《温病条辨》青蒿鳖甲汤现代药理及临床应用研究进展

Research Advances on Modern Pharmacology and Clinical Application of Qinhao Biejia Decoction(青蒿鳖甲汤) of Detailed Analysis of Epidemic Warm Diseases

青蒿鳖甲汤出自《温病条辨》,系治疗温病后期阴虚邪伏代表性方剂,内清血中伏热、外透阴分伏邪。对原因不明发热及慢性疾病、肿瘤、血液病、术后消耗性发热,疗效显著,无严重不良反应,广泛应用于内、外、妇、儿等各科疾病。随着老龄化社会和疾病谱变化,邪伏阴分发热成为多种疾病共性证候,对"热自阴来"的发热,存在"夜热早凉,热退无汗"等诸证,无论有无阴虚症状或轻重,均可使用,须"审因论治",明确系温热病后期,邪伏阴分兼阴虚,灵活加减,阴虚较重加元参养阴滋液;虚热甚加地骨皮清透伏热。药理研究主要集中在白血病,已经证实青蒿鳖甲汤能阻止白血病细胞增殖进程,促进白血病细胞凋亡,降低s TNFαR含量,提高免疫力;促进DC分泌IL-12,增加抗肿瘤作用,其他方面研究较少。未来应深入研究作用机理和应用范围。

Qinhao Biejia decoction was originated from ＂Detailed Analysis of Epidemic Warm Diseases＂ . It is a representative prescription for the treatment of yin deficiency and evil in the late period of epidemic febrile diseases, and it can clear the latent heat in the blood and dispelling evil from the channels. It shows significant effects for the treatment of fever from unknown origins, other chronic diseases, tumor, hemopathy, and consuming fever after surgeries without serious adverse reactions. This prescription has been widely used in many diseases from the departments of Internal Medicine, General Surgery, Gynaecology and Paediatrics. With the development of aging society and the change of disease spectrum, fever from Yin points of evil has been the common syndrome of many diseases. For the fever from ＂Heat from Yin＂ , there are several common syndromes including ＂fever at night and normal in the morning＂ and ＂absense of sweat relief of fever＂ . Therefore, this prescription could be used regardless of the syndromes of deficiency of Yin and the degree of seriousness. However, it should be confirmed that it is in the later stages of epidemic febrile diseases, and perform flexible addition and subtraction of some TCMs according to the syndromes of different diseases. For example, Radix Scrophulariae should be added in this prescripti＇on to nourish Yin and increase the liquid if with the syndrome of deficiency of Yin. And cortex lycii radicis should be added to clear the latent heat if with the syndrome of severe deficiency-heat. Pharmacological studies have focused mainly on leukemia. It has been proved that Qinghao Biejia decoction can prevent the process of leukemia cell proliferation, promote apoptosis of leukemia cells, reduce the content of sTNF αR, and enhance immunity; promote DC IL-12 secretion, and increase the antitumor effects. However, limited studies have been carried out in other fields. In the future, we should study in depth the mechanisms and application scopes of Qinhao Biejia decoction.