中医药研究论丛

262.3 疏肝行气温经通络法治疗摄护腺癌术後混合性尿失禁病例报告

TJ TCM.26(2) : 33-40, 2023

DOI : 10.6516/TJTCM.202306_26(2).0003
 
疏肝行气温经通络法治疗摄护腺癌术後混合性尿失禁病例报告
Dispersing stagnated liver Qi and warming, dredging blood channels Treatment for
Mixed incontinence after prostate cancer surgery : Case Report
 
袁郁婷1 陈安履1
1 台北市立联合医院仁爱院区中医科
【摘要】
混合性尿失禁是摄护腺癌术後至中医门诊求诊的常见原因不仅大幅影响病患生活品质,也可能会增加泌尿道慢性疾病的罹患风险。本病例报告男性病患摄护腺癌术後混合性尿失禁超过六个月之中医诊治过程。主要的症状有,排尿两次间隔小於1 小时,并在腹部用力时出现尿失禁的情况。医师经临床评估与病因病机四要素分析後,决定采取疏肝解郁为主,温通血络补肾为辅的治疗方法,以加味逍遥散与香附为核心处方,佐以安中散、艾叶温通下焦血脉,稍佐桑螵蛸散安神、补肾缩尿。患者经过一个月治疗後尿失禁持
续改善,不仅排尿两次间隔由小於1 小时进步为1 至2 小时,且腹部用力时出现尿失禁的频率亦降低。由於中医治疗男性接受摄护腺切除术後,混合性尿失禁相关研究资料仍十分缺乏,而本病例以疏肝、温经通络方法对混合性尿失禁患者产生不错的疗效,故供临床同道叁酌讨论。
【关键词】摄护腺癌; 中药; 混合性尿失禁; 疏肝行气;温经通络
Yu-Ting Yuan1Andy Chern1,2*
1Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
【Summary】
Mixed incontinence (MI) symptom is the primary reason for those patients with prostate cancer surgery to go to the doctor in the Traditional Chinese Medicine Clinic. MI not only affects the patient’s quality of life but also may increase the risk of urinary tract chronic disease. This case report presents the Traditional Chinese medicine diagnosis and treatment process for a patient with prostate cancer surgery who suffered from MI symptoms for more than six months. The primary symptoms include the interval between two urinations less than one hour and the presence of Urge incontinence (UI) when subject to an abdominal strain. The doctor then adopted the treatment strategy: dispersing stagnated liver qi for reliving qi stagnation as the primary treatment method in combination with the supplemental treatments of warming, smoothing, dredging blood channels, and invigorating the kidney.
Furthermore, supplemented peripatetic powder and cyperus were used as the core prescription. As to the supplemental medicines, AN ZHONG SAN and mugwort leaf was used to warm, smooth, and dredge the lower burner, and Sang Piao Xiao San was used to soothe the nerves, invigorate the kidney and reduce urination as well. After being treated for over one month, the MI symptom of the patient continuously improved. For example, the interval between two urinations was appreciably extended from 1 hour to 1 - 2 h. In addition, the frequency of UI was significantly reduced under abdominal strain conditions. Up to date, the literature related to the MI disease associated with patients with prostate cancer surgery is very scarce. However, this case report demonstrates a very effective curative effect via the treatment approach of dispersing stagnated liver qi for reliving qi stagnation. Thus, it may be helpful as a reference in future clinical work.
【Keywords】Prostate cancer; Traditional Chinese Medicine; dispersing stagnated
liver Qi for reliving Qi stagnation; warming, dredging blood channels