心因性嘔吐之內科治療病例報告

Chinese Medicine Treatment for Psychogenic Vomiting: a Case Report

10.7102/JTCIM.202312_21(2).0004

佘佳穎(Chia-Yin She)；蔡岳廷(Yueh-Ting Tsai)

心因性嘔吐 ； 心理社會因素 ； 催吐 ； 功能性消化不良 ； 科學中藥 ； Psychogenic vomiting ； Psychosocial factor ； self-induced vomiting ； functional dyspepsia ； Chinese herbal products

中醫內科醫學雜誌

21卷2期（2023 / 12 / 01）

34 - 46

繁體中文;英文

心因性嘔吐（psychogenic vomiting），為一精神障礙，患者常見反覆嘔吐（自發性或故意催吐），經檢查多無明顯器質性病變。此疾患常見於青年女性。與心理社會因素相關，通常在情緒緊張或壓力狀態下發生。本例為一31歲女性患者，主訴症狀為飯後催吐、嘔吐復發已數月，伴上腹脹痛、灼痛、食慾時佳時差，曾至診所與童綜合醫院就診，做過胃鏡與相關抽血檢查無特殊發現，，服用mosapride、domperidone、fludiazepam症狀無緩解，故於112/05/26至本院中醫部就診，經西醫鑑別診斷為心理因素導致之功能性消化不良，經中醫辨證屬心氣陰虛挾熱，肝鬱氣滯，肝氣犯胃，胃氣上逆，並給予科學中藥治療後（此期間無服用西藥），第一次回診起即表示症狀改善（催吐頻率減、上腹痛緩解），顯示中醫對心因性嘔吐之治療亦有所成效。

Psychogenic vomiting, a psychiatric disorder, defined as recurrent vomiting (spontaneously or self-induced) without any known discernible organic reasons. This disorder is more prevalent in young females, and closely related with psychosocial factors , It occurs as a result of an emotional or psychic disturbance. This patient is a 31-year-old female with an aggravated condition of self-induced vomiting and vomiting after meal for months, accompanied with upper abdominal distending pain and burning pain, poor appetite off and on. She received gastroscopy and abdominal ultrasound but nothing was found, and she had visited the local clinic and Tungs' Taichung MetroHarbor Hospital for medical treatment (mosapride、 domperidone、 fludiazepam) but symptoms didn't relieve. As a result, she came to the Department of Traditional Chinese Medicine of Kuang Tien General Hospital for help. Differential diagnosis showed psychogenic vomiting of functional dyspepsia. Syndrome differentiation showed deficiency of heart (yin, chi), dysfunction of liver controlling dispersion (liver qi), and liver qi invading stomach. Based on it, we adopted nourishing the heart, tranquillizing mind and smoothing the liver qi as principle of treatment. After treatment with Chinese medicine powder only, her symptoms relieve(less frequency of vomiting and abdominal pain relieved).This experience showed that Chinese Medicine can also plays an important role in psychogenic vomiting of functional dyspepsia treatment.

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