丹梔逍遙散加味治療癮疹之病例報告

A Case Report of Chronic Urticaria Treated with Dan-Zhi-Xiao-Yao-San

慢性蕁麻疹是六週以上、反覆且持續出現紅腫癢的皮膚疾病，主要有三個症狀，症狀會依嚴重程度而定。一為膨疹，在身體各處起膨疹，膨疹數量會依嚴重程度而定。二為癢感，膨疹通常會有癢的感覺，特別是在夜晚更明顯。三為血管性水腫，在皮膚較薄處如眼睛、嘴巴容易腫起，並有癢、腫脹的不適感。本病例為一59歲女性，在車禍後服用西藥一段時間，及工作心理壓力之下，出現風疹塊，病灶表現邊緣泛紅、邊界容易界定，凸起，大小不一，並伴有極度搔癢感。患者就診時已發作兩個月，中醫診斷為癮疹，辨證為風客腠理，津氣不利，而以肝鬱脾虛為本，處方以丹梔逍遙散搭配祛風解痙的單味藥治療。本例為一無西藥介入的慢性蕁麻疹治療之案例，提供給臨床中醫師作為參考。

Chronic urticaria is defined by the presence of recurrent urticaria (also called hives or wheals), angioedema, or both, for a period of six weeks or longer. Urticarial lesions have three typical features: (1)An area of central swelling of various size, usually with surrounding erythema (2)An itching sensation (3)A fleeting time course for an individual lesion (usually 30 minutes to 24 hours) with the skin returning to normal without ecchymoses. This case report describes a 59-year-old female who suffered from chronic urticaria for two months. Under stress at work and taking medicine for a period of time after a car accident, wheals appeared. The lesions are central swelling of various size with surrounding erythema and itching sensation. The traditional Chinese medicine (TCM) syndrome was wind attacking subcutaneous tissue (風客腠理), and thus stagnation of Qi and Jin(津氣不利). Based on liver depression and spleen deficiency, the prescription was Dan-Zhi-Xiao-Yao-San combined with some wind-extinguishing and spasms-stopping single herbs. This case is a case of chronic urticaria treated with TCM without other intervention, which can provide clinical Chinese Medicine doctors an acceptable treatment option for patients who suffer from certain disease.