| 中文摘要 |
一位27 歲男性病患，患口破己13 年，單發或多發，癒合時間約需7 至10 天以上。過去曾多次尋求中醫治療，效呆並不明顯。去年曾於本院以滋陰清熱法治療約三個月，病情稍有改善，癒合時間縮短，發作頻率減少，但仍無法根治。近四口瘡疼痛加劇，至門診求診。患者素體畏寒，手足厥冷，過冷手指發白、發紫。常上腹脹，偶吐微酸水，過風則顛頂及側頭痛，脈;兄弦，舌淡紅，苔薄白。診斷為復發性口瘡合併雷諾氏現車，中醫辨證屬厥陰寒逆，肝寒犯胃之證'治以當歸四逆湯合理中湯加減，月且無兩週，口瘡癒合。其後足以當歸四逆湯合其茱英湯加減治其頭痛，月且蕪兩遇，頭痛亦不再發，唯手溫仍稍低於常人。追蹤七個月，口瘡及雷諾氏現象均未見復發。Oral ulcers may be simple or multiple with the time of healing taking usually 7 to 10 days. We report the case of a 27-year-old male with recurrent oral ulcer for about 13 years who visited our hospital last year seeking alternative treatment. After being treated with the method of'enriching yin and clearing heat' (yang yin qing re) for 3 months, the healing time and the recurrent frequency of the oral ulcer improved. However, complete cure remained unattained. Recently, the patient visited our outpatient department again, with the chief complaint of serious pain due to an oral ulcer. Besides the oral ulcer, the patient also had a history of coldintolerance, pallor and cyanosis in distal fingers, especially after exposure to cold. Other symptoms included usual upper abdominal fullness, occasional gastric juice regurgitation, chronic recurrent headache, deep and string-like pulsation, light redness of tongue, and thin, white tongue fur. The diagnosis was 'recurrent aphthous ulcer combined with Raynaud's phenomenon' or in terms of 'pattern identification' in Chinese medicine as 'counterflow cold of reverting Yin' and 'liver cold seeping into the stomach'. The patient was treated with 'Tangkuei Counterflow Cold Decoction' (dang-gui si ni tang) combined with 'CenterRectifying Decoction' (li zhang tang) for 2 weeks, After that time the oral ulcer healed completely. The headache got better following treatments with 'Tangkuei Counterflow Cold Decoction' (dang-gui si ni tang) and 'Evodia Decoction' for 2 weeks. A recent follow-up indicated that the patient had been free of the recurrence of either oral ulcer or Raynaud's phenomenon for 7 months. |
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