林昌松辨治白塞病经验

LIN Chang-Song’s Experience in Differentiating and Treating Behcet’s Disease

白塞病可归属于中医“狐惑病”范畴。林昌松教授认为,白塞病乃本虚标实之证,肝郁脾虚为白塞病的根本病机,外感邪气为其发病诱因,湿热内蕴为其证候表现。林昌松教授采用《金匮要略》所载的甘草泻心汤,重用甘草,自拟“白塞方”“口炎方”治疗白塞病,取得了良好的临床疗效。林昌松教授基于中医经典的原文记载及临床用药经验,提出甘草之用量宜大,常用30~40 g。针对脾胃虚弱证明显的白塞病患者,治以“白塞方”(由炙甘草、党参、鹿衔草、法半夏、干姜、黄芩、黄连等组成)加减,宜用炙甘草;针对湿热炽盛的白塞病患者,拟“口炎方”(组成药物为生甘草、黄芩、黄连、法半夏、干姜、大枣、太子参、薄树芝、淡竹叶、车前子等)治疗,宜用生甘草。同时强调患者平素“食饮有节,起居有常,不妄作劳”对防止白塞病复发的重要性。

Behcet’s disease can be classified into the category of fox-creeper disease in the field of traditional Chinese medicine(TCM).Professor LIN Chang-Song believes that the pathogenesis of Behcet’s disease is characterized by deficiency in origin and excess in superficiality,and liver depression and spleen deficiency is the fundamental pathogenesis of Behcet’s disease.The cause of Behcet’s disease is due to exogenous attack of pathogenic qi,and the disease has the syndrome manifestation of internal accumulation of damp-heat.For the treatment of Bechet’s disease,the use of self-made Baisai Prescription and Kouyan Prescription which were derived from Gancao Xiexin Decoction recorded in Jin Gui Yao Lve(Essentials from the Golden Cabinet)together with large dosage of Glycyrrhizae Radix et Rhizoma has achieved good clinical efficacy.According to the original records of traditional Chinese Medicine classics and by combining the clinical medication experience,Professor LIN Chang-Song proposed that the dosage of Glycyrrhizae Radix et Rhizoma should be enlarged,usually in the dose of 30-40 g.For the treatment of patients with Behcet’s disease with obvious spleen and stomach deficiency syndrome,modified Baisai Prescription(composed of Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Codonopsis Radix,Pyrolae Herba,Pinelliae Rhizoma Praeparatum,Zingiberis Rhizoma Recens,Scutellariae Radix,Coptidis Rhizoma,etc.)is adopted and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle should be used.For the treatment of patients with intense damp-heat type of Behcet’s disease,Kouyan Prescription(composed of Glycyrrhizae Radix et Rhizoma,Scutellariae Radix,Coptidis Rhizoma,Pinelliae Rhizoma Praeparatum,Zingiberis Rhizoma Recens,Jujubae Fructus,Pseudostellariae Radix,Ganoderma Capense,Lophatheri Herba,Plantaginis Semen,etc.)is recommended and raw Glycyrrhizae Radix et Rhizoma should be adopted.Moreover,the importance of having proper eating and drinking,keeping regular living and avoiding to overwork to prevent the recurrence of Behcet’s disease was stressed.