食用守宮木造成肺損傷之中醫會診病例報告

A Case Report of Lung Injury Related to Consuming Sauropus Androgynus Vegetable in Traditional Chinese Medicine

王賓緯(Pin-Wei Wang)；王大成(Ta-Chen Wang)；陳俐彣(Li-Wen Chen)；林原禾(Yuan-Ho Lin)；蔡金川(Chin-Chuan Tsai)

守宮木 ； 導水茯苓湯 ； 肺纖維化 ； Sauropus androgynus ； Dao Shui Fu Ling decoction ； pulmonary fibrosis

臺灣中醫醫學雜誌

14卷1期（2016 / 03 / 01）

1 - 10

繁體中文

守宮木，別名樹仔菜，俗稱減肥菜。臺灣於1994年時，民眾以減重為目的過量食用其原汁或其萃取液而蔚為風潮。大量的受害案例於童年被揭露；時至今日仍有許多患者受其遺毒所苦。本病例為當年受害者之一，肺部呈現嚴重纖維化，此次即因高碳酸血性呼吸衰竭而入院治療，主訴為胸悶、胸緊、呼吸困難並伴隨著眠差、食慾不振等症狀，我們辨證諭治後，採用利濕瀉肺和牌之法，使用導水茯苓湯為主要方劑作為治療，成功舒緩病人的不適。

Sauropus androgynus, also known as katuk, commonly known as weight-controlvegetable. Consuming its raw leaves or its aqueous extract for the purpose of weight reduction was a fad in Taiwan in 1994. Soon after, an outbreak of Sauropus androgynus intoxication in Taiwan has been reported around next year. This case report tells the story of a patient, a victim of weight-losing hoax, suffered from pulmonary fibrosis for several years. This time, due to acute hypercapnic respiratory failure, she was brought to our hospital with intermittent chest tightness and dyspnea. In pattern-based Traditional Chinese Medicine (TCM), we used Dao Shui Fu Ling decoction to remove the dampness, drain the lung and restore the spleen. The treatment successfully eased her symptoms and she discharged in a few days. TCM may be of value in the treatment of pulmonary fibrosis, which could be further research priorities.

1. Chang, YL,Yao, YT,Wang, NS,Lee, YC(1998).Segmental Necrosis of Small Bronchi after prolonged intakes of Sauropus androgynus in Taiwan.American Journal of Respiratory and Critical Care Medicine,157(2),594-598.
2. Lai, RS,Chinag, AA,Wu, MT,Wang, JS,Lai, NS,Lu, JY,Ger, LP,Roggli, V(1996).Outbreak of bronchiolitis obliterans associated with consumption of Sauropus androgynus in Taiwan.Lancet,348,83-85.
3. Luh, SP,Lee, YC,Chang, YL,Wu, HD,Kuo, SH,Cho, SH(1999).Lung transplantation for patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO)syndrome.Clinical Transplantation,13,496-503.
4. Ou, CY,Chen, CZ,Lee, CH,Lin, CC,Chang, HY,Hsiue, TR(2013).Pulmonary function change in patients with Sauropus androgynus-related obstructive lung disease 15 years later.Journal of the Formosan Medical Association,112,630-634.
5. Wang, JS,Tseng, HH,Lai, RS,Hsu, HK,Ger, LP(2000).Sauropus androgynus-constrictive obliterative bronchitis/bronchiolitis: histopathological study of pneumonectomy and biopsy specimens with emphasis on the inflammatory process and disease progression.Histopathology,37,402-410.
6. 江大雄,林增記,蔡明宏,岳萬君,鄧昭芳(2008)。減肥菜中毒事件致病因子之探討。疫情報導，14(9)，295-310。
7. 胡晶晶,楊珺超,夏永銀,汪潞(2005)。肺氣虛與肺纖維化形成相關性的探討。山西中醫學院學報，16(1)，77-78。
8. 張伯臾（編）(2005).中醫內科學.臺北市:知音出版社.
9. 陳瑞,王鵬(2005)。淺談肺痺與特發性肺纖化的關係。中國中醫藥信息雜誌，12(6)，90-91。
10. 謝文全(2002).台灣常見藥用植物圖鑑.臺北市:行政院衛生署中醫藥委員會.