【作者】 陈薇莉；

【导师】 马健；

【作者基本信息】 南京中医药大学 ， 中医临床基础， 2009， 博士

【摘要】 经方的应用在近代中医临床研究上益发展露头角,以其方虽简,却用量讲究,配伍严谨,疗效卓著,临床随证选用,每建奇功。此次研究特选白头翁汤来做探讨。白头翁汤首见于张仲景的《伤寒论·厥阴篇》:“热利下重者,白头翁汤主之。下利欲饮水者,以有热故也,白头翁汤主之”。传统为治疗热痢下重的中医经方。本论文的目的为探求古方中是否能再找出新思维?白头翁汤是否仅能用于治疗热痢,若配伍其他方药或方剂是否更能强化其作用抑或能用于新的疾病治疗上。甚者,于现代临床使用上有何新的方法与禁忌。通过对白头翁汤相关文献的研究,详细地比对白头翁汤方源的组成及不同的功效,并回顾了该方在我国古代临床应用的历史,结合现代的临床应用,对白头翁汤的病因病机及药理进行了相关的分析研究。发现白头翁汤的病因为湿热,其表现常兼肝火、湿热、气滞三者互结之证。除具备了清热燥湿、凉肝解毒的功效外,也确立了归经于肝,为治疗厥阴热利主药的盛誉。此外立基于上,通过现代各大医师于期刊发表之白头翁汤新用及在台湾中医院临床应用体会,探讨了白头翁汤的常用治疗疾病谱和加减药物后对不同疾病的诊治,发现,白头翁汤的适应症非常广泛。从基本的热痢表现如急、慢性结肠炎,细菌性痢疾,慢性非特异性结肠炎等。到湿热气滞或兼夹火毒表现者皆可参酌用之。如痔疮、泌尿道感染、湿疹、带状疱疹、银屑病、产后血淋、带下、痿症等。又以其病位在肝、大肠,故可以使用于症如急性结膜炎、肝胆囊疾患、妇女乳痈、月经病、军丸炎、反复性鼻衂、肝脾不和所致之胃炎、木火刑金之肺系疾病等。当然,经现代药理学研究证实,白头翁汤煎液对细菌有抑制作用,并能杀灭阿米巴原虫和阴道滴虫。故可用于相关感染性疾患的治疗,如阿米巴痢疾,阿米巴肝脓疡,细菌性痢疾,泌尿道感染,霉菌及滴虫性阴道炎,急慢性盆腔炎、人芽囊原虫病等。也发现在治疗使用汤药的方法上除去口服之外还有灌肠、甚至外敷等方法对疗效的增加有正向的帮助。又,以方中四药尽皆苦寒原不适用于阴虚血少或脾胃虚寒者但透过适当的加减则仍可使用收效。所以慎用而毋须禁用。透过对白头翁汤的研究,期望能让更多的人了解中医方药应用广泛,在某些疾病治疗上与西方医学有不惶多让之效,甚至,毒副作用更小,从而关心中医药、热爱中医药药和研究中医药。更多还原

【Abstract】 The research of classical remedy is much more popular than usual in Chinese medicine modern research. As we know, the composition of classical remedy is simple but with good effects.In this paper, the author of Pulsatilla Decoction literature research, detail the composition of Pulsatilla Decoction and different efficacy and recalled in the clinical application of China’s ancient history.Pulsatilla Decoction is an ancient remedy in《On Cold Damage》from Jing Zhong Zhang and it is a major remedy for reverting yin dysentery with heat. In this research, we want to know is there any other diseases can be cured by Pulsatilla Decoction or addition and subtraction on its composition of drugs.Author modern clinical application of pharmacological Pulsatilla Decoction conducted an analysis of related research. Through the author at Clinical application of Chinese medicine hospital in Taiwan to explore the Pulsatilla Decoction common diseases and treatment of drug addition and subtraction on the diagnosis and treatment of different diseases, as well as the prescriptions of the type of identification and drug delivery methods。And we find the indications of Pulsatilla Decoction exceeded our expectations In addition to the indications beyond the basic such as acute colitis, chronic colitis、bacillary dysentery、chronic non-specific colitis, there are damp-heat pattern, qi stagnation pattern and fire toxin pattern, such as hemorrhoids, urinary tract infection、eczema、herpes zoster, psoriasis、post-natal blood strangury、vaginal discharge, wilting disease. And Pulsatilla Decoction also can cool the liver and extinguish wind, so, it can cure the diseases such as acute conjunctivitis, liver and gallbladder disease、mammary welling-abscess、gastritis caused by liver-spleen disharmony. By modern pharmacology research has shown that Pulsatilla Decoction can inhibit bacteria、kill the parasite entamoeba and trichomonas vaginalis, so, it can used in treatment for infection disease.Through the research of Pulsatilla Decoction make more people know of this Chinese medicine, make them love Chinese medicine and research Chinese medicine更多还原