中西醫結合治療特發性肺纖維化病例報告

Treatment of Idiopathic Pulmonary Fibrosis with Integrated Traditional Chinese and Western Medicine : A Case Report

10.7102/JTCIM.201706_15(1).0005

黃棋政(Chi-Cheng Huang)；謝瓊慧(Chiung-Hui Shieh)

特發性肺纖維化 ； 尋常性間質性肺炎 ； 宣肺清熱 ； 益氣滋陰 ； Idiopathic pulmonary fibrosis (IPF) ； usual interstitial pneumonia (UIP) ； clearing heat and dispersing lung qi method ； replenishing qi and nourishing yin method

中醫內科醫學雜誌

15卷1期（2017 / 06 / 01）

46 - 57

繁體中文

一位68歲女性，被診斷為乾燥症、類風溼性關節炎併發特發性肺纖維化（idiopathic pulmonary fibrosis, IPF）/尋常性間質性肺炎（usual interstitial pneumonia，UIP），經給予類固醇、hydroxychloroquine sulfate及抗生素等藥治療後，仍因發燒、咳嗽胸痛及呼吸困難等症狀反覆住院，肺部纖維化在短短數月內迅速惡化，因而照會本院中醫科。中醫辨證診斷為「痰熱壅肺為標，氣陰兩虛為本」，故以麻杏甘石湯加減先宣肺清熱治其標，後再加竹葉石膏湯、清燥救肺湯等方益氣滋陰扶其正，患者的症狀逐漸獲得改善。IPF一般預後不佳，本案例的治療經驗顯示中藥之介入可有效的減輕病人的症狀，改善生活品質，是值得推展的治療選項。

A 68 year-old female was diagnosed with Sjögren's syndrome, rheumatoid arthritis and idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP). She was still hospitalized recurrently because of acute episodes of fever and dyspnea after treated by steroids, hydroxychloroquine sulfate and antibiotics. Pulmonary fibrosis symptoms deteriorated rapidly within several months . Therefore, she consulted the division of Traditional Chinese Medicine of our hospital. Being diagnosed with “ phlegm-heat obstructing lung and deficiency of both vital qi and yin combined pattern”, she was treated by modified Ma-Xing-Gan-Shi-Tang to clear heat, disperse lung qi and dissipate phlegm at first, and coupled with Zhuye-Shigao-Tang and then Qing-Zao- Jiu-Fei-Tang to replenish qi and nourish yin lately. Her symptoms were alleviated gradully. The management experience shows that the intervention of traditional Chinese medicine can reduce the symptoms of IPF and improve the quality of life significantly. Accordingly, we propose that the integration of traditional Chinese and Western medicine is worth promoting for the treatment of IPF.

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