血管炎之中醫治療病例報告

Vasculitis Treated with Traditional Chinese Medicine: A Case Report

張（王夋）瑛(Chun-Ying Chang)；鄭宏足(Hung-Tsu Cheng)

熱入血室 ； 小柴胡湯 ； 血管炎 ； 紫斑 ； Vasculitis ； Purpura ； Xiao Chai Hu Tang ； Heat into the blood chamber

臺灣中醫醫學雜誌

16卷2期（2018 / 09 / 30）

45 - 56

繁體中文

本病例為37歲男性病患，在105年11月中旬，雙下肢陸續出現紫斑，上肢發作輕微，導致夜間搔癢難眠，所以在105/11/15時前往台大新竹分院就診，並被診斷為『動脈炎』，西醫給予NSAID（diclofenac）治療，但是不幸的是藥物未見療效。於是患者於105/11/25回診續服用相同藥物（diclofenac）。在未見改善的狀況下，於105/11/28轉就診於新竹馬偕紀念醫院尋求進一步的治療，他被診斷為『其他血管炎局限於皮膚』，並給予類固醇prednisolone。服藥後紫斑搔癢獲得控制，在服用類固醇prednisolone兩周餘後，紫斑搔癢復發，患者希望停用類固醇，遂來本院尋求中醫診治。在經過中藥療程治療之後，紫斑和搔癢消失。

This is a 37-year-old male patient. In mid-November, purpura appeared on both lower extremities and minor on upper extremities, resulting in itching at night and sleeping disorder. So he went to National Taiwan University Hospital Hsin-chu Branch on 105/11/15,then diagnosed as ＂arteritis＂. The doctor treat with NSAID (diclofanac). Unfortunately, the drug was ineffective. The patient came back to the hospitsal on 105/11/25 and treat with the same drug (diclofenac) again. Without any improvement, he transfered to Hsinchu MacKay Memorial Hospital for further help on 105/11/28. He was diagnosed as ＂other vasculitis confined to the skin＂ and given steroids (prednisolone). Then, the itching and purpura were under control. After taking more than two weeks of steroids(prednisolone), with recurrent itching and purpura the patient asked to stop steroids. Therefore he came to our clinic for Chinese medicine treatment. After Chinese medicine treatment course, the itching and purpura vanished.

1. 百家諸子中國哲學書電子化計畫https://ctext.org/wiki.pl?if=gb&res=528853&searchu=%E5%AE%A4%E5%B1%8B
2. Elmonselhi, Adel(2018).Cardiology: An Integrated Approach.USA:McGraw-Hill Education.
3. Kasper, Dennis L.,Fauci, Anthony S.,Longo, Dan L.,Hauser, Stephen L.,Jameson, J. Larry,Loscalzo, Joseph(2015).Harrison’s Principles of Internal Medicine.USA:McGraw-Hill Companies.
4. Peter A Merkel, MD, MPH : Overview of and approach to the vasculitides in adults, (UPToDate) last updated: Sep 22, 2015: P 1-19.
5. 王洪圖(2004).黃帝內經素問白話解.北京:人民衛生出版社.
6. 田安然(2014).金匱要略義理探要.台北:知音出版社.
7. 吳敦序(2009).中醫基礎理論.上海:上海科技出版社.
8. 孟澍江(2001).溫病學.台北:知音出版社.
9. 林昭庚(2004).中西醫病名對照大辭典.台北:國立中國醫藥研究所.
10. 柯琴(2010).傷寒來蘇集.太原市:山西科學技術出版社.
11. 胡希恕(2017).胡希恕金匱要略講座.北京:中國中醫藥出版社.
12. 陳仁壽(2008).四庫全書．傷寒論.南京:江蘇科學技術出版社.
13. 陳亦人(2017).傷寒論譯釋.上海:上海科學技術出版社.
14. 陳熠(1999).喻嘉言醫學全書.北京:中國中醫藥出版社.
15. 劉渡舟(2017).傷寒論校注.北京:人民衛生出版社.
16. 劉渡舟(2008).劉渡舟傷寒論講稿.北京:人民衛生出版社.