中藥治療有乳癌病史患者之慢性腹瀉病例報告

A Case Report of Chinese Medicine Treatment for Chronic Diarrhea of a Patient having the History of Breast Cancer

10.7102/JTCIM.201712_15(2).0006

黃鈺翔(Yu-Hsiang Huang)；許中華(Chung-Hua Hsu)

慢性腹瀉 ； 腸胃疾病 ； 中藥 ； chronic diarrhea ； gastrointestinal disease ； Chinese medicine

中醫內科醫學雜誌

15卷2期（2017 / 12 / 01）

58 - 69

繁體中文

慢性腹瀉是一種常見的臨床症狀。以西醫而言，大部分一般的腹瀉可由症狀描述、理學檢查、實驗室檢查來詳細診斷，通常也很容易治療，但由於慢性腹瀉的病因較為複雜且病程遷延，故慢性腹瀉常是臨床醫師診斷與治療的挑戰。而以中醫而言，雖導致泄瀉的原因很多，總括而言，可分為外因、內因、不內外因三大類。外因以風寒或暑濕內犯腸胃較為多見，內因有七情不遂，不內外因有飲食所傷、肝脾不和、脾胃虛弱及腎陽虛衰等多種因素。而慢性腹瀉屬中醫學「久瀉」的範疇，臨床多分脾虛濕盛、肝脾失調、脾腎陽虛三型辨證治療。此病患有乳癌病史，且來診時懷疑可能有復發的跡象，然而卻有氣血虛弱之證，若僅顧補益氣血，則會有助長癌細胞生長之虞，本病例為一種治療的方式，使患者腹瀉情況減緩，故提供此病例作為參考與應用。

Chronic Diarrhea is a common disease. From the perspective of western medicine, the causes of most general diarrhea can be easily diagnosed and rooted out by symptoms, physical examinations, and laboratory findings. However, the causes of chronic diarrhea are complicated. Thus, it often becomes a challenge to diagnose the causes of chronic diarrhea accurately. Nevertheless, from the perspective of Chinese medicine, the causes of most diarrhea can be briefly classified into three groups, external factors、internal factors and other factors. External factors include wind-cold and summer-heat with dampness. Internal factors include various emotional disorders. Other factors include the deficiency of spleen and stomach, the deficiency of Yin in kidney, the incoordination between liver and spleen, the injury due to diet. In Chinese medicine, chronic diarrhea is classified into three types, the deficiency of Yang in spleen and kidney, the incoordination between liver and spleen, the damp abundance due to splenic asthenia. In the case, the patient had a history of breast cancer and was worried about a recurrence of it. Moreover, the patient had symptoms of deficiency of qi and blood. If we had only focused on enriching qi and blood, the cancer cells might have got the nutrients we had supplied. Hence, the report offers a way to cure a patient having a history of breast cancer is suffering from chronic diarrhea for reference.

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