中醫治療繼發性痛經病例報告

The Therapeutic Effect of Traditional Chinese Medicine to Treat Secondary Dysmenorrhea in Women: A Case Report

痛經為臨床上常見的婦科疾病，發作起來常常造成患者生活和工作的困惱。個案35歲女性，自述從唸高中開始經痛至今已近20年，就診西醫婦產科診斷為子宮內膜異位，雙側卵巢有8 cm巧克力囊腫，並於民國102年接受內視鏡手術，但術後痛經並未緩解，月經時都得服用止痛藥來止痛。109年3月婦產科檢查發現子宮腺肌症，使用異位寧（Visanne）治療療效不佳，並出現頭暈痛和腹瀉副作用，於109年4月因此而停藥，因此前來中醫門診尋求治療，中醫辨證為氣滯血瘀、肝鬱脾虛、心火亢盛，治則為行氣活血化瘀、疏肝健脾、清心火，經過4個月治療後痛經明顯改善。藉此案例可知中醫可以做為痛經另一種治療方式。

Dysmenorrhea is one of the most common clinical gynecological diseases, which often impacts a person’s daily life and work. The 35-year-old woman in this study had suffered from dysmenorrhea for nearly 20 years since she was in high school. She was diagnosed with endometriosis and chocolate cysts on both ovaries, which were removed by endoscopic surgery in 2013. The dysmenorrhea was not relieved, and analgesics were required during menstruation. She was diagnosed with adenomyosis in March 2020 and had been treated with dienogest (Visanne). The symptom of dysmenorrhea did not improve after Visanne treatment and the side effects of dizziness, pain, and diarrhea occurred, so she visited a Traditional Chinese Medicine (TCM) clinic for further treatment. The syndrome differentiation by TCM was the pattern of qi stagnation and blood stasis, liver stagnation and spleen deficiency, and heart fire hyperactivity. The principle of treatment involves using medicine that can promote blood circulation for removing blood stasis combined with invigorating the spleen, soothing the liver, and clearing heart fire to treat dysmenorrhea. The symptom of dysmenorrhea was clearly relieved after four months of treatment as expected.