轉貼：中醫治療主動脈瓣狹窄病例之理論與病例報告

https://health.udn.com/health/story/5977/4437631  劉真病逝 醫：主動脈瓣狹窄不常見，有胸悶暈眩速就醫 如果家人有此症，避免開刀風險的另一種選擇－－中醫療法 －－－－－－－－－－－－－－－－－－－－－－－ 中醫治療主動脈瓣狹窄病例之理論與病例報告 原載網址　http://www.tpcma.org.tw/index.php?id=593563&id2=1153 Traditional Chinese Medicine (TCM) Treatment of Aortic Stenosis : TCM Theory and Case Report

張凱惟1,2　張清貿1,3,5　陳方佩1,4,5　龔彥穎1,4,5* 1 臺北榮民總醫院傳統醫學部，台北，台灣 2 中國醫藥大學學士後中醫學系，台中，台灣 3 長庚大學臨床醫學所，桃園，台灣 4 國立陽明大學傳統醫藥研究所，台北，台灣 5 陽明大學醫學系，台北，台灣

【摘要】

中醫並無主動脈瓣狹窄相關病名，但根據主動脈瓣狹窄的臨床症狀，可歸屬於中醫的「心痹」、「胸痹」、「心悸」⋯⋯等範疇。發病原因與先天稟賦不足、感受外邪、年老體虛等有關，進而導致氣血陰陽虧損，痰飲火瘀阻滯，導致心失所養，心脈運行失暢，而出現相關的臨床症候。治療思路以益氣養血、活血化瘀為主，藉此達到陰平陽密的治療原則。 本病例是一位64 歲女性，從民國98 年開始斷斷續續出現胸悶、胸痛且呼吸不順暢之現象，入院接受門診檢查，心臟科醫師診斷為嚴重主動脈瓣膜狹窄，心臟科醫師建議手術治療，患者不考慮接受手術治療轉至中醫門診求助診療。 治療期間主要中醫複方以木防己湯、炙甘草湯和生脈飲為主，而單位藥的加減上以丹參、三七、鬱金和香附為主。本病例之患者透過六年中藥治療，胸悶、呼吸不順暢的不適感均獲得減輕，病情趨於穩定，目前仍持續於門診進行追蹤治療，可提供臨床中醫師治療主動脈瓣狹窄之有效臨床案例作參考。

【關鍵詞】主動脈瓣狹窄、心痹、木防己湯、炙甘草湯、丹參、三七

Kai-Wei Chang1,2　Ching-Mao Chang1,3,5　Fang-Pey Chen1,4,5　Yen-Ying Kung 1,4,5* 1Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 2School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan 3Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan 4Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan 5Faculty of medicine, National Yang-Ming University, Taipei, Taiwan

【Summary】

Aortic stenosis is not a disease classification in TCM, but according to the clinical symptoms of aortic stenosis, it shares the same attributes as the TCM disease classified as “heart impediment ”（心痹）, “chest impediment ”（胸痹）or “palpitations”（心悸）. Based on TCM theory, the cause of disease is related to congenital deficiency, invasion of exogenous pathogens and feeble body due to old age. These factors led to the weakness of qi, blood, yin and yang, which in turn caused phlegm blockage and blood stasis, resulted in the lack of nutrients for heart support, loss of flowing rhythm of the heart and pulse, and thus, the emergence of the clinical symptoms. A 64-year-old woman, presented with the intermittent chest tightness, chest pain and breathing difficulties was admitted into the hospital in 2009. The patient was diagnosed with severe aortic valve stenosis and surgery was recommended by the cardiologist. However, patient refused surgery treatment and she seek for Traditional Chinese medicine (TCM) outpatient clinic.The TCM treatment plan for this case was to nourish the qi and blood which promoted the blood circulation to achieve the balance of yin and yang. The main TCM formula during the course were “Mu-Fang-Ji-Tang”, “Zhi-Gan-Cao-Tang” and “Sheng-Mo-Yin”, while the TCM single herbs were “Dan-Shan”, “San-Qi”, “Yu-Jin”, and “Xiang-Fu”. Since the patient has received six years of TCM treatment, the clinical symptoms of chest tightness and breathing difficulties has improved well and her condition is currently stabilized. At present, the patient is still undergoing outpatient TCM treatment. This case report could be presented as an effective clinical case study of aortic stenosis using TCM treatment. Keywords：Aortic stenosis, Heart impediment , Mu-Fang-Ji-Tang, Zhi-Gan-Cao-Tang, Dan-Shan, San-Qi