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 bie jia jian wan 鱉甲煎丸  (in English and Chinese 中英文)

 Translated and edited by: Joe Hing Kwok Chu    朱興國编譯

 

Name of Formula: bie jia jian wan  (Jin Gui Yao Lue)

Application:  Cirrhosis of liver, enlargement of liver and spleen, liver cancer with syndrome of tight and thin pulse, lack luster of tongue, lump(s) under rib cage which can not be moved when pushed.

Medical Function:

After using this formula in chronic hepatitis, cirrhosis of liver, the liver and spleen can reduce the sizes due to enlargement, improve liver function, reduce the concentration of zinc sulphate and 5-Methyl-2-isopropylphenol (thymol), correct the A/G ratio. It can improve the syndrome and prolong lives of liver cancer patients.

Composition:

bie jia (baked) 12 parts, tao ren 2 parts, chai hu 6 parts, jiang lang (boiled) 6 parts, she gan ((prepared),huang qin 3 parts,  shu fu (boiled), gan jiang 3 parts, da huang 3 parts,  gui zhi 3 parts, shi wei (rid of hair) 3 parts, hou po 3 parts,  qu mai 3 parts,  ling xiao hua 3 parts,  e jiao 3 parts, feng ke (bakd) 4 parts,  chi xiao 12 parts, shao yao 5 parts,  dan pi 5 parts,  tu bie chong (boiled) 5 parts, ren shen  1 part, ban xia 1 part, ting li zi 1 part.
 

Take 3 g each time. 3 times a day.

Note: A/G test is also known as TP, Albumin/Globulin ratio test.

 

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鱉甲煎丸 (金櫃要略)

【主治】瘧疾日久不愈,脅下痞硬有塊,肝臟硬化,以及便秘。
1.本方為消
散結(可縮小腫大了的肝臟脾臟)之名方。以脅下癖塊,觸之鞭痛, 推之不移,舌黯無華,脈弦細為証治要點。
2.常用於治療肝癌,肝硬化 ,肝脾腫大,等病,符合上述証治要點者。


〖組成〗 

鱉甲 (炙) 十二份,桃 仁 二 份 ,柴 胡蜣螂 (熬),各 六份
射干(炮),黃 芩, 鼠婦(熬),乾 薑大 黃  桂枝石 葦(去 毛),厚 樸瞿 麥凌霄花阿膠, 各 三份, 蜂窠炙 四 份 ,赤硝十二份,芍 藥牡丹皮土 鳖虫 (熬),各五份 ,人 參半夏葶靂子 各一份
 

用法:取灶 下灰三斤, 黃酒10斤,浸灰內濾過取汁,煎鱉甲成膠狀,其餘二十二味共為細末,將 鱉甲膠放入煉蜜中 ,和勻為小丸,每服3g,每日三次。

【藥理作用】

1.抗肝纖維化作用: 本藥方中
鱉 甲土 鳖虫桃 仁有 抑制結締組織增生作用,鱉甲富含蛋白質 ,氨基酸,微量元素,故 能提高血漿蛋白。

2.免疫調節作用 鱉甲能增強體液免疫功能,而桃仁,丹皮等能抑制細胞免疫功能,故本藥對肝病患者的免疫功能紊亂有一定的調節作用。

【禁忌】孕 婦忌服 。由 於本方長於消癥散 結(可縮小腫大了的肝臟脾臟), 但是扶正之力不足,若肝脾腫 大而正氣虛甚者慎用。


【臨床應用】
1. 慢性肝炎,肝硬化 (肝組織壞死): 用本藥治療後,能降低硫酸鋅濃度和麝香草酚濃度,糾正A/G比值失常,促進肝脾回縮,改善肝功能。用本藥治 療 後,能降低硫酸鋅濃 度和麝香草酚濃度,糾正A/G比值失常,促進肝 脾回縮,改善肝功能。
2.肝癌: 能改善症狀,延長存活期。

《千金方》去 鼠婦,赤硝,而加海藻大 戟, 以軟堅化水更妙。

註:A/G ratio. 白蛋白(Albumin)和球蛋白(G)的比率顯示病變程度的關係。
 

鱉甲煎丸聯合大黃(庶虫)虫丸抗肝纖維化的臨床研究
Clinical Study on Bie-jia-Jian Pills and Da-huang -zhe-zhong Pills in the Treatment of Hepatic Fibrosis
<<實用中西醫結合臨床 >>2006年02期
陳明 , 楊慧芳 , Chen Ming , Yang Hui-fang

 

目的:研究鱉甲煎丸聯合大黃(庶虫)虫丸抗肝纖維化的作用.方法:以臨床診斷為肝纖維化患 者220例為觀察對象,隨機分為4組,每組55例,設(A)對 照 組,(B)鱉甲煎丸組,(C)大黃(庶虫)虫丸組,(D)鱉甲煎丸+大黃(庶虫)虫丸聯 合用藥組,分別治療,觀察治療前後肝纖維化血清學指標:肝纖 四項 (透明質酸HA,層粘連蛋白LN,Ⅳ型膠原CⅣ,Ⅲ型前膠原氨基端肽PⅢNP)和彩色多 普勒超聲檢查:血流動力學指標(門靜脈內徑,門靜脈平均血 流速度, 脾靜脈內徑,脾靜脈平均血流速度).結果:除對照組外,肝纖四項指標均低於治療前,血 流動力學得以改善,鱉甲煎丸組和大黃(庶虫)虫丸2組無 明顯區別 (P>0.05),但 與對照組相比明顯改善(P<0.05),聯合組與對照組,鱉甲煎 丸組和大黃(庶虫)虫丸組各項指標的改善更加明顯(P<0.05). 結論:鱉甲煎丸和大 黃(庶虫)虫丸均能降低慢性肝炎患者的血清纖維化指標和肝臟彩 色多普勒超聲圖像指標,二者聯合用藥效果更為顯著.

 

 

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