小兒功能性便秘之中醫藥治療案例

A Case Report of Functional Constipation in Children Treated by Traditional Chinese Medicine

小兒便秘是臨床門診常見的問題，根據研究統計，在台灣，國小兒童的發生率約為32.2%。影響便秘的因素眾多，包括飲食、心理、身理、環境和社會因素。西醫治療小兒便秘一般多使用緩瀉劑或甘油球，然而很容易有依賴性的問題產生，而手術治療亦可能造成大便失禁之風險。許多病患家屬因而紛紛轉向中醫尋求幫助。本案例為一個便秘2-3個月之3歲女童就診中醫之病案。經採用滋陰清熱，通調氣機的治則，以甘露飲與小柴胡湯加減處方，其便秘在服藥一週內明顯改善，不須甘油球通便，第二週起自解便順暢，故開始減量服藥，第三週起諸症平穩，故囑咐家屬逐漸調整小兒飲食，可以漸進式停服中藥。前後三週，依中醫辨證原則，未使用通腑瀉下中藥，順利控制此小兒便秘之案例。

Constipation, which is common among children, is accounting for an estimated 3 to 5 percent of all visits to pediatricians. Among different causes of constipation, functional constipation is particularly common among preschoolage children. Functional constipation describes persistently difficult or seemingly incomplete defecation, without evidence of a primary biochemical or anatomic cause. There are multiple factors that influence constipation, such as dietary, psychological, physical, environmental and social factors. We report a case of a 3-year-old female children with constipation for 2-3 months who is seeking TCM advice. The symptoms was improved after taking Chinese herbal formulae within 3 weeks. This approach seems to offer a effective alternative treatment for funtional constipation children.