葛根芩連湯加味治療酒糟性皮膚炎兼有大腸激躁症之病例報告

Rosacea and Irritable Bowel Syndrome with Ge-Gen-Qin-Lian Decoction: A Case Report

酒糟性皮膚炎或稱酒糟鼻、玫瑰斑，是臨床上常見的一種主要表現在臉部的慢性皮膚疾患，通常由喝酒、熱飲、抽煙、吃辣的食物、運動或情緒激動所誘發，並且使皮膚病灶更為嚴重，目前尚不知道此病真正的致病原因；臨床上可能有各種表現，例如：紅疹、血管擴張、丘疹等，嚴重時甚至會有增生腫瘤贅物，發作時會有搔癢、紅腫、甚至脹痛感，常常令人難以忍受。本病例為一25歲男性，長年飽受酒糟性皮膚炎與大腸激躁症困擾的患者，多年來因天氣變化、生活作息等反覆發作，此次就診已發作約兩周，自行服用西藥處理後效果不佳，遂尋求中醫幫助；辨證為中焦濕熱、陽明燥結，因此以經方葛根芩連湯加減治療，初期搭配疏風、清上焦熱的單味藥加減，待狀況穩定後，專攻中下焦濕熱，經過約兩個月的中藥治療，皮膚狀況改善許多，且排便也維持穩定，為一中醫內外科合併治療之成功案例，提供給臨床中醫師選方用藥上的參考。

Rosacea is a common, chronic disorder that can present with a variety of cutaneous or ocular manifestations. Multiple factors have been anecdotally associated with exacerbations of cutaneous signs and symptoms of rosacea, including sun exposure, spicy foods, alcohol, exercise, psychologic feelings, or certain drugs. However, the pathways that lead to the development of rosacea are not well understood. Proposed contributing factors include abnormalities in innate immunity, inflammatory reactions to cutaneous microorganisms, ultraviolet damage, and vascular dysfunction. Patients with rosacea may exhibit chronic redness of the nose and medial cheeks. Involvement of other sites, such as the ears, lateral face, scalp, and chest, occasionally occurs. As there is no cure for rosacea, treatment is focused on symptom suppression. Therefore, patients with rosacea often seek Chinese Medicine doctor for help in Taiwan. This case report showed a 25-year-old man who suffered from rosacea accompanied with irritable bowel syndrome for many years. During the treatment, Ge-Gen-Qin-Lian Decoction was the main regiment, then we added some other drugs for clearing heat and removing dampness. After Chinese Medicine treatments for about two months, the lesion of rosacea was suppressed and didn't relapse. Furthermore, his abdominal pain was relieved and watery diarrhea dried out to be moderate formed stool which occurred once a day. The patient had an excellent outcome after several times of treatment, which can provide clinical Chinese Medicine doctors an acceptable treatment option for patients who suffer from certain disease.