身心症之中醫診療病例報告

Chinese Medicine Treatment of Somatization Disorder: A Case Report

蔡佩玲(Pei-Ling Tsai)；蔡佳玲(Jia-Ling Tsai)；施睿宏(Ruey-Horng Shih)

身心症 ； 傳統中醫藥 ； 病例報告 ； Somatization disorder ； TCM medication ； Case report

北台灣中醫醫學雜誌

6卷1期（2014 / 06 / 01）

37 - 48

繁體中文

本案例為一名60歲女性患者，職業為家管。就診前三週突發右胸痛、呼吸困難、頭暈無力。且因胸痛、呼吸困難嚴重，這段期間曾二次送新北市某醫院急診與隨後之門診回診，X光攝影、心電圖檢查、腦波檢查、心臟超音波檢查、抽血檢查均無特殊發現，服西藥無效果。經友人介紹到本院區就診，分析患者病情，此一案例為患者因近期親人過世，悲傷過度引發身心症（somatization disorder）之典型案例，中醫診斷為鬱證。以理氣解鬱之法給予治療，服藥一週後自述症狀已緩和，服藥三週後病情十分只剩二分，服藥第五週回診時，自述症狀已改善九成以上，三個月後追蹤病情無復發。

A 60-year-old female patient, occupation housewife. She suffered sudden right side chest pain, breathing difficulties, dizziness and weakness three weeks before treatment. She was twice sent to emergency in a hospital in New Taipei City in Taiwan during this period. The data of X-ray, EKG, EEG, echocardiography and blood tests showed no specific findings. It was also without therapeutic effect by taking medicine. She was introduced to our hospital for seeking treatment. Analysis of this patient's condition, we considered this case was a typical case of somatization disorder induced by grief due to recently death of a family, her younger brother. This case is diagnosis of depression by Traditional Chinese Medicine (TCM). Soothing-liver-relieve-depressed and qi-conditioning- stopped-pain methods of treatment were given to treat this patient. Symptoms have eased one week after TCM medication. The state of the illness was decreased eighty percent after three weeks. After five weeks, symptoms have improved more than ninety percent assessed by the patient. Three months later, there was no recurrence of the disease.

1. Hasin, D,Katz, H(2007).Psychosom.Med,69(9),870.
   連結：
2. (2013).The Diagnostic and Statistical Manual of Mental Disorders.American Psychiatric Association.
3. Jackson, JL,Kroenke, K.(2008).Prevalence, impact, and prognosis of multi-somatoform disorder in primary care: a 5-year follow-up study.Psychosom Med,70(4),430-434.
4. Lipowski, ZJ(1988).Somatization: the concept and its clinical application.Am. J. Psychiatry,145,1358-1368.
5. UpToDate online 2013. Somatization: Epidemiology, pathogenesis, clinical features, medical evaluation, and diagnosis.（http://www.uptodate.com/contents/search?search=somatization+disorder&sp=0&searchType=0&source=USER_INPUT&searchControl=TOP_PULLDOWN&searchOffset=&autoComplete=true）
6. 王小青(2012)。碩士論文(碩士論文)。湖北，湖北中醫藥大學。
7. 李選(2003)。精神衛生護理學。臺北市:五南書局。
8. 黃宜宣、黃心樹、陳瑞蘭、金蓉蓉、呂雀芬、湯美霞、闕可欣、林靜蘭、餘靜雲、馬玉琴(2012)。最新精神科護理學。臺北市:永大書局。