中医药研究论丛

201.13中医交通心肾法治疗第二型糖尿病之病例报告
中医交通心肾法治疗第二型糖尿病之病例报告
Case Report of Type II Diabetes Mellitus Treated by Restoring Normal Coordination between Heart and Kidney of Traditional Chinese Medicine
王馥筑1 戴有志1*
1 佛教慈济医疗财团法人台北慈济医院中医部,台北,台湾
【摘要】
糖尿病是由许多病因所造成的代谢异常疾病,主要是胰岛素分泌异常,胰岛素作用异常,进而产生慢性高血糖。如果不进行治疗,可能会引发许多并发症。现代医学主要以胰岛素及各类口服降血糖药治疗,但因其有一定副作用,且停药後易复发,故希望能以中医治疗以达到更持久的疗效及较低的副作用。本篇病例报告一位四十六岁男性,於2015 年2 月开始口乾渴欲饮,於家医科诊断为第二型糖尿病,HbA1C:12.1%,2015 年3 月服用一个月口服降血糖药,病人希望单纯以中药治疗其糖尿病,因此自4 月停用西药,於本院就诊进行中药治疗,初起临床诊断为消渴,证属肺胃热盛,肾阴阳两虚,气阴两虚之证,治以清肺胃热,补肾之阴阳,气阴双补。经科学中药白虎加叁汤合八味地黄丸加味治之,由於仍有口乾渴欲饮之症状,考量心肾不交亦与糖尿病之产生有关,加入黄连胶囊以清其心火,患者之口乾渴始改善,後续分别於2015 年6 月及10 月追踪其HbA1C 为5.4% 及5.5%,控制佳。藉此个案说明中医药治疗第二型糖尿病有确实之疗效。
【关键词】
消渴、八味地黄丸、黄连、心肾不交、中医药治疗
 
Wang Fu-Chu1 Tai Yu-Chih1*
1Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taipei, Taiwan
【Summary】
The term "Diabetes mellitus"(DM) describes a metabolic disorder of multiple etiology characterized by chronic hyperglycaemia resulted from defects in insulin secretion, insulin action, or both. If left untreated, it can cause many complications. The standard treatment for diabetes is insulin injection and oral medication. Given that western medical intervention is known to have side effects and relapse is common upon drug withdrawal, it was hoped that Chinese medical treatment could achieve a longer lasting effect and lower side effects.
In the following month he was given only western drug, during a clinical examination in February 2015, presented with symptoms of dry mouth and thirst. In March of 2015, after his HbA1C level was found to be 12.1%, he was diagnosed with type II Diabetes. In the following month he was given a combined regimen of western drugs and Chinese pharmaceuticals. Because the patient hoped to control diabetes only through TCM therapy, starting in April 2015, he voluntarily concluded his western medicine treatment opting for treatment only by TCM therapy. The Chinese medicine diagnosis for was “wasting-thirst disease”with lung and stomach heat, kidney yin and yang vacuity, qi vacuity and yin vacuity. The treatment goals were clearing lung and stomach heat, supplementing kidney yin and yang, replenishing qi and nourishing yin. After treatment with a Bai Hu Jia Ren Shen Tang and Ba Wei Di Huang Wan variant in powder form, the patient still complained of thirst. Reasoning that non-interaction of the heart and kidney had also induced diabetes, Coptidis Rhizoma capsule was added to clear heart fire. After using Coptidis Rhizoma capsule, the patient’s thirst subsided and in a subsequent check-up performed in June of 2015 HbA1C decreased to 5.4%. In October 2015, the patients HbA1C remained stable at 5.5%. From this case it is clear that TCM treatment is effective in the treatment of Diabetes.
Keywords:Wasting-thirst pattern, Ba Wei Di Huang Wan, Coptidis Rhizoma,
non-interaction of the heart and kidney, Traditional Chinese Medicine