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Liu Wei Di Huang Wan  六味地黃丸  ( in English and Chinese 中英文 )

Translated by: Joe Hing Kwok Chu    按此看中文     

Name of Formula: lie wei di huang wan   《source:Xiao Er Yao Zheng Zhi Jue 》

This formula is one of the ten most famous classical Chinese herb formulae.

Uses: shenyinxu (kidney yin deficient)

Syndromes:

Back pain, lack of strength in knees an legs, losing hair, bad gum and teeth, irregular menses, ringing the ears, red face, hot body, prefer cool, uneasiness, dry and cracked lips, dark red tongue with yellow fur, or even with cracks, or black and with spurs.

Modern day usage includes: as anti-oxidant[1], anti-inflammatory [1], anti- cancer, for prostate enlargement, geriatric dementia , and type II diabetes, together with the use of gui pi tang to improve white blood cell count caused by chemotherapy, chronic infection of the sinus area..

Prescription:

shu di huang 32%, shan zhu yu 16%, shan yao 16%, mu dan pi 12%, fu ling 12%, ze xie 12%.  Grind into powder and make into pills.

If there heat syndrome exists use zhi bai di huang wan.

Warning: There are 2 cases reported that there are 2 patients in  2 different hospitals, suffered from bleeding in the digestive tract. They had been using this formula and were diagnosed with sclerosis of the liver.   It is not sure if the incidences were related to liu wei di huang wan, since about 2/3 of cirrhosis patients, during their lifetime encounter bleeding in the digestive tract.

This formula contains mu dan pi which possesses a strong anticoagulation effect. So this formula may not suitable to use with anti-coagulants like Aspirin, heparin or warfarin (Athrombin-K, Carfin, Coumadin, Panwarfin, Sofarin, Warfilone).

There are studies that showed this formula can correct the low level of testosterone of rats, increase hepatic glycogen, lessen the muscle glycogen and improve stamina, correct the metabolism of free radicals in the body. It possesses the effect of anti-tiredness and improve the ability of physical activities.

Warning: There are many herb manufacturers that produced this formula. The editor has encountered some fake products in some part of Asia. It is advisable to buy the product from well established manufacturers and from established herb stores.

Prescription for decoction:

shu di huang 18 g,   shan zhu yu 12 g,  dan pi 9 g, fu ling 12 g, ze xie 9 g, shan yao 12 g

Rinse herb with water. Add 3 bowls (about 1200 cc) of water and simmer down to 90% of a bowl. Strain and use as tea while warm. Then add 2 1/2 bowls (about 1000 cc) of water to the herb and re-boil. Simmer down to 80% of a bowl. Strain and use as tea while warm. One package per day to be taken in two servings.

The above quantity of herb can be adjusted according to syndrome.

 

Adjustment:

  1. Dry mouth and pain in the throat: add xuan shen 9 g, jie geng 9 g.

  2. Achy loin and back: add niu xi 12 g, du zhong 15 g, sang ji sheng 12 g

  3. Irritable and thirsty: add huang qi 9 g , ren shen 2 g.

  4. Frequent urination: take out ze xie, add yi zhi ren 12 g  fu pen zi 10 g.

  5. Cough and rapid breathingadd wu wei zi 9 gmai dong 10 g。
     

Modern application includes: for anti-cancer, enlargement of prostate gland, type II diabetes, combining with gui pi tang for treatment of low white cell count caused by chemotherapy, chronic infection of sinus.

Note:

Bleeding in the digestive tract

Varices (varicose veins) can be formed in cases of sclerosis of the liver because of the in-ability of the portal vein to carry the normal amount of blood.  Blood from the intestines and spleen backs up into blood vessels in the stomach and esophagus and causes these blood vessels to be enlarged and causes the wall and the blood vessels to become thin and carry high pressure. Because of the high pressure and the thin walls, they are  likely to burst. If they burst, the result can be bleeding to death unless the patient gets  immediate medical attention.

Portal vein:

A vein that conducts blood from the digestive organs, spleen, pancreas, and gallbladder to the right port of the liver and joins with the artery of the liver and permeates the liver tissues.

Formulae that derived from this formula:

Liu wei huang wan with adding gui zhi and fu zi is called ba wei di huang wan.

This is one of the ten famous herbal formulas

Note: This is one of the ten famous herbal formulas  

[1] J Diabetes. 2011 Apr 1. doi: 10.1111/j.1753-0407.2011.00130.x. [Epub ahead of print]

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中國十大名方之一

六味地黃丸 《方源:小兒藥証直訣  》

症狀﹕腰背酸痛﹐腿膝無力﹐髮脫齒搖﹐耳聾耳鳴﹐月經不調﹐面色潮紅或通紅,身熱,喜涼,狂燥不安,口唇燥裂,舌質紅絳,苔色黃或老黃,甚則燥裂,或黑而生芒刺。

現代應用包括﹕抗氧化[1], 抗炎[1]防癌症﹐前列腺腫大﹐老人痴呆症﹐非胰島素依賴的糖尿病; 歸脾湯 配 六味地 黃丸治化療所致白血球減少﹐長期鼻流膿

 

湯 劑

處方 熟地黃 18克﹐ 山 茱 萸 12克﹐丹皮 9 克﹐ 茯苓 12 克﹐ 澤瀉 9克﹐山藥15克。

 第一次煎﹕水三碗。煎九分。溫服。

 藥渣再煎﹕水兩碗半。煎八分。溫服。

加減﹕

1。 口乾咽痛:加 玄 參 9 桔 梗  9

2。 腰痠背痛:加  牛 膝 12 克, 杜 仲 15 克, 桑寄生12

3。 虛煩口渴:加 黃 耆 9 人 參 2 克

4。 小便频数去掉澤瀉益 智 仁 12   覆盆 子  10

5。 咳嗽  氣促加入 五味子9 麥 冬10 克。

處方﹕

熟地黃 32%,山 茱萸 16%,淮山藥 16%,牡丹皮 12%,白茯苓 12%,澤瀉 12%。 研作細末為丸。

注意﹕有兩項報告有硬化者發生消化道出血。此兩位病人曾服用六味地黃丸。是否出血與此方有關尚不能下定論。

湯 劑

處方﹕ 熟地黃 18克﹐ 山 茱萸 12克﹐丹皮 9 克﹐ 茯苓 12 克﹐ 澤瀉 9克﹐山藥15克。第一次煎﹕水三碗。煎九分。溫服。

藥渣再煎﹕水兩碗半。煎八分。溫服。

 

加減﹕

1。 口乾咽痛:加 玄 參 9 桔 梗  9

2。 腰痠背痛:加  牛膝 12 克, 杜 仲 15 克, 桑寄生12

3。 虛煩口渴:加 黃 耆 9 人 參 2 克

4。 小便频数去掉澤瀉益 智仁 12   覆 盆子  10

5。 咳嗽  氣促加入 五味子9 麥 冬10 克。

畏寒怕冷,痰多重之人不宜服用


有報導說有兩位病人(在兩間不同醫院)發生吐血。兩位病人都患有肝硬化。都有服用六味地黃丸

肝硬化者可能有肝靜脈曲張,因為肝門靜脈血流量不足。血從脾與腸擠壓而涌到胃部與食道,而致血管擴大,管道薄,壓力大而可能爆裂而出血。嚴重的可能導致死亡如没有及時醫療處理

這出血是否因服六味地黃丸所引起則無定論。

本方中的丹皮 有抑制凝血作用不應與抑制凝血西药阿斯匹林 Aspirin (乙醯水楊酸)  華法林或肝素warfarin (Athrombin-K, Carfin, Coumadin, Panwarfin, Sofarin, Warfilone)heparin 等同用。

有報導六味地黃湯能糾正大鼠血睪酮降低,增加肝糖元含量,使肌糖原消耗減少,增加耐力,改善體內自由基代謝,具有抗疲勞,提高運動能力的作用。

六味地黃丸衍化方劑:


(1)知柏地黃丸

  六味地黃丸加入知母12 黃柏10 功用:滋陰降火。主治:陰虛火旺,骨蒸潮熱,遺精盜汗之證。

(2)麥味地黃丸

 六味地黃丸加入麥冬10 五味子8 克  ,功用:滋腎斂肺。用于肺腎陰虛之喘咳。

(3)杞菊地黃丸

 六味地黃丸加入枸杞子15 菊花12 克  ,功用:滋腎養肝。用于因肝腎陰虛而致的 兩眼昏花,視力不清,或有眼晴干澀,迎風流淚症狀。

(4)都氣丸

 六味地黃丸加入五味子10 克 ﹐ 功用:滋腎納氣,用于腎陰虛之氣喘。

  註 :此是中藥十大名方之一

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