中醫治療慢性咳嗽之病例報告

Treatment of chronic cough using Traditional Chinese Medicine: A Case Report

10.7102/JTCIM.202012_18(2).0008

王育才(Wang, Yu-Tsai)；呂琇蓉(Lu, Hsiu-Jung)；蔡承諺(Tsai, Cheng-Yen)；羅煥奎(Lo, Huan-Kuei)

慢性咳嗽 ； 傳統中醫 ； 鼻涕倒流 ； 胃食道逆流 ； chronic cough ； Traditional Chinese Medicine ； postnasal drip ； gastroesophageal reflux

中醫內科醫學雜誌

18卷2期（2020 / 12 / 01）

88 - 100

繁體中文

慢性咳嗽，是中醫門診常見主訴之一，絕大多數的慢性咳嗽患者可以得到明確診斷，咳嗽症狀可以得到消除或緩解。無論如何，對於經過西醫久治不癒的慢性咳嗽，使用中醫治療的方式有其優勢，而且具有較佳的療效。本臨床案例報告一位42歲未婚女性之慢性咳嗽患者，胸部X光檢查、肺功能檢查、IgE和Eosinophil count數值皆在正常範圍，接受西醫治療超過兩個月未癒之後，改由中醫治療的歷程。因為病情反覆，病因病機複雜，西醫治療無法奏效。根據病患本身體質與症狀徵象，進行辨證論治。主證是痰濕壅肺，肺失宣降；次證是脾虛失運，氣鬱不舒。治法宜宣肺化痰，健脾行氣。文章分析患者慢性咳嗽的病因病機與運用中藥方劑治療之成效。本案例之西藥與中藥用藥時間，完全沒有重疊；因此，中藥治療的效果可以排除西醫用藥的影響。中醫治療方式確實有其療效。

Chronic cough is one of the common main complaints in traditional Chinese medicine (TCM) clinics. The vast majority of chronic cough patients can get a clear diagnosis, and the cough symptoms can be eliminated or relieved. However, for chronic coughs that have been treated by Western medicine for a long time, the use of TCM has its advantages and has better curative effects. This clinical case reports a 42-year-old unmarried woman with chronic cough. Chest X-ray, pulmonary function test, IgE and Eosinophil count values are all in the normal ranges. After receiving Western medicine treatment for more than two months, she was treated by Chinese medicine. Because of the repetitive symptoms and complicated etiology and pathogenesis, Western medicine treatment cannot be effective. According to the patient's physical constitution and symptoms, conduct differentiation and treatment. The primary symptom is phlegm dampness in the lungs, and pulmonary failure of ascending and descending. The secondary symptom is dysfunction of the spleen in transport, and Qi depression. The treatment method should be clearing lung and eliminating phlegm, and strengthening the spleen and promoting qi. The article analyzes the etiology and pathogenesis of patients with chronic cough and the effectiveness of treatment with TCM. In this case, there is no overlap in the administration time of western medicine and TCM; therefore, the effect of TCM treatment can exclude the influence of western medicine. TCM treatment does have its effects.

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