急性胃痛会诊中医之病例报告

Treating Acute Epigastric Pain with Traditional Chinese Medicine: A Case Report

游铠缦1江佩蓉1,*

1台中荣民总医院传统医学部，台中，台湾

本病例为一位56岁女性，因急性肾盂肾炎入院，药物滴注後作急性胃痛，

经西医检查已排除可能导致胃脘疼痛的急性病症。因服用止痛药、胃药後，胃

痛(NRS:8-9)、胃脘闷胀、食欲不振等症状均无改善，故於住院第2天会诊中医

。诊断为病中情志不舒，致肝气郁结、横逆犯胃之胃痛。先以清热止痛、和胃

降逆为治则，予以针灸改善急性疼痛(第一次针灸後NRS：6-7)；再以半夏泻心

汤重用甘草，调和肠胃、健脾益气。会诊期间西医胃药并无新增，胃部症状逐

次改善，至两周後出院前，已无任何不适。

【关键词】胃痛、肝胃不和、针灸止痛

A 56-year-old woman was admitted to the hospital due to acute pyelonephritis. She developed acute epigastric pain after drug infusion. Western medical examination has ruled out acute conditions that may cause epigastric pain. Yet, symptoms including epigastric pain (Numerical Rating Scale: 8-9), epigastric distension, and loss of appetite did not improve after taking analgesics and stomach medicine. Hence she asked for consulting traditional Chinese medicine on the second day of hospitalization. The diagnosis of traditional Chines medicine was that the patient was emotionally disturbed by the discomfort, which led to the stagnation of liver qi and then invading the stomach, thus caused epigastric pain. The therapeutic principle was clearing heat to relive pain, and downbearing erflow to harmonize stomach in the beginning. Acupuncture was given (NRS after the first acupuncture: 6-7) firstly. Banxia Xiexin Decoction with added licorice was then given for harmonizing the intestines and stomach, and fortifying the spleen and boosting qi. No new western gastric medicines were added during the consultation. The gastric symptoms had gradually improved, and no discomfort was noted by the time she was discharged two weeks later.

【Keywords】Epigastric Pain； Disharmony between the Liver and Stomach； Acupuncture for Pain Relief