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篇名
小兒手術後腸沾黏之中醫治療經驗--案例報告
並列篇名
THE THERAPEUTIC EXPERIENCE OF POSTOPERATION INTESTINAL ADHESION IN CHILDREN WITH CHINESE MEDICINE – A CASE REPORT
作者 林芸薇黃升騰朱建福
中文摘要
引發腸沾黏的原因很多,包括骨盆腔發炎、闌尾發炎、癌症放射線治療等均會造成腸沾黏,最常見仍以腹部手術後所造成併發症為最多。本文報告一位小兒術後腸沾黏案例。病童在四歲時因腸套疊併發腸壞死,而接受大段小腸切除手術;術後曾併發短腸症,在西醫接受長時間靜脈點滴營養輸注。後雖嚴重腹瀉和營養不良的情況減緩,可以由口進食,但只要緊張或飲食稍不慎即可誘發反覆的腹脹腹痛,導致病童不時需求助於西醫胃腸科門診或甚至急診,每次皆在給予支持性療法後即脹痛緩解,經診斷為術後腸沾黏引起之後遺症。因求助於西醫不見改善,故家屬帶病童至中醫門診尋求幫助。經辨證為肝脾不和,脾胃虧虛,飲食積聚。中藥處方給予香砂六君子湯合四逆散及麻子仁丸加減,並配合飲食、生活以及情緒管理等衛教。服用中藥一個月後,病童的腹脹滿痛便溏等腸胃諸症狀均獲得大幅改善,期間未再服用任何西藥。總而言之,疏肝健脾,行氣止痛、消導寬中對於術後腸沾黏的症狀有不錯的治療效果。Many etiologies could lead to intestinal adhesion, including pelvic inflammatory disease, appendicitis, or post-radiology therapy, etc. However, the abdominal surgery is the most common reason to induce intestinal adhesion. Herein, we reported a pediatric case of post-operation intestinal adhesion which presented as abdominal distension and pain. This boy suffered from small bowel necrosis due to intussusception when he was four-year-old. He received small bowel resection surgery, then short bowel syndrome was diagnosed before long. The severe diarrhea and nutrition deficiency improved after western medical administration with intravenous dripping. He was able to eat and recovered gradually. But recurrent abdominal distension and pain were noted frequently when he was nervous or inadvertent food intake. The young boy visited pediatric outpatient clinic and emergent room often due to recurrent abdominal symptoms. The complication as intestinal adhesion was impressed. The symptoms and signs of intestinal adhesion treated with western medicine still attacked recurrently so that he was brought to our Chinese medicine clinic for further investigation. Based on the Chinese medical differential diagnosis, we confirmed that he has disharmony of liver and spleen, deficiency of spleen and stomach and food stagnation. Therefore, traditional Chinese prescription of Xiang-Sha-Liu-Jun-Zi-Tang, Sini San, and Ma-Ren-Wan associated with health education, such as food choice, mood control and lifestyle modification was given. The recurrent symptoms and signs improved dramatically after approximately one month TCM treatment without any western medical assistance. Altogether, it is valuable to use the TCM methods of Shu-Gan-Jian-Pi (soothing liver and strengthening spleen), Xin-Qi-Zhi-Tong (promoting qi movement and reliving pain) and Xiao-Dao- Kuan-Zhong (resolving food stagnation and soothing the middle) in the patients with post-operation of intestinal adhesion.
起訖頁 157-163
關鍵詞 暈針危險因子病例對照研究Needle sicknessRisk factorCase-control study
刊名 中醫藥雜誌  
期數 201012 (21:3-4期)
出版單位 衛生福利部國家中醫藥研究所(原:國立中國醫藥研究所)
該期刊-上一篇 乳癌放療後肛門膿瘍之中醫診療--病例追蹤報告
 

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