吳又可、薛生白與吳鞠通的類三甲方劑討論－新冠肺炎、腦霧及現代應用的可能性

The Background, Comparison, and Possibility of Modern Application on COVID-19 Sequelae of Three Prescriptions Named as "Three-carapace"

10.6968/TJCCM.202401_30(1).0007

林以正(Yii-Jeng LIN)；薛博文(Bo-Wen HSUEH)

自律神經失調 ； 無症狀低血氧 ； 腦霧 ； Autonomic Nerve Disorder ； Silent Hypoxia ； Brain Fogs

台灣中醫臨床醫學雜誌

30卷1期（2024 / 01 / 01）

99 - 116

繁體中文;英文

在新冠病毒的全球流行中，溫病學派對於疫病的治療經驗給了中醫界許多的指引，在薛生白的《濕熱論》中提出「主客交渾」的概念，在得病一周後出現意識模糊狀態，是即將轉為重症的徵兆，在時間及症狀上皆令人聯想到新冠肺炎的無症狀／快樂低血氧（silent/happy hypoxia），薛建議使用「仿（吳又可）三甲散」來予以治療。除了吳又可的三甲散及薛生白的仿三甲散以外，另一個以三甲為方名的，是相隔百年的吳鞠通，提出「三甲復脈湯」來治療手指蠕動、心律不整……等症狀，以防止病情惡化為暈厥昏倒。這三首以三甲為名的方劑（以下簡稱為：類三甲方劑），皆治療重症，而與神經學症狀相關，在中醫典籍中有十分特殊的地位，值得深入探究。本文將從三位醫家創立類三甲方劑的時空背景，比較主治症狀及藥物組成，來探討類三甲方劑在當時所面對的病原體及醫學問題，並提出在現代中醫的基層照護體系中，類三甲方劑的對於新冠肺炎後遺症以及自律神經失調疾病治療的應用可能性。

During the global epidemic of the COVID-19 coronavirus, the experience of treating epidemic febrile disease by TCM doctors in Ming and Qing dynasty provides a lot of guidance. There was an unique observation in the Chapter of Damp-Heat: the patients revealed disturbed consciousness at the 7th day of infectious course, which is mimic as the early deterioration of COVID-19 infection (happy/silent hypoxia) in the second week. Shengpai Xue (1681-1770), the author, suggested a special formula "imitated-three carapace power" which was deprived from "three-carapace power" by Youke Wu (1582-1652). In addition to these two prescriptions, another formula also named as three-carapace is "three-carapace pulse-recovering decoction". This formula which was created by Jutong Wu (1758-1836), was designed to treat symptoms such as finger peristalsis, arrhythmia, and fainting. These three prescriptions named as three-carapace are very special in Traditional Chinese Medicine and are worthy of further exploration. This article will discuss the possible pathogens and medical problems faced by these "three-carapace prescriptions" and the background of the three physicians' creation of the prescriptions. We further compare the composition between these three prescriptions and propose the possibility of application of these "three-carapace prescriptions" for the treatment of COVID-19 sequelae, brain fogs, and anxiety disorder.