以古中藥複方當歸龍薈丸水煎劑治療小柳原田症候群病例報告

A Case Report of Vogt-Koyanagi-Harada Syndrome Treated With the Ancient Formula: Dang Gui Long Hui Wan water decoction

目的：探索傳統中醫藥作為治療「小柳原田症候群」非類固醇療法之可行性。觀察：一名56歲雙眼急性期小柳原田症候群男性患者，其全身症狀恰與中醫的肝火上炎吻合，以古方「當歸龍薈丸」複方水煎劑連續治療一星期後，其肝火症狀迅速消退，兩眼視力也逐漸好轉，並持續服藥兩個月以鞏固療效。以光學同調斷層掃描和循血綠眼底血管攝影追蹤檢查，顯示其滲出性視網膜剝離完全消退，而且兩眼的葡萄膜發炎症狀完全控制。持續定期眼科門診追蹤5年，無任何復發跡象。結論和重要性：小柳原田症候群和葡萄膜炎對應到眼睛之肝，與中醫五輪學說的風輪相關，且此原田氏症患者對單獨使用「當歸龍薈丸」複方水煎劑反應良好，這項結果可能為治療原田氏症或其他葡萄膜發炎疾病提供新的視角。

Purpose: To explore a viable non-steroid anti-inflammatory therapy in treating Vogt Koyanagi-Harada Syndrome (VKHS) using Traditional Chinese Medicine (TCM). Observations: A 56-year-old male with VKHS acute stage in both eyes whereas his symptoms were consistent with liver fire flaming upward of TCM. He was treated with the ancient Chinese Angelica, Gentian & Aloe Formula (Dang Gui Long Hui Wan), water decoction for one week. The symptoms of liver fire quickly subsided and his vision gradually improved. He continued to take the medicine to consolidate the effect over the course of two months. The optic coherence tomography (OCT) and indocyanin green angiography (ICG) showed his exudative retinal detachment fully subsided and the uveitis in both eyes were completely controlled. No recurrent symptoms found in the 5-year follow-up. Conclusions and Importance: VKHS and uveitis linked to the wind wheel of five wheels theory in TCM corresponding to the liver of the eye, and the VKHS patient showed an excellent response to the Dang Gui Long Hui Wan water decoction alone. This study may shed light on a new perspective in treating VKHS or other uveal inflammatory diseases.