中醫交通心腎法治療第二型糖尿病之病例報告

Case Report of Type II Diabetes Mellitus Treated by Restoring Normal Coordination between Heart and Kidney of Traditional Chinese Medicine

糖尿病是由許多病因所造成的代謝異常疾病，主要是胰島素分泌異常，胰島素作用異常，進而產生慢性高血糖。如果不進行治療，可能會引發許多併發症。現代醫學主要以胰島素及各類口服降血糖藥治療，但因其有一定副作用，且停藥後易復發，故希望能以中醫治療以達到更持久的療效及較低的副作用。本篇病例報告一位四十六歲男性，於2015年2月開始口乾渴欲飲，於家醫科診斷為第二型糖尿病，HbA1C:12.1%，2015年3月服用一個月口服降血糖藥，病人希望單純以中藥治療其糖尿病，因此自4月停用西藥，於本院就診進行中藥治療，初起臨床診斷為消渴，證屬肺胃熱盛，腎陰陽兩虛，氣陰兩虛之證，治以清肺胃熱，補腎之陰陽，氣陰雙補。經科學中藥白虎加參湯合八味地黃丸加味治之，由於仍有口乾渴欲飲之症狀，考量心腎不交亦與糖尿病之產生有關，加入黃連膠囊以清其心火，患者之口乾渴始改善，後續分別於2015年6月及10月追蹤其HbA1C為5.4%及5.5%，控制佳。藉此個案說明中醫藥治療第二型糖尿病有確實之療效。

The term ＂Diabetes mellitus＂(DM) describes a metabolic disorder of multiple etiology characterized by chronic hyperglycaemia resulted from defects in insulin secretion, insulin action, or both. If left untreated, it can cause many complications. The standard treatment for diabetes is insulin injection and oral medication. Given that western medical intervention is known to have side effects and relapse is common upon drug withdrawal, it was hoped that Chinese medical treatment could achieve a longer lasting effect and lower side effects. In the following month he was given only western drug, during a clinical examination in February 2015, presented with symptoms of dry mouth and thirst. In March of 2015, after his HbA1C level was found to be 12.1%, he was diagnosed with type II Diabetes. In the following month he was given a combined regimen of western drugs and Chinese pharmaceuticals. Because the patient hoped to control diabetes only through TCM therapy, starting in April 2015, he voluntarily concluded his western medicine treatment opting for treatment only by TCM therapy. The Chinese medicine diagnosis for was ＂wasting-thirst disease＂ with lung and stomach heat, kidney yin and yang vacuity, qi vacuity and yin vacuity. The treatment goals were clearing lung and stomach heat, supplementing kidney yin and yang, replenishing qi and nourishing yin. After treatment with a Bai Hu Jia Ren Shen Tang and Ba Wei Di Huang Wan variant in powder form, the patient still complained of thirst. Reasoning that non-interaction of the heart and kidney had also induced diabetes, Coptidis Rhizoma capsule was added to clear heart fire. After using Coptidis Rhizoma capsule, the patient's thirst subsided and in a subsequent check-up performed in June of 2015 HbA1C decreased to 5.4%. In October 2015, the patients HbA1C remained stable at 5.5%. From this case it is clear that TCM treatment is effective in the treatment of Diabetes.