桂枝湯加黃耆治療妊娠二十八週巨細胞病毒感染病例報告

A Case Report of a Pregnant Patient with Cytomegalovirus Pneumonitis Treated with Gui-Zhi-Tang in Addition to HuangQi

妊娠28週的23歲女性患者，於2009年5月31日因反覆高燒不退，經診斷為肺炎，而進入中國醫藥大學附設醫院接受診治。入院後先以廣效性抗生素治療9天，但高燒仍反覆發作，抽血檢查發現為巨細胞病毒感染，故改用抗病毒藥物治療，7天後仍持續發燒不止，於2009年6月9日會診中醫。患者每日反覆高燒惡寒約4次，乾咳無痰，嚴重時呼吸喘促易發作、口不乾渴，舌淡紅嫩，苔薄白而有津，脈弦浮數而無力，服西藥退燒後汗出淋漓，經診斷為妊娠發熱，證屬太陽中風證，遷延日久，正氣已傷，治以桂枝湯加味，益氣調營和衛解表、兼清氣分鬱熱。加服中藥1天後病人發燒頻率逐漸減少，於13天治療期間惡寒僅發作一次，6月22日順利自中國醫藥大學附設醫院出院，並於同年8月24日順利產下一名健康男嬰。

The female aged 23 years, pregnant at 28 week, was diagnosed as pneumonia and admitted due to recurrent high fever. The doctor prescribed empiric antibiotics after admission but the high fever recurred.The laboratory data showed cytomegalovirus infection and the doctor shifted antibiotics to antivirus therapy. Due to still recurrent high fever, the doctor consulted the doctor who was majored in the traditional Chinese medicine. The patient presented with the symptoms and signs including recurrent high fever and chills four times a day, dry cough without sputum, easy attack of dyspnea , non-thirsty and easy perspiration as dripping wet. The tongue inspection showed pink color, tender, and thin white moist fur. The pulse condition was weak, floating and rapid. The diagnosis was fever during pregnancy and the pattern identification was greater yang wind stroke pattern with recurrence and damage the healthy qi. We prescribed modified Gui-Zhi-Tang to harmonize the nutrient and defense, tonify qi and release the exterior, and clear stagnated heat of the qi aspect. The frequency of fever decreased after taking the medicine and the chill happened once only during treatment. She was discharged and produce a healthy baby.