232.12 归脾汤治疗免疫性特发性血小板缺少症之病例报告
TJ TCM.23(2) : 159-168,2020
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归脾汤治疗免疫性特发性血小板缺少症之病例报告
A Case Report of Gui-Pi-Tang Used on the Patient with Idiopathic Thrombocytopenic Purpura
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庄凯雯1 陈文娟1* 李聪界1 罗纶谦2
1 财团法人彰化基督教医院中医部，彰化，台湾
2 中国医药大学附设医院中医部，台中，台湾
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【摘要】
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免疫性特发性血小板缺少症临床上分为急性期和慢性期两型，急性期好发於孩童，慢性期好发在成人，严重者有肠胃出血和脑内出血的风险。本病例为成人型的免疫性特发性血小板缺少症，在中医属於「血证」、「发斑」的范畴，此39 岁女性，血小板数目在2019/04/15 为35×10^3/μL，因血小板持续低下以及全身不定处不定时的瘀青密布，於同年05/27 至中医门诊，主诉全身瘀青。中医诊断为紫癜，证属脾气虚兼肾阴虚，给予归脾汤和仙鹤草、旱莲草加减，以补养心脾气血和养阴止血，06/10 血小板数目上升到64×10^3/μL，全身遍布的瘀青颜色转淡、范围缩减，为一中医治疗成人型免疫性特发性血小板缺少症的有效临床病例。
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【关键词】：紫癜、特异性免疫性血小板缺少、归脾汤、仙鹤草、旱莲草
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Kai-Wen Chuang1Wen-Jiuan Chen1*Tsung-Chieh Lee1Lun-Chien Lo2
1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
2China Medical University and Hospital, Department of Traditional Chinese Medicine Taichung, Taiwen
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【Summary】
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Immune idiopathic thrombocytopenia is clinically divided into acute phase and chronic phase. The acute phase occurs in children, and the chronic phase occurs in adults. In severe cases, there is a risk of gastrointestinal bleeding and intracerebral hemorrhage. This case is an adult-type immune idiopathic platelet deficiency. The number of platelets in this 39-year-old woman is 35×10^3/μL at 2019/04/15, because the platelets continued to be low and the body was indefinitely inaccurate petechiae. In the same year, from 05/27 to the Chinese medicine clinic, the main complaint was petechiae all over the body. The diagnosis of Chinese medicine is purpura, and the syndrome belongs to both spleen qi deficiency and kidney yin deficiency. It is given to Gui Pi Tang , Xian He Cao and Han Lian Cao to supplement and nourish heart and spleen and blood and nourish yin and stop bleeding. The number of platelets rises to 64×10^3/μL in 06/10. The color of the petechiae, which is spread throughout the body, is diminished and the range is reduced. It is an effective clinical case for the treatment of adult-type immune idiopathic platelet deficiency in a Chinese medicine practitioner.
【Keywords】idiopathic thrombocytopenic purpura, petechiae, Gui Pi Tang, Xian He Cao, Han Lian Cao
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