Source 出处 · Shanghan Lun · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Four ingredients, and it is the clearest example in the classical literature of a formula built for a mixed situation: an exterior that has not resolved and an interior that has already turned hot. Ge Gen Huang Qin Huang Lian Tang comes from the Shanghan Lun, where the line attached to it describes diarrhea that continues together with fever and a rapid pulse. The traditional reading is that heat has settled in the bowel while the exterior is still held, so the formula both lifts the exterior with 葛根 and clears the interior with the two bitter, cold roots. - The modern translation of that presentation is diarrhea with fever, and that is where a reader has to be careful, because diarrhea with fever has a differential that the traditional category does not contain. Blood or pus in the stool, high fever, signs of dehydration, severe abdominal pain, or diarrhea beginning after antibiotics all point to assessment rather than to a pattern: invasive bacterial infection, Clostridioides difficile, inflammatory bowel disease, dysentery and sepsis are on that list. In infants and older adults dehydration can become dangerous quickly, and oral rehydration, not a herbal formula, is the first thing that matters. - 黄连 is coptis rhizome, and its main constituent berberine is one of the better-studied herbal compounds, which is exactly why it needs a careful paragraph. Berberine displaces bilirubin from albumin, which is why berberine-containing preparations are a recognised hazard in jaundiced newborns and appear in the kernicterus literature; that is also why caution or avoidance is discussed in pregnancy, in breastfeeding and in neonates. Berberine inhibits CYP2D6, CYP3A4 and P-glycoprotein, so it can raise the blood levels of a wide range of medicines - ciclosporin and tacrolimus, some statins, some calcium channel blockers, metformin and others - and it can lower blood glucose, which is a hypoglycaemia concern for anyone already on glucose-lowering treatment. Gastrointestinal upset and constipation are common. - 黄芩 is scutellaria root. Liver injury has been reported in connection with Scutellaria-containing products, though attribution is usually confounded because the products are multi-ingredient; that is the honest framing - a signal exists, human evidence is limited. - 葛根 is kudzu root, and the name covers more than one article: 野葛 (Pueraria lobata) and 粉葛 (Pueraria thomsonii) are both used and are not identical. Kudzu is rich in the isoflavone puerarin, which has phytoestrogenic activity, and that is a reason for caution in hormone-sensitive conditions and for anyone on oestrogen-modulating treatment. - 甘草 is licorice, and in sustained amounts it produces a mineralocorticoid-like syndrome of sodium and water retention, potassium loss and raised blood pressure. - Whether this formula shortens infective diarrhea has not been established by well-conducted controlled trials. The honest verdict is unproven. Quantities are decided by a licensed practitioner; this site deliberately does not list them.
本方仅四味，是古典文献中「表里同病」配伍结构最清晰的一例：表未解而里已热。葛根黄芩黄连汤出自《伤寒论》，其条文所述为下利不止而脉促、喘而汗出者。传统读法是热邪内陷于肠而表气仍郁，故本方以 葛根 升提解表，以两味苦寒之根清里。 - 这一表现翻译成现代语言就是「发热伴腹泻」，而读者在此必须谨慎，因为发热伴腹泻的鉴别清单并不在传统类别之内。便血或黏液脓血、高热、脱水征象、剧烈腹痛，或使用抗生素后出现的腹泻，指向的都是评估而非某个证：侵袭性细菌感染、艰难拟梭菌感染、炎症性肠病、痢疾与脓毒症皆在其列。婴幼儿与老年人脱水可在很短时间内变得危险，而第一位重要的是口服补液，不是某一首方。 - 黄连 为黄连根茎，其主要成分小檗碱（berberine）是草药成分中被研究得较充分的一个，正因为如此它需要一个仔细的段落。小檗碱可把胆红素从白蛋白上置换下来，这正是含小檗碱制剂在黄疸新生儿中被视为已知危害、并在核黄疸文献中出现的原因；也因此孕期、哺乳期与新生儿的慎用或避免被反复讨论。小檗碱还抑制 CYP2D6、CYP3A4 与 P-糖蛋白，可升高多种药物的血药浓度 —— 环孢素、他克莫司、部分他汀、部分钙通道阻滞剂、二甲双胍等 —— 且可降低血糖，对已在降糖治疗中的人构成低血糖顾虑。胃肠不适与便秘较常见。 - 黄芩 为黄芩根。含黄芩制品有肝损伤报告，但归因通常混杂，因为制品多为复方；诚实的说法是：信号存在，人体证据有限。 - 葛根 为葛根，而这一名称涵盖不止一种药材：野葛（Pueraria lobata）与 粉葛（P. thomsonii）均在使用，两者并不等同。葛根富含异黄酮葛根素，具植物雌激素活性；因此激素敏感状态者以及正在接受雌激素相关治疗者需当心。 - 甘草 长期摄入产生类盐皮质激素综合征：钠水潴留、失钾、血压升高。 - 本方是否缩短感染性腹泻的病程，并未被设计良好的对照试验证实；诚实的结论是「未被证实」。用量由持证医师决定，本站刻意不列。