台北市中医师公会中医药研究论丛

医疗废弃物清除机构一览表

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诚徵：执业中医师－汉补世家中医诊所体系

201.12妇科术後子宫颈外翻合并反覆带下之病例分析与心得

妇科术後子宫颈外翻合并反覆带下之病例分析与心得

A Case of Cervical Ectropion Complicates with Recurrent Vaginal Discharge Treated by Chinese Medicine

周书慧1　蔡真真2*

1 台中荣民总医院传统医学科，台中，台湾

2 全德中医诊所，台中，台湾

【摘要】

本病例为一位47 岁女性，过去曾剖腹产及有卵巢肿瘤、子宫颈息肉接受手术切除，此外，有子宫肌瘤及子宫腺肌症、子宫颈外翻之病史。病患长年多次妇科手术後，受带下困扰已20 多年，曾接受中西药治疗，可获得改善但仍易反覆发作。此次因压力大，影响睡眠而诱发带下发作，故从妇科病史探讨体质特性及分析妇科手术的影响，深入探讨发病诱因，中医辨证属肝郁脾虚，以四逆散加减治疗後，症状获得明显改善。虽然中医典籍多提及带病以祛湿为要，本文则提出一则以理气疏肝治疗妇科手术後子宫颈外翻反覆带下的病案，分享在治疗反覆性带下时，必须思考病机特性与手术史的干扰，藉平衡肝脾脏腑功能与增加水谷精气而减少疾病复发，改善生活品质。

【关键词】

子宫颈外翻、带下、中医、四逆散

Shu-Huey Chou1　Chen-Chen Tsai2*

1Department of traditional Chinese medicine, Taichung Veterans General Hospital, Taichung, Taiwan

2Chander Clinic, Taichung, Taichung, Taiwan

【Summary】

A 47-year-old woman had received the cesarean section, laparoscopic enucleation and cervical polypectomy many years ago. Additionally, she also has GYN history of myoma and adenomyosis. She was bothered by intermittent vaginal discharge after several gynecological surgery during past 20 years and symptom and sign had relieved by vaginal tablet and Chinese Medicine. This time, she suffered from recurrent vaginal discharge with vulvar itch and malodor due to stress and sleep disturbance. We investigated with gynecology constitution and diagnosed as liver depression and spleen deficiency. We administered the Si Ni San modified formula and the symptom got improved. Though the Classics of Chinese Medicine believe to dispel dampness in treating with leucorrhea, we should think about the mechanism of the disease and the effect of the surgery when treating recurrent vaginal discharge. We tried to treat a case of persistent cervical ectropion by regulate qi and sooth the liver. Thus, to balance the liver and the spleen, increase the nutrition, decrease the recurrence, and improve the quality of life.

Keywords：cervical ectropion, vaginal discharge, Chinese Medicine, Si Ni San

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