台北中医医学杂志

104.5 中医治疗肝癌并新冠後腹泻纳差之病例报告

 

中医治疗肝癌并新冠後腹泻纳差之病例报告
Hepatocellular Carcinoma combined Post-Covid 19
syndrome Treated with Traditional Chinese
Medicine--A Case Report.
陈昕元 1,2 张凯惟 1,3 龚彦颖 1,3,4,*
【摘要】
54 岁男性患者有慢性B 型肝炎病史,於2013 年被诊断为右侧肝脏肿瘤复发合并主
肝门静脉及左肝门静脉侵犯,2022 年10 月5 日经肝胆肠胃科门诊收治住院接受常规标
靶免疫治疗时,於9 月19 日确诊Covid-19 後出现噁心、腹泻、食欲不振及体重减轻情
况,寻求协同治疗。其症候为噁心、腹泻、食欲差、精神疲倦、腹胀、轻微右侧腹闷痛、
咳嗽与胸闷,舌红绛,苔白黄厚少津,脉弦滑有力,中医诊断为症瘕、鼓胀、症积,证属,
外邪伤正,肝旺脾虚,湿浊中阻气滞,给予五苓散、痛泻药方,合行气、芳香化湿药物
加减以补脾泻肝、利水渗湿、下气宽中,合并传统针灸与雷射针灸治疗,经过六天治疗,
腹泻、纳差症状获得显着改善,体重增加1.5 公斤,患者於10 月15 日出院继续门诊追
踪治疗。
【关键词】B 型肝炎、肝癌、新冠感染、补脾泻肝、利水渗湿、宽中下气
Hsin-Yuan Chen1,2, Kei-Wei Chang1,3 ,Yen-Ying Kung1,3,4*
1Center of Traditional medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
3Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
4School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
【Summary】
A 54-year-old male with chronic hepatitis B and Hepatocellular carcinoma combined with
covid infection on September 19, 2022 was admitted by Gastroenterology Outpatient Department for regular immunotherapy for hepatocellular carcinoma on October 5, 2022. After admission, the symptoms of nausea, diarrhea, loss of appetite and weight loss were noted and his attending physician consulted Traditional Chinese Medicine for collaborative treatment. During the consultation, the patient’s symptoms were nausea, diarrhea, poor appetite, fatigue, abdominal distension, mild abdominal pain on the right side, cough and chest tightness. Red, crimson and thick tongue coating white and yellow with less fluid, stringy, slippery and strong pulse were also noted. The diagnosis of Traditional Chinese Medicine was accumulation of lumps and the syndrome belongs to external pathogenic injury, liver hyperactivity and spleen deficiency, and turbid damp obstructing in middle with qi stagnation. The formula of Wulingsan and Tong Xie Yao Fang was for painful diarrhea, combined with qi-promoting and aromatic dampnessremoving medicines to invigorate the spleen, relieve the liver, and diuresis. Diarrhea and anorexia symptoms were significantly improved after six days of treatment, and patient’s body weight gained 1.5 kg. The patient was discharged on October 15 to continue outpatient follow-up treatment.
【Keywords】Hepatitis B, liver cancer, covid infection, invigorating the spleen and relieve the liver, diuresis and dampness, widening the middle and qi-promoting