台北中医医学杂志

102.4 顽固型便秘以非泻下剂为主方治疗三例

 

顽固型便秘以非泻下剂为主方治疗三例
Three Cases of Non-classic Laxative
Treatment of Chronic Refractory Constipation
侯耀华1* 邹腾樟1
1 芦山风泽中医诊所,桃园,台湾
【摘要】
全球便秘的盛行率约有20%,治疗常以泻下润肠剂作为短期通便的选择,但久用效率降低且需要增剂,也不能处理便秘患者常连带之腹胀、腹痛、呃逆等肠胃症状。本篇蒐集三个不同年龄层顽固型便秘患者,以兼顾上下消化道排空能力及稳定神经系统作为考量,依照中医整体辨证论治法调理,先调整脾胃异常症状後,再改善便秘,结果可以减少长期使用泻下剂患者的使用剂量,并改善便秘及连带症状。使用方药包括泻心汤类方:以半夏、生姜(乾姜)为主轴。行气疏肝类方:以枳壳、厚朴、枳实、柴胡、香附等为主轴。温阳健脾类方:以理中辈、四君子辈加减。可以做为治疗便秘时的思考方向与辨证论治选择。
【关键词】中药、临床诊疗、顽固型便秘、肠躁症
Yao-Hua Hou1* Teng-Chang Tsou1
1Lushan Fengze Chinese Medicine Clinic, Taoyuan, Taiwan
【Summary】
The prevalence of constipation is about 20% around the world. The common medical therapies are laxative and secretagogues. However, it is only useful for short-term treatment and do not resolve comorbidities such as abdominal fullness, stomachache, hiccup, nor gastroesophageal reflux. Here are three cases of chronic refractory constipation patients in three age groups. By regulating the transit of upper and lower gastrointestinal system and sedating nerve system associating to the gastrointestinal system with the wholistic treatment principle of tradition Chinese medicine, cases reduce their dosage of laxative, and relive comorbidities. The use of Chinese medicine are: Xiexin tang, such as pinellia and ginger, drug for conduct Qi and dispersing liver, such as fructus aurantii, fructus aurantii immaturus, mangnolia officinalis, radix bupleuri and cyperus rotundus, etc., durg for warm yang and tonifying spleen, such as ginseng, atractylodes rhizome, poria cocos, liquorice, ginger etc.. This strategy could be an option for chronic constipation treatment.
【Keywords】
Chinese medicine, clinical management, chronic refractory constipation, irritable bowel syndrome