《伤寒论》苦酒汤治疗难治咽部溃疡1例并文献复习  

Kujiu decoction for refractory pharyngeal ulceration:a case report and literature review

作　　者：姚钰宁 张龙生[2] 孙静[2] 曹克刚[3] YAO Yuning;ZHANG Longsheng;SUN Jing;CAO Kegang(Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China;Tongzhou District,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 101121,China;Beijing University of Traditional Chinese Medicine Brain Disease Research Institute,Beijing 100027,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学东直门医院通州院区,北京101121 [3]北京中医药大学中医脑病研究院,北京100027

出　　处：《山东大学耳鼻喉眼学报》2023年第5期68-73,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发[2017]24号)。

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。Objective To report a case of refractory pharyngeal ulceration treated with Kujiu decoction according to the ancient Chinese literature,Shanghanlun,and study the specific syndrome and formulation of Kujiu decoction.Methods This study reviewed and summarized the diagnosis and treatment process of a case of refractory pharyngeal ulceration that was treated with Kujiu decoction.Findings from a review of the literature on the prescription,formulation,and indications of Kujiu decoction were summarized.Results Kujiu decoction was effective for pharyngalgia,pharyngeal ulcerations,and aphonia caused by “Shaoyin disease” and “Yin deficiency and fire exuberance syndromes”.Vinegar can be used as Kujiu.In Kujiu decoction,Kujiu,pinellia,and albumen were used together to achieve the effects of nourishing yin,clearing heat,and resolving phlegm,which in turn,treated pharyngalgia and pharyngeal ulceration.Zhang Zhongjing's method of adding albumen after the temperature of the decoction became lukewarm may enhance the effects.Clinically,Kujiu decoction can be used to treat acute and chronic pharyngitis,aphonia,laryngogenic cough,globus hysteriocus,and oral ulcerations after radiotherapy.Conclusion Kujiu decoction has definite clinical efficacy in the treatment of pharyngeal ulcerations and other pharyngeal diseases.Further studies on the optimal decoction formulation are warranted.Furthermore,in the future,studies that investigate its clinical applications and mechanisms of action are also necessary.

关 键 词：伤寒论 苦酒汤 咽部溃疡 煎服法 

分 类 号：R276.1[医药卫生—中医五官科学]