台北中医医学杂志

101.7 中医治疗胆结石胃胀之病例报告
中医治疗胆结石胃胀之病例报告
A Traditional Chinese Medicine Case Report
of Stomach Distension related to Gallstone
叶芝琦1 陈欣瑜1 叶家豪1*
1 台北市立联合医院阳明院区中医科,台北,台湾
【摘要】
胆结石是临床上常见的疾病,与中医典籍所记载的「胆胀」、「腹痛」、「脇痛」、「癖黄」类似,以中医的观点来看,其病因病机与「气滞」、「湿」、「热」有关,在五脏六腑中与肝、胆较为相关,且五行上木与土容易互相影响,因此亦与脾、胃有关。
本病例为一位有胆结石、糖尿病、高血压病史的64岁男性,因胃胀、上腹痛持续两周而求诊中医。我们依照病人的症状与四诊的情况,再叁考西医病史与相关理学检查,判断病人由肝失疏泄、肝气郁滞开始,最後导致肝胆气郁,胃失和降、气机郁滞而生诸症,因此以疏肝利胆、理气和胃的方法治疗,在一周内缓解了病人的胃胀、上腹痛等症状。
【关键词】胆结石、胃胀、柴胡疏肝散、温胆汤
Chih-Chi Yeh1 Hsin-Yu Chen1 Chia-Hao Yeh1*
1Department of Chinese Medicine, Taipei City Hospital, Yang-ming Branch, Taipei, Taiwan
【Summary】
Gallstone is a commonly clinical disease, which is more related to “gallbladder distension”, “abdominal pain”, “hypochondriac pain” and “jaundice” in the classics of traditional Chinese medicine. From the perspective of traditional Chinese medicine, it is related to “stagnation of qi”, “dampness”, and “heat”, and is more related to the liver and gallbladder. Because of the relationship between wood and earth on the five elements, it is also related to the spleen and stomach. This case is about a 64-year-old man, with past history of gallstone disease, diabetes, and hypertension, who has suffered from stomach distension and upper abdominal pain for two weeks. Based on the patient’s condition, past history, and physical examinations, we differentiated that his disease was caused by liver depression and qi stagnation, which led to the symptoms of liver-gallbladder qi depression, stomach qi failing to descend, and qi stagnation. Therefore, we treated it with the methods of soothing the liver, promoting gallbladder, regulating qi, and harmonizing the stomach. And all of the patient’s symptoms, including stomach distension and upper abdominal pain, were relieved within a week.
【Keywords】gallstones, stomach distension, Chaihu Shugan powder, WenDan
decoction