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中医药研究论丛
 222.16 中医介入西医感染症治疗四肢水肿之病例报告
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TJ TCM.22(2) : 157-170, 2019 157
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中医介入西医感染症治疗四肢水肿之病例报告
A Case Report of Bilateral Pleural Effusion and Limbs Edema with Zhen Wu Decoction
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曾子澄1,2 陈安履1 陈朝宗1,3,4*
1 台北市立联合医院仁爱院区中医科，台北，台湾
2 中国医药大学中医学系，台中，台湾
3 国立阳明大学医学院传统医药研究所，台北，台湾
4 台北市立大学通识教育中心，台北，台湾
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【摘要】
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本病例为一76 岁住院会诊中医的女病患，入院前半年患中耳炎，经西医治疗後，症状稍改善，但呼吸道症状仍持续，入院前一个月，反覆高烧约38˚C，伴随乾咳无痰、倦怠无力、微喘、下肢水肿等症状，感染科诊断肺炎收入院治疗，经西医治疗约一个月後，症状仍无改善，於是在住院第28 天会诊中医寻求协助。病人初诊症状喘症严重、四肢水肿3+、全身倦怠无力、纳差、小便频、夜尿多、大便多次但量少、眠差易醒，实验室检查数据皆倾向於体内仍有严重发炎反应，肺部X 光双侧肋膜积液严重。本病辨为心脾肾气虚，兼有阴虚血热证，治疗方向以真武汤加减为主，搭配西医常规治疗利尿剂与白蛋白，加入中药三天後效果明显，一周後四肢水肿即消，体重下降约9 公斤，其馀临床症状亦持续进步，此病例为一中医介入西医感染症，治疗水肿的显效案例，提供给临床中医师选方用药上的叁考。
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【关键词】四肢水肿、真武汤、利尿剂、白蛋白
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Tzu-Cheng Tseng1,2 An-Lu Chen1 Chao-Tsung Chen1,3,4*
1Department of Chinese Medicine, Taipei City Hospital, RenAi Branch. Department of Health,
Taipei City Government, Taipei, Taiwan
2School of Chinese Medicine, China Medical University, Taichung, Taiwan
3Institute of Traditional Medicine National, School of Medicine, Yang-Ming University, Taipei, Taiwan
4General Education Center, University of Taipei, Taipei, Taiwan
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【Summary】
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A 76-year-old female without any past medical history had URI symptoms related to otitis media about 5 months. After treatment of antibiotics, her symptoms of otitis media were relieved. However, she still suffered from URI symptoms. In May 2018, she had a fever up to 38˚C, accompanied with dry cough, dyspnea, general weakness, and bilateral lower limbs edema. Three weeks later, she came to Taipei City Hospital, RenAi Branch for help where lab data revealed leukocytosis and elevation of AST, ALT which indicated a damage of liver function. Chest X-ray showed suspicious RLL pneumonia. Under the impression of fever, suspected otitis media or pneumonia, she was admitted for further evaluation and management. After admission, prophylactic antibiotics was given, but in vain. Three weeks later, she still had mild fever about 37.5˚C, and her dyspnea and lower limb edema worsened. She also gained 6kg when compared with the first day of admission. Therefore, her family considered to consult Chinese medicine for integrated treatment with Western medicine. Therefore, we considered our plan of treatment and prescribed Zhen Wu Decoction, and monitored her clinical condition everyday. After giving this treatment for 4 days, her dyspnea relieved and extremities edema decreased. After one week of treatment, her overall condition improved.
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【Keywords】
limbs edema, Zhen Wu Decoction, diuretics, albumin
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