TJ TCM.24(1) : 147-156, 2021
|
中医治疗腹泻型大肠激躁症之病例报告
Traditional Chinese Medicine Treatment
of Diarrhea Predominant Irritable Bowel Syndrome (IBS)-A Case Report
|
|
杨鲤源1 叶家豪1*
1 台北市立联合医院阳明院区，台北，台湾
|
|
【摘要】
|
|
大肠激躁症是一种常见的疾病，常见症状包含腹痛、腹部不适、腹胀及排便失调。属於功能性异常的肠胃疾病，通常会反覆发作、慢性且持续，目前尚未完全清楚大肠激躁症的致病机转，虽病患肠道结构正常但却表现出异常的蠕动功能及肠道脏器过度敏感。一般认为情绪和压力是诱发及恶化因素，病患的症状可能受到基因、环境和心理因素影响。肠躁症在中医被归类於「泄泻」、「腹痛」、「便秘」等范畴，和肝、脾、肾相关，病位在大肠。本案例是泄泻为主要症状的大肠激躁症病患，每天腹胀痛、水便3-4 行约40年，经中医辨证为肝郁脾虚，故以疏肝解郁，益气健脾为基本治疗原则，使用叁苓白术散及加味逍遥散加减，经过中药调理後缓解症状，并改善病患生活品质，大肠激躁症生活品质评量表（IBS-QoL）从一开始就诊的10 分提升至57 分。
|
|
【关键词】大肠激躁症、肝、脾、叁苓白术散、加味逍遥散
|
|
Li-Yuan Yang1Chia-Hao Yeh1*
1Taipei City Hospital, Yangming Branch, Taipei, Taiwan
|
|
【Summary】
|
|
Irritable bowel syndrome (IBS) is a common disease. Abdominal pain, abdominal discomfort, abdominal distension and defecation disorder are the most common symptoms. It is a functional gastrointestinal disease that usually occurs repeatedly, chronically and persistently. The pathophysiology of IBS is not clear. Although the patient’s intestinal structure is normal, but it shows abnormal peristaltic function and oversensitization of intestinal organs. It is generally believed that emotions and stress are inducing and deteriorating factors, and patients’ symptoms may be affected by genetic, environmental, and psychological factors. Intestinal irritability is classified in the categories of "diarrhoea","abdominal pain", and "constipation" in Chinese medicine. It is related to liver, spleen, and kidney, and the disease location is in the large intestine. This case is a patient with irritable bowel syndrome with as the main symptom. He had abdominal pain and 3-4 times of diarrhea for about 40 years. The clinical syndrome is liver stagnation and spleen deficiency. Therefore, the basic treatment principle is to relieve the liver and relieve depression, and benefit qi and spleen. Suffering from quality of life. We used Shen-ling-bai-zhu-san and Jia-wei-xiaoyao- san to treat this patient and successfully relieve symptoms and improve patients’ quality of life. IBS-QoL increased from 10 at the beginning to 57.
【Keywords】Irritable Bowel Syndrome; Liver; Spleen; Shen-Ling-Bai-Zhu-San; Jia-Wei-Xiao-Yao-San
|
241.12 中医治疗腹泻型大肠激躁症之病例报告
