中医药研究论丛

281.12中西医结合治疗以腮腺肿大为主诉之修格兰氏症病例报告

TJ TCM.28(1) : 167-181, 2025

DOI : 10.6516/TJTCM.202503_28(1).0012

中西医结合治疗以腮腺肿大为主诉之修格兰氏症病例报告

ntegration of Traditional Chinese and Western Medicine for the Treatment of Sjögren Syndrome with Chief Complaint of Parotid Gland Enlargement: A Case Report

林湘宛1,2洪慈莹1吴璟凰1林虹均3,4张清贸1,3,5,*

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国立阳明交通大学传统医药研究所,台北,台湾

4国军桃园总医院中医科,桃园,台湾

5国立阳明交通大学中医学系,台北,台湾

【摘要】

一名81岁男性患者,主诉左侧耳前明显肿块已一个月,伴随口乾眼乾等症状,原预计以手术切除治疗,然患者因担心手术风险而於2022年9月16日时至台北荣民总医院传统医学部门诊求诊,经过中医四诊诊断辨证为肝肾阴虚化火、肝气郁结、气阴两虚,治以清热养阴、滋补肝肾、疏肝解郁、益气生津,亦根据其家族史及其它症状表现,建议其至风湿免疫科进行相关检查,於2022年11月确诊为修格兰氏症(Sjögren syndrome),暂缓手术并给予药物共同治疗。

经中西医门诊持续回诊追踪治疗下,患者无再发耳前肿块,口乾舌燥、眼乾涩、皮肤乾燥搔痒等症状均明显改善,舌诊追踪亦显示裂纹减少、舌苔舌津均增加。本病例报告显示中西医结合治疗可有效缓解修格兰氏症之乾燥及淋巴肿大症状,同时可监测与预防疾病进展为淋巴癌的可能性,可作为中医药治疗修格兰氏症及淋巴癌经验之叁考。

【关键词】中药、腮腺肿大、修格兰氏症、舌诊、淋巴癌
【Summary】
An 81-year-old male patient presented with a noticeable swelling in front of his left ear for one month, accompanied by symptoms such as dry mouth and dry eyes. The initial treatment plan was surgical removal of the lump. However, due to concerns about surgical risks, the patient sought treatment at the Center of Traditional Medicine of Taipei Veterans General Hospital on September 16, 2022. Based on the four diagnostic methods of Traditional Chinese Medicine (TCM), the patient was diagnosed with "Liver and Kidney Yin Deficiency with generation of Fire, Liver Qi Stagnation, and Dual Qi-Yin Deficiency". The TCM treatment was to "Clear Heat and Nourish Yin, Replenish the Liver and Kidney, Relieve Liver Depression, and Tonify Qi to generate Fluid". Given the patient’s family history and other symptoms, he was also recommended to undergo related examinations in the Rheumatology outpatient department. In November 2022, he was diagnosed with Sjögren’s syndrome and the surgery was temporarily suspended while he was treated with Western medication. Under continuous follow-up treatment in both TCM and Western Medicine, the recurring swelling in front of the ear of this patient had diminished. And the symptoms such as dry mouth, dry eyes, and dry, itchy skin significantly improved. TCM Tongue diagnosis also showed reduced cracks, and an increase in tongue coating and tongue fluid. This case report shows that the Integrated TCM and Western medicine can effectively alleviate the dryness and lymphadenopathy symptoms of Sjögren’s syndrome, while also could be monitored and prevented the possible progression of the disease into lymphoma. It serves as a reference for the experience of treating Sjögren’s syndrome and lymphoma with TCM.
【Keywords】Traditional Chinese medicine; Parotid gland enlargement; Sjögren Syndrome; Tongue diagnosis; Lymphoma