| 中文摘要 |
這是一位六十二歲男性患者，於1996年始知罹患C型肝炎、於2001年診斷出肝硬化合併肝癌，分別於2002年及2005年接受過經肝動脈化學栓塞及右上腹放射線治療，於2006年4月1日因上消化道出血住院治療。因黃疸指數持續竄高達22.36mg/dl，身目發黃明顯，於2006年4月7日會診中醫，會診前尚有發燒、腹痛、解黑便情形。會診時患者之症候為嗜睡、身目發黃甚、口乾甚、眠差、納減、 腹脹，舌紅絳，苔白厚少津，脈弦滑有力，中醫診斷為黃疸、癥積，證屬肝膽濕熱蘊毒，陰虛血熱，瘀熱互結，給予茵陳蒿湯合涼血化瘀軟堅藥物加減以清熱利濕解毒、涼血化瘀、滋陰軟堅，經過三十多天治療，黃疸指數由22.36mg/dl逐漸下降至6.2mg/dl，症狀獲得改善，患者於5月17日出院繼續門診追蹤治療。A 62 year-old man was diagnosed as having hepatitis C virus-related liver cirrhosis in Child stage C and hepatocellular carcinoma in 2001,and was treated with transcatheter arterial chemoembolization(TACE) in 2002 and radiotherapy in 2005. He was admitted to our hospital due to duodenal bleeding on April 1, 2006. Six days later, We were consulted for the traditional Chinese medicine treatment on April 7, 2006. The patient presented with fever, abdominal pain and tarry stool before consultation, and a one- week history of worsening jaundice and complained of dry mouth, insomnia, poor appetite, and abdominal fullness. Physical exzamination revealed a lethargic individual with icteric sclera ,yellowish discoloration of skin and ascites. The tongue diagnosis showed redcrimson and a white-thick dry fur. The pulse diagnosis revealed a powerful string-slippery pulse. The jaundice with tympanites, and pattern of liver-gallbladder dampness-heat, yin deficiency with blood heat, and blood stasis were diagnosed. The serum total bilirubin level was 22.36mg/dl. The patient was administered a modified formular of “Yin-Chen-Hao-Tang” to clear heat, eliminate dampness, cool the blood and resolve stasis, nourish yin, soften hardness and dissipate binds.After 30-days of treatment, the symptoms of jaundice, dry mouth, insomnia, appetite loss, and abdominal discomfort improved. Moreover, the total bilirubin concentration had declined to 6.2 mg/dl . The patient was discharged on May 17, 2006 and followed up in out-patient department. |
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