANG Keqiong. Experience of kujiu decoction in treating oral ulcer after radiotherapy[J]. Journal of Practical Traditional Chinese Medicine, 2015, 31(9): 866 [19] 谈博, 操红缨. 少阴病咽痛之方证考释[J]. 中华中医药学刊, 2007, 25(2): 372-373. doi:10.13193/j.archtcm.2007.02.181.tanb.082 TAN Bo, CAO Hongying. Textual research on prescription and syndrome of sore Yin disease and pharyngalgia[J]. Chinese Archives of Traditional Chinese Medicine, 2007, 25(2): 372-373. doi:10.13193/j.archtcm.2007.02.181.tanb.082 [20] 林慧光. 陈修园医学全书: 明清名医全书大成[M]. 北京: 中国中医药出版社, 1999 [21] 李泽明, 程绍民. 浅析仲景论治少阴咽痛诸证[J]. 浙江中医杂志, 2020, 55(2): 149-150. doi:10.13633/j.cnki.zjtcm.2020.02.045 LI Zeming, CHENG Shaomin. Analysis of Shao-Yin pharyngalgia evidence of zhongjing treatment[J]. Zhejiang Journal of Traditional Chinese Medicine, 2020, 55(2): 149-150. doi:10.13633/j.cnki.zjtcm.2020.02.045 [22] 张众,田乐,赵莹,等.苦酒汤配方工艺优化及其药效机制研究[J/OL].中国现代应用药学:1-6[2023-02-20].http://kns.cnki.net/kcms/detail/33.1210.R.20220915.1639.002.html [23] 写国斌, 曾志秀. 加味苦酒汤治疗急性扁桃体炎80例疗效观察[J]. 中医临床研究, 2014, 6(17): 115-116. doi:10.3969/j.issn.1674-7860.2014.17.067 XIE Guobin, ZENG Zhixiu. Clinical observation on treating 80 cases of acute tonsillitis with Kujiu Decoction[J]. Clinical Journal of Chinese Medicine, 2014, 6(17): 115-116. doi:10.3969/j.issn.1674-7860.2014.17.067 [24] 李月. 改良苦酒汤促进慢性扁桃体炎术后恢复的临床疗效观察[D]. 南京: 南京中医药大学, 2020 [25] 王淑珍, 钟彦. 苦酒汤改良剂型治疗急性咽喉病53例[J]. 河南中医, 1998, 18(5): 63-64 WANG Shuzhen, ZHONG Yan. Treatment of 53 cases of acute throat disease with modified formulation of kujiu decoction[J]. Henan Traditional Chinese Medicine, 1998, 18(5): 63-64 [26] 徐建英. 苦酒汤治疗慢性咽炎358例[J]. 甘肃中医, 1995, 8(6): 14 XU Jianying. Treatment of 358 cases of chronic pharyngitis with kujiu decoction[J]. Gansu Journal of Traditional Chinese Medicine, 1995, 8(6): 14 [27] 刘玉平, 宋凤丽, 康宁, 等. 苦酒汤治疗急性放射性食管炎初探[J]. 中华中医药杂志, 2022, 37(6): 3200-3203 LIU Yuping, SONG Fengli, KANG Ning, et al. Preliminary study on Kujiu Decoction in treating acute radiation esophagitis[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2022, 37(6): 3200-3203 [28] 郑文少, 许先鑫, 郑亿彬, 等. 改良苦酒汤治疗喉源性咳嗽的临床研究[J]. 中国医药科学, 2011, 1(15): 118-118, 120 ZHENG Wenshao, XU Xianxin, ZHENG Yibin, et al. Report of the clinical effects by using improved Kujiu Decoction to cure against laryngeal cough[J]. China Medicine and Pharmacy, 2011, 1(15): 118-118, 120 [29] 朱安龙. 蒺麦饮合苦酒汤治疗梅核气70例[J]. 实用中医药杂志, 2001, 17(12): 7. doi:10.3969/j.issn.1004-2814.2001.12.005 ZHU Anlong. Globus hystericus(70 cases)treated by ji-Mei decotion and ku-Jiu decoction[J]. Journal of Practical Traditional Chinese Medicine, 2001, 17(12): 7. doi:10.3969/j.issn.1004-2814.2001.12.005 [30] 邵桂珍, 王延周. 苦酒汤治疗金实不鸣33例[J]. 湖北中医杂志, 1985, 7(5): 39 SHAO Guizhen, WANG Yanzhou. Treatment of 33 cases of golden stagnation with bitter wine decoction[J]. Hubei Journal of Traditional Chinese Medicine, 1985, 7(5): 39 [31] Osa M, Sato A, Sakagami M, et al. Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review[J]. BMC Infect Dis, 2021, 21(1): 252. doi:10.1186/s12879-021-05943-w [32] Luo L, Huang WH, Ren FF, et al. Pharyngeal ulceration and perforation: a rare manifestation in anti-MDA5 dermatomyositis[J]. Rheumatology(Oxford), 2021, 60(4): e132-e133. doi:10.1093/rheumatology/keaa730 [33] 侯波, 梁程程, 魏东敏, 等. 耳鼻咽喉门诊咽喉良性病变老年患者喉镜观察与嗓音声学分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 20-25. doi:10.6040/j.issn.1673-3770.1.2020.111 HOU Bo, LIANG Chengcheng, WEI Dongmin, et al. Laryngoscopy observation and voice acoustic analysis of elderly patients with benign laryngopharyngeal lesions in an ENT out-patient clinic[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 20-25. doi:10.6040/j.issn.1673-3770.1.2020.111 [34] 吴飞虎, 宋任洁, 钱雅琴, 等. 疏风解毒胶囊对急性咽炎大鼠干预作用及机制探讨[J]. 现代中西医结合杂志, 2021, 30(9): 923-925, 935. doi:10.3969/j.issn.1008-8849.2021.09.003 WU Feihu, SONG Renjie, QIAN Yaqin, et al. Intervention effect and mechanism of Shufeng Jiedu capsule on acute pharyngitis rats[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2021, 30(9): 923-925, 935. doi:10.3969/j.issn.1008-8849.2021.09.003 [35] 王思佳, 陈世华, 黄佩蓓. 中药抗慢性咽炎作用机制研究进展分析[J]. 陕西中医药大学学报, 2021, 44(6): 127-131. doi:10.13424/j.cnki.jsctcm.2021.06.026 WANG Sijia, CHEN Shihua, HUANG Peibei. Research progress of anti-chronic pharyngitis mechanism of traditional Chinese medicine[J]. Journal of Shaanxi University of Chinese Medicine, 2021, 44(6): 127-131. doi:10.13424/j.cnki.jsctcm.2021.06.026 [36] 刘克辉, 滕博, 辛丁, 等. 顽固性咽部溃疡中T淋巴细胞亚群的分布[J]. 中国免疫学杂志, 2004, 20(12): 873-874 LIU Kehui, TENG Bo, XIN Ding, et al. T-lymphocyte subsets distribution in recurrent pharyngeal ulcer[J]. Chinese Journal of Immunology, 2004, 20(12): 873-874 [37] 滕博, 金春顺, 辛丁, 等. 顽固性咽部溃疡黏膜中炎细胞的病理学意义[J]. 吉林大学学报(医学版), 2003, 29(2): 182-184. doi:10.13481/j.1671-587x.2003.02.029 TENG Bo, JIN Chunshun, XIN Ding, et al. Pathological significance of cell infiltrationin recurrent pharyngeal ulcer[J]. Journal of Norman Bethune University of Medical Science, 2003, 29(2): 182-184. doi:10.13481/j.1671-587x.2003.02.029 |
[1] | 范志涛,刘朝兵,乔振花. 以咽痛、咽部溃疡为主要表现的汞中毒1例[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 88-89. |
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