台北中医医学杂志

104.3 溃疡性结肠炎之中药治疗病例报告
溃疡性结肠炎之中药治疗病例报告
Treatment of Ulcerative Colitis with
Traditional Chinese Medicine (TCM): A Case
Report
梁曦1 陈俊良2 陈星谕3*
【摘要】
本病例是一位六十馀岁男性,过去有高血压及脑中风病史,使用高血压药物及抗
凝血剂控制追踪中。患者在2020 年1 月,因间歇性血便两周伴随腹痛至林口长庚院求
诊,经大肠镜、切片及电脑断层检查,诊断溃疡性结肠炎,并有肛周脓疡。後续患者
转院至本院急诊就诊,当时再次大肠镜检查发现全结肠炎及巨结肠状况,合并有检验
白血球及发炎指数升高(WBC 17.6k, Seg 95%, CRP 62.21),明显贫血(Hb 6.6),於
2020/01/17 进行全结肠切除手术合并终端回肠造口术。术後病患於胃肠肝胆科追踪,
除了口服Mesalazine 治疗,也接受生物制剂vedolizumab 及Adalimumab 治疗。
术後一年馀,患者肛门周围仍持续有脓血分泌物,肛门内侧有疼痛感,下腹时有异物下
坠感,於2021/03/15 求诊中医内科,希望藉由中药改善以上问题。中药治疗以清热利
湿,化浊止血概念为主,经过12 个月中药治疗,患者肛门周围脓血分泌物以及肛门内
侧疼痛感已稳定改善,且下腹时有异物下坠感已大幅减缓。
【关键词】溃疡性结肠炎、中医
Liang Hsi1, Jiun-Liang Chen1,2, Hsing-Yu Chen1,2*
1. Department of Traditional Chinese Medicine,
Chang Gung Memorial Hospital,
Taoyuan, Taiwan
2. Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine,
Chang Gung Memorial Hospital, Taoyuan, Taiwan
【Summary】
A 60-year-old Taiwanese male with hypertension and hemorrhagic stroke history, presented to Linkou Chang-Gung Memorial Hospital proctology department with hematochezia and abdominal pain for two weeks in January 2020. Examination including colonoscopy, biopsy, and abdominal CT resulted in diagnosis of ulcerative colitis with peri-anal abscess. The patient received a total colectomy with end ileostomy on 2020/01/17 because subsequent colonoscopy showed extensive ulcerative colitis with megacolon complication. After operation, the patient had received oral Mesalazine, Vedolizumab and Adalimumab from a gastroenterologist. Due to persistent rectal mucus discharge with blood, rectal pain and tenesmus despite the treatment, he presented to our center of tradition Chinese medicine’s clinic inquiring about traditional Chinese medicine treatment for symptoms relief. The principle of treatment for this case is "clearing heat and promoting diuresis, promoting hemostasis and removing turbid pathogen". The patient’s rectal pain, frequent rectal discharge with blood and tenesmus got improved after receiving the tradition Chinese medicine over 12 months. This case is suggestive that traditional Chinese medicine may be a helpful treatment of patients with ulcerative colitis, rectal pain and mucus discharge symptoms.
【Keywords】Ulcerative colitis, traditional Chinese medicine (TCM)