東垣升陽益胃湯治療慢性泄瀉臨床病案報告

The Therapeutic Effect of Sheng Yang Yi Wei Tang on Chronic Diarrhea – A Case Report

本病例報告為一名40歲男性，自述民國98年開始有大便不成形症狀，喝冰水後症狀加重，大便稀溏，完榖不化，夾少量黏液，伴有解不淨感，一日3~4行。103年6月開始出現失眠症狀，不易入睡，眠淺多夢，易醒，醒來不易再入睡，白天自覺身體疲倦，精神差，怕冷，容易出汗，汗非清冷，未有形寒之狀。103年9月12日至本院中醫門診就診，經中醫診治辨證為脾虛濕鬱，清氣下陷，熱擾心神，肺衛不固。初診處方給予升陽益胃湯加味，一週後大便形質稍聚，泄瀉頻率減為一日2~3行。二診三診持續進步，大便漸成形，解便頻率為一日1~2行，四診時大便形質已正常，解便頻率一日1行，五診時睡眠已安，眠淺易醒症狀大幅緩解，可連續睡眠達7小時。總計中藥治療療程共6週，患者長達五年腹瀉症狀恢復正常，睡眠品質亦大幅進步。本患者治療成效令人振奮，以升陽益胃法隨證加減治療慢性泄瀉，可取得良好效果，本病案說明傳統中醫藥不失為治療慢性泄瀉的另一選擇。

A 40-year-old male had suffered from persistent diarrhea since 2009. The symptoms included: thin sloppy stool, clear grain diarrhea and ungratifying defecation which exaggerated after consumption of cold foods. This patient also had suffered from initial insomnia, profuse dreaming, tendency to awake and difficulty in going back to sleep since 2014/6. The accompany symptoms were physical fatigue, lassitude of spirit, aversion to cold and excessive sweating. He visited our Chinese Medicine department on 2014/9/12.
After four examinations were performed, we determined the patterns were spleen vacuity damp encumbrance, central qi fall, spirit disturbed by heart fire and lung defense vacuity. Based on Chinese medical differential diagnosis, we prescribed Sheng-yang-yi-wei-tang. The symptoms improved after one week TCM treatment. During the third week of treatment, the diarrhea was resolved. The TCM treatment persisted six weeks. After six weeks, the insomnia was alleviated. In conclusion, Chinese Medicine may be the complementary therapy of chronic diarrhea and even can be the first choice of this intractable disease.