中醫治療子宮肌瘤合併經痛之病例報告

Uterine Leiomyoma Accompanied Dysmenorrhea Treated with Traditional Chinese Medicine

在台灣，子宮肌瘤是女性骨盆腔中最常見的良性腫瘤，生育年齡的婦女因其所造成的症狀深受困擾，例如：不正常的出血、痛經、壓迫感、甚至不孕等等。許多婦女為了保留生育功能、避免手術治療以及西藥副作用，而求助於傳統醫學，希望能藉由中醫的治療方式減輕症狀。本篇病例報告一位患有子宮肌瘤、伴有痛經的婦女，2007/10/19超音波診斷子宮肌瘤（2顆：5.2×4.3cm，2.6×2.2cm），西醫建議手術治療。2007/11/08開始中醫診治，臨床診斷為癥瘕合併痛經，證屬本虛標實，氣滯血瘀為標，肝腎虧損為本，治則以活血化瘀，補益肝腎為主，佐以調經止痛。經科學中藥複方桂枝茯苓丸為主方加減治療約3個月之後，子宮肌瘤明顯縮小與消失，痛經症狀改善。超音波追蹤於2009/07/02顯示子宮肌瘤已完全消失，至今月經仍規律來潮且子宮肌瘤未見復發。藉此個案說明中醫藥治療子宮肌瘤有確實之療效，比起現行西醫治療之副作用小，且安全性高，值得合理推廣。

Uterine leiomyoma are the most common benign tumor of the female pelvis in Taiwan. Symptoms such as abnormal bleeding, dysmenorrhea, oppressive, even infertility bother women of childbearing age. For avoid surgery and western medicine side effects, some women seek Traditional Chinese Medicine (TCM) for preserving fertility.This is a report of a patient with uterine leiomyoma accompanied dysmenorrhea, who was diagnosed of uterine leiomyoma (2: 5.2x4.3 cm, 2.6x2.2 cm) by ultrasound in October 2007. Western doctor recommend surgery, but patient hesitated. She received TCM treatment since November 2007. Clinical diagnosis of TCM was Zheng Jia combined dysmenorrhea. The pattern of TCM was chi and blood stasis combined liver and kidney insufficiency. The treatment goals were promoting blood circulation, replenishing liver and kidney, and relieving pain. After treatment of finished herbal product of GUI ZHI FU LING WAN dominated approximately 3 months, uterine leiomyoma was significantly reduced and disappeared, and dysmenorrhea symptoms improved. The follow-up ultrasound in July 2009 showed no uterine fibroids. Until now, the patient has regular menstrual cycle without dysmenorrhea and no recurrence of uterine leiomyoma. Via this case, we know that TCM treatment of uterine leiomyoma is really effective and safety, with low risk of side effects compared to the current Western medicine. It is reasonable to be promoted.