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中医药研究论丛
 211.14 中医治疗主动脉瓣狭窄病例之理论与病例报告
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TJ TCM.21(1) : 171-190, 2018
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中医治疗主动脉瓣狭窄病例之理论与病例报告
Traditional Chinese Medicine (TCM) Treatment of Aortic Stenosis : TCM Theory and Case Report
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张凯惟1,2 张清贸1,3,5 陈方佩1,4,5 龚彦颖1,4,5*
1 台北荣民总医院传统医学部，台北，台湾
2 中国医药大学学士後中医学系，台中，台湾
3 长庚大学临床医学所，桃园，台湾
4 国立阳明大学传统医药研究所，台北，台湾
5 阳明大学医学系，台北，台湾
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【摘要】
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中医并无主动脉瓣狭窄相关病名，但根据主动脉瓣狭窄的临床症状，可归属於中医的「心痹」、「胸痹」、「心悸」⋯⋯等范畴。发病原因与先天禀赋不足、感受外邪、年老体虚等有关，进而导致气血阴阳亏损，痰饮火瘀阻滞，导致心失所养，心脉运行失畅，而出现相关的临床症候。治疗思路以益气养血、活血化瘀为主，藉此达到阴平阳密的治疗原则。本病例是一位64 岁女性，从民国98 年开始断断续续出现胸闷、胸痛且呼吸不顺畅之现象，入院接受门诊检查，心脏科医师诊断为严重主动脉瓣膜狭窄，心脏科医师建议手术治疗，患者不考虑接受手术治疗转至中医门诊求助诊疗。治疗期间主要中医复方以木防己汤、炙甘草汤和生脉饮为主，而单位药的加减上以丹叁、三七、郁金和香附为主。本病例之患者透过六年中药治疗，胸闷、呼吸不顺畅的不适感均获得减轻，病情趋於稳定，目前仍持续於门诊进行追踪治疗，可提供临床中医师治疗主动脉瓣狭窄之有效临床案例作叁考。
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【关键词】主动脉瓣狭窄、心痹、木防己汤、炙甘草汤、丹叁、三七
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Kai-Wei Chang1,2 Ching-Mao Chang1,3,5 Fang-Pey Chen1,4,5 Yen-Ying Kung 1,4,5*
1Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
3Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University,
Taoyuan, Taiwan
4Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
5Faculty of medicine, National Yang-Ming University, Taipei, Taiwan
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【Summary】
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Aortic stenosis is not a disease classification in TCM, but according to the clinical symptoms of aortic stenosis, it shares the same attributes as the TCM disease classified as “heart impediment ”（心痹）, “chest impediment ”（胸痹）or “palpitations”（心悸）. Based on TCM theory, the cause of disease is related to congenital deficiency, invasion of exogenous pathogens and feeble body due to old age. These factors led to the weakness of qi, blood, yin and yang, which in turn caused phlegm blockage and blood stasis, resulted in the lack of nutrients for heart support, loss of flowing rhythm of the heart and pulse, and thus, the emergence of the clinical symptoms.
A 64-year-old woman, presented with the intermittent chest tightness, chest pain and breathing difficulties was admitted into the hospital in 2009. The patient was diagnosed with severe aortic valve stenosis and surgery was recommended by the cardiologist. However, patient refused surgery treatment and she seek for Traditional Chinese medicine (TCM) outpatient clinic.The TCM treatment plan for this case was to nourish the qi and blood which promoted the blood circulation to achieve the balance of yin and yang. The main TCM formula during the course were “Mu-Fang-Ji-Tang”, “Zhi-Gan-Cao-Tang” and “Sheng-Mo-Yin”, while the TCM single herbs were “Dan-Shan”, “San-Qi”, “Yu-Jin”, and “Xiang-Fu”. Since the patient has received six years of TCM treatment, the clinical symptoms of chest tightness and breathing difficulties has improved well and her condition is currently stabilized. At present, the patient is still undergoing outpatient TCM treatment. This case report could be presented as an effective clinical case study of aortic stenosis using TCM treatment.
Keywords：Aortic stenosis, Heart impediment , Mu-Fang-Ji-Tang, Zhi-Gan-Cao-Tang, Dan-Shan, San-Qi
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