中醫「通法」治療肥胖症病例報告

A Medical Case Report of the Clinical Effect of “Regulating Qi”, a Special Chinese Therapy in Obesity

患者為一33歲肥胖女性（body mass index [BMI]：36 kg/m2），有左小腿靜脈曲張，靜脈抽除手術史。自2009~2010年起因壓力大，下班晚，常吃宵夜飲紅酒，一個月10多次，一次飲1瓶半的紅酒，於一年內胖10公斤，近一年嚐試戒酒（一個月喝1~2次，一次50毫升），改為清淡飲食，仍持續增加體重，總計3年多從55公斤增為85公斤，今年度亦增加5公斤。無運動習慣，月經規則。初診見肌膚有濕疹、晨起頭昏不清、手易腫脹僵後麻木感，小便不暢（日飲2000cc.只小便2次）、大便偏黏不臭、晨起空腹飲食會泛酸反胃、晚睡（凌晨１點至２點）。舌質淡紅，兩 側有瘀斑，津偏少，略胖大，邊有齒痕，尖有朱點，苔中根薄白膩，舌下囊泡，見舌下絡脈但無怒張、分支。 脈右濡弱尺弱，左濡弱無力，皆重按較有力。經診斷證屬痰濕阻滯三焦，鬱而生熱，化生濁瘀致使氣機不暢，氣虛又加重濕的停著。給予溫膽湯清熱祛痰濕，佐以“通法”小柴胡湯合防風通聖散暢通三焦、內外表裡。經治療1個月19天後，在無增加運動或改變飲食習慣下，體重減輕3.3公斤，BMI值減為35 kg/m2，濕疹收斂乾燥無再發，晨起精神好，手不再僵硬麻木，小便順暢（飲水不變，由一日2次增為每2小時1次）、大便正常、可食早餐不反胃、可提早入眠。

We report a 33-year-old female with past history of varicose veins. She has suffered from obesity over 3 years. Since 2009~2010, because of heavy life pressure, she had kept drinking and eaten very late after work, usually, over 10 times each month, one and half bottles of wine each time. And then, she had gained 10 kg in one year. Nearly a year, she has tried to lose the weight through keeping off alcohol (reducing the frequency to 1~2 times each month, 50 c.c. each time ),and organic, light food. But these changes didn’t make her slimmer. She still has gained weight over 5 kg, totally form 55kg to 85kg during 3 years. No regular exercise, normal menstrual cycle, eczema on the skin, dizziness in the morning, stiff and then numb hand, oliguria( input about 2000cc, output: 2-times urination each day ), sticky stool, nausea as fasting in the morning, falling asleep very late, a little purple-colored, swollen and indented tongue with greasy fur, blurred and weak pulsation. According to these symptoms and signs, she was diagnosed in the pattern” Phlegm-heat”, and was given formulas of Chinese Medicine” Wendantang powder, Fngfeng tongsheng powder, Xiaochaihu powder.” After one-month- and- 19-days treatment, she lost weight of 3.3kg. Also, the problem of eczema on the skin, dizziness in the morning, stiff and then numb hand, sticky stool, nausea as fasting in the morning, falling asleep very late all relieved, especially, the condition of oliguria dramatically changed,( it changed from input about 2000cc, output: 2-times urination each day into having urine one time each 2 hours. ),