『傷寒論』에 근거하여 小柴胡湯加減方과 小柴胡湯을 처방하여 호전된 만성 바르톨린샘 낭종 증례 1례 보고 – 대한상한금궤의학회

Case Report

『傷寒論』에 근거하여 小柴胡湯加減方과 小柴胡湯을 처방하여 호전된 만성 바르톨린샘 낭종 증례 1례 보고

A case report of chronic Bartholin's cyst that improved with modified Sosiho-tang based on Shanghanlun

2023 Vol. 15 No. 1

정재원1, 이숭인2*

전라북도 전주시 덕진구 사근1길 10 2층 해빛한방병원 원장

전라남도 나주시 동신대길 120-9 동신대학교 한의과대학 방제학교실 부교수

Jae-won Jeong1 · Lee Soong-in2*

Director. Habit Korean Medical Hospital, 2F, 10, Sageun 1-gil, Deokjin-gu, Jeonju-si, Jeonlabuk-do, Republic of Korea*

Associate Professor, Department of Herbal Formula Science, College of Korean Medicine, Dong-Shin University, 120-9 Dongshindae-gil, Naju, Jeonnam, South Korea

Abstract

Objective : This study reports a case of chronic Bartholin's cyst treated with Sosiho-tang and suggests a modifying method.

Methods : We reviewed a 41-year-old female patient with fatigue accompanied by chronic Bartholin's cyst. Symptomatic changes were checked on every visit using SF-12 (Short-form-12 health survey) and VAS (Visual analogue scale). The 104th provision in Shanghanlun was compared with diagnosis and process analysis.

Results : The modified Sosiho-tang removed Scutellariae Radix and used Phlomidis Radix of the same weight. The exacerbation factors were characterized with excessive activity (大), Edema and swelling of the foot (滿), Feeling tired in morning (朝) in 104th provision. After 45 days modified Sosiho-tang and 15 days Sosiho-tang, SF-12 and VAS ameliorated. No adverse effects was observed to the last follow-up visit.

Conclusions : Modified sisiho-tang and Sosiho-tang were effective to the patient. Clinical application of 104th provision of Shanghanlun can consider excessive activity, edema, and morning fatigue.

Key words : Sosiho-tang, Scutellariae Radix, Phlomidis Radix, Shanghanlun, Bartholin's cyst

Figure

Table

Table 1. Key diagnostic points in 104th provision and the related ancient chinese charaters.

Chinese in Shanghanlun 104th provision Chinese etymology Related patient information

Character Information Interpretation

大 Oracle characters (甲骨文), J23191, Meaning large

→ big, great, vast, large, high Excessive physical and psychosocial activity

孚

(for 浮) Bronze characters (金文), B03643 from hand-above 爫 zhuǎ and

child 子 zi.

→ brood over eggs; have confidence Lots of work and housework to take care of children

満 Seal characters (说文解字的篆字), S08128 three-dot-water 氵 shuǐ and

related phonetic two-cow-balance 㒼 mán

→ fill; full, satisfied Swelling and pain of the foot at night

呕 - - - Frequent digestive problems, and in severe cases, vomiting

朝

(for 潮) Bronze characters (金文), B10015 original of 潮 morning tide 晁.

→ dynasty; morning Feeling tired in morning

利 Oracle characters (甲骨文)

J10699 grain 禾 hé and

(rem-刂刀 dāo) from

knife 𠚣勿 wù

→ gains, advantage, profit, merit Genital secretion caused by Bartholinian cyst, vaginitis, cystitis

Characters and interpretation above were from CHINESE ETYMOLOGY(https://hanziyuan.net/, retrieved, 1 Dec 2023.).

Table 2. Herbal formula of the modified Soshiho-tang and manufacturing method from Gangpyeong Shanghanlun.

Herbal name Daily dose (g)

柴胡 Bupleuri Radix 24

半夏 Pinellia Rhizoma 9

人蔘 Ginseng Radix 9

大棗 Zizyphi Fructus 12

生薑 Zingiberis Rhizoma recens 9

甘草 Glycyrrhizae Radix 9

韓續斷 Phlomidis Radix 9

Dried herbs above are weight of herbs of one day dose. The herbs above were boiled with water, and residues were removed. The patient was administered 120cc each, three times a day.

Table 3. Herbal formula of Soshiho-tang and manufacturing method from Gangpyeong Shanghanlun.

Herbal name Daily dose (g)

柴胡 Bupleuri Radix 24

半夏 Pinellia Rhizoma 9

人蔘 Ginseng Radix 9

大棗 Zizyphi Fructus 12

生薑 Zingiberis Rhizoma recens 9

甘草 Glycyrrhizae Radix 9

黃芩 Scutellariae Radix 9

Dried herbs above are weight of herbs of one day dose. The herbs above were boiled with water, and residues were removed. After the residue was removed, only water was boiled for an additional hour. The patient was administered 120cc each, three times a day.

Table 4. Changes in chief symptoms related to Bartholin gland cyst

Herbal prescription VAS SF-12

Fatigue Genital feeling Gastric disturbance PCS MCS

Pain Foreign body Pressure

1st visit Modified Sosiho-tang, 15 days 9 7 8 6 7 34.03 48.35

2nd visit Modified Sosiho-tang, 15 days - - - - - - -

3rd visit Modified Sosiho-tang, 15 days 5 6 5 5 2 - -

4th visit Sosiho-tang, 15 days - - - - - - -

5th visit (End of treatment) 2 2 1 1 0 48.35 50.03

SF-12, Short-form-12 health survey; PCS, Physical score; MCS, Mental score; Average PCS and MCS of USA population, 50.00; VAS, visual analogue scale.

전체 0

« 『傷寒論』甘草附子湯으로 호전된 거골 박리성 골연골염 증례 1례