胃食道逆流合併慢性胃炎中醫治療經驗－－病例報告

The Therapeutic Experience of Gastroesophageal Reflux Disease and Chronic Gastritis With Chinese Medicine – A Case Report

本病歷報告為一58 歲女性，自小即有緊張易腹瀉及偶完穀不化，到高中時開始出現胃嘈雜不舒及食後腹脹。97 至98 年間發生胸痛徹背的情形，至高雄聖功醫院心臟科檢查未發現異常。99/01/20，因覺食道灼熱疼痛，在高雄聖功醫院檢查，胃鏡下發現有食道炎和胃竇炎。服用Esomeprazole、Al（OH）3、MgO三個月，疼痛消，但胃脘不舒、食後腹脹、嘈雜一直未緩解，故至本院中醫門診求診。經中醫辨證為中焦氣機不暢，脾胃升降失宜，木鬱土壅，濕熱內蘊，胃熱脾寒。中醫處方給予半夏瀉心湯合小陷胸湯加味。一週後，症狀即消，治療持續三週，半年後再次追訪，其症狀並未復發。在此其間，並未合併服用任何西藥。以中西醫用藥的時序而言，我們推論應是中醫藥達到的效果，而幫助了病人解除其長年之苦。以中醫藥治療胃食道逆流及慢性胃炎常見的症狀，可以得到很好的緩解效果，可作為傳統中醫藥治療此類疾病之參考。A 58-year-old woman experienced diarrhea with undigested food when she was in anxiety state. When she was in senior high school, she suffered from gastric pain and abdominal distention. During 2008 to 2009, she felt chest pain radiating to her back but no cardiac dysfunction was noted. On 01/20/2010, owing to heart burn, gastritis and esophagitis were observed under gastro-fiberscopy. After taking esomeprazole, Al(OH)3, MgO for three months, abdominal pain relieved but she still felt gastric upset and abdominal distention after meal. Because of persisting symptoms, she went to our Chinese medicine clinic for treatment. Based on Chinese medical differential diagnosis, we prescribed Banxiaxiexin tang combined with Xiaoxianxiong tang. The gastric discomfort and associated symptoms improved dramatically after approximately one week TCM treatment without any western medical assistance. The TCM treatment persisted three weeks. And after 6 months, the gastric symptoms did not relapse in this period. In conclusion, chinese medicine might be the complementary therapy of chronic gastritis and gastroesophageal reflux disease.