中医药研究论丛

201.14小儿功能性便秘之中医药治疗案例
小儿功能性便秘之中医药治疗案例
A Case Report of Functional Constipation in Children Treated by Traditional Chinese Medicine
许尧钦1 徐尉芳1 王瑜婷1 张仁旭1 王宏铭1*
1 奇美医疗财团法人奇美医院中医部,台南,台湾
【摘要】
小儿便秘是临床门诊常见的问题,根据研究统计,在台湾,国小儿童的发生率约为32.2%(1)。影响便秘的因素众多,包括饮食、心理、身理、环境和社会因素。西医治疗小儿便秘一般多使用缓泻剂或甘油球,然而很容易有依赖性的问题产生,而手术治疗亦可能造成大便失禁之风险。许多病患家属因而纷纷转向中医寻求帮助。
本案例为一个便秘2-3 个月之3 岁女童就诊中医之病案。经采用滋阴清热,通调气机的治则,以甘露饮与小柴胡汤加减处方,其便秘在服药一周内明显改善,不须甘油球通便,第二周起自解便顺畅,故开始减量服药,第三周起诸症平稳,故嘱咐家属逐渐调整小儿饮食,可以渐进式停服中药。前後三周,依中医辨证原则,未使用通腑泻下中药,顺利控制此小儿便秘之案例。
【关键词】
小儿便秘、中医、功能性便秘、甘露饮、小柴胡汤
 
Yao-Chin Hsu1 Wei-Fang Hsu1, Yu-Ting Wang1 Ren-Shiu Chang1
Hung-Ming Wang1*
1 Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan
【Summary】
Constipation, which is common among children, is accounting for an estimated 3 to 5 percent of all visits to pediatricians. Among different causes of constipation, functional constipation is particularly common among preschoolage children. Functional constipation describes persistently difficult or seemingly incomplete defecation, without evidence of a primary biochemical or anatomic cause. There are multiple factors that influence constipation, such as dietary,psychological, physical, environmental and social factors.
We report a case of a 3-year-old female children with constipation for 2-3 months who is seeking TCM advice. The symptoms was improved after taking Chinese herbal formulae within 3 weeks. This approach seems to offer a effective alternative treatment for funtional constipation children.
Keywords:Pediatric constipation, Traditional Chinese Medicine, functional constipation, Gan-Lu-Yin, Xiao-Chai-Hu-Tang