中醫治療糖尿病之顯效病例報告及理論推導

Remission of Type II Diabetes Mellitus by Traditional Chinese Medicine - Theoretical Derivation and Case Report

糖尿病為一代謝異常疾病，多數患者需長期服用西藥，如胰島素及各類口服降血糖藥，以達到控制血糖之目的，但因部分藥物會造成腹瀉等腸胃道副作用，甚至起紅疹等過敏反應。因此中醫門診常有糖尿病病人求診，期望藉由中西醫合併治療，降低副作用，並達到更持久的療效。本篇病例報告一位三十七歲女性，於104 年10 月30 確診為第二型糖尿病，因服西藥易腹瀉，且其口乾渴症狀仍未改善，因此無規則服用西藥，亦無飲食控制、生活習慣改變，並於104 年11 月20 日至中醫科就診，當時其飯前葡萄糖為146，糖化血色素為9.5，希望藉由服用中藥控制其糖尿病。初起臨床診斷為消渴，證屬肺胃熱盛，腎陰陽兩虛，兼脾虛生濕，氣陰虛損之證，治以清瀉肺胃，補腎之陰陽，兼健脾袪濕，補氣滋陰。經科學中藥白虎加參湯合八味地黃丸加味治之，其口乾渴、易飢、頻尿、夜尿等症狀均有緩解，且三個月後抽血數值亦有大幅改善，糖化血色素為5.5，亦透過中藥改善其服西藥後疲倦、腹瀉等副作用。藉此個案說明中醫藥治療糖尿病有確實之療效。

The term 'Diabetes mellitus' (DM) is a metabolic disorder disease and most patients diagnosed of Diabetes mellitus have to receive western medical intervention, such as oral medication and insulin injection for a long time. Given that western medical intervention is known to have side effects and could result in allergic reactions. it was hoped that chinese medical treatment could be adopted to lower side effects and achieve a longer lasting effect. In the following we present the case of a 37-year-old female who had diarrhea after taking oral medication for type II Diabetes, diagnosed in October 2015. In November of 2015, due to the side effects of the western medicine and little improvement of the symptoms of dry mouth and thirst, she did not take western medicine regularly and come to TCM department for combined consultant. At that time, her GLU-AC was found to be 146 and HbA1C was 9.5. The Chinese medicine diagnosis for the patient was “wasting-thirst disease” with lung heat and stomach heat, kidney yin and yang vacuity, dampness due to spleen qi vacuity, yin vacuity. The treatment goals were clearing lung heat and stomach heat, supplementing kidney yin and yang, replenishing spleen qi, drainage dampness and nourishing yin. After treatment with a Bai Hu Jia Ren Shen Tang and Ba Wei Di Huang Wan variant in powder form, the symptoms including of dry mouth, thirst, frequent urination and nocturia were all improved. In a subsequent check-up performed in February of 2016 HbA1C decreased to 5.4% and the symptoms such as tiredness and diarrhea resulted from western medicine were improved as well. From this case it is clear that TCM treatment is effective in the treatment of Diabetes.