心臟衰竭導致陰囊水腫之中西醫診療病例報告

Combined Treatment of Chinese and Western Medicine on Hydrocele caused by heart failure: A Case Report

本案為中西醫結合治療心臟衰竭所致陰囊水腫之案例。64歲男性，有心衰竭病史，一個月前於大同醫院因心衰竭合併肺水腫入院治療後出院，10日前在喝大量冰飲後出現陰囊與下8肢水腫。再送至大同醫院急診，診斷為（1）心臟衰竭（2）水腫（陰囊與下肢），經西醫處以利尿劑9治療後，下肢水腫消退，陰囊水腫減輕一半，但因服西藥感胸悶氣短、體力減退，而尋求中10醫診療。經中醫辨證為寒飲內停，心脾腎陽虛，病名為「水疝」，處方選真武湯合八味地黃丸11加減，患者服用一週藥物後症狀明顯改善，陰囊水腫減退，三週後水腫已減輕剩一成，五個12月後追蹤電訪確定水腫消退，未再復發。13

This case presents a 64-year-old male with hydrocele caused by heart failure successfully treated with combination of Chinese and Western medicine. He was admitted to Kaohsiung Municipal Ta-Tung Hospital due to heart failure related with pulmonary edema, and was discharged after treatment one month ago. He was again admitted to the emergency department of Kaohsiung Municipal Ta-Tung Hospital 10 days ago due to sudden onset of hydrocele and bilateral lower limb edema after consuming a large amount of ice cold beverages, and he was diagnoses as (1) heart failure (2) edema (scrotum and lower limbs). After treated with diuretics, lower limb edema was completely alleviated, while hydrocele was remitted by half. However, he suffered from chest tightness, dyspnea, and hypodynamia, which might be the side effects of previous treatments. He thus seeked for Chinese medicine treatment. According to traditional Chinese medicine pattern identification, he is recognized as cold fluid retention and heart-spleen-kidney yang deficiency and is diagnosis as “hydrocele” at the same time. The traditional Chinese medicine prescriptions are Zhen-Wu Tang and Ba-Wei-Di-Huang Wan with modification. After one-week treatment, the patient reached near-complete symptom remission. And the hydrocele with 10% left after 3 weeks. His condition was well-controlled without relapse in five-month follow-ups by telephone interview.