柴胡桂枝湯合五苓散治療肋膜積液病例報告

Chinese Medical Treatment for pleural effusion with Chai Hu Gui Zhi Tang and Wu Ling San - A Case Report

黃琦雯(Chi-Wen Huang)；楊登凱(Deng-Kai Yang)

肋膜積液 ； 柴胡桂枝湯 ； 五苓散 ； pleural effusion ； Chai Hu Gui Zhi Tang ； Wu Ling San ； Traditional Chinese Medicine

北台灣中醫醫學雜誌

11卷2期（2019 / 09 / 01）

57 - 72

繁體中文

本病例報告為一位49歲女性，20年前有非開放性肺結核及乾燥症病史，前陣子因家人生病，緊張憂慮，照顧家人勞累，於近一個半月來出現間歇性胸痛，並伴有呼吸喘促，經西醫住院抽取胸水並接受藥物治療後，症狀未完全緩解，於108/7/12會診中醫治療，經診斷證屬邪陷少陽，飲停胸脅，服用柴胡桂枝湯及五苓散一週後症狀緩解而出院。本文透過病例探討飲證相關之病因病機，體現中醫辨證論治的個人化治療特色。

Pleural effusion is an excessive accumulation of fluid in the pleural space. The common symptoms associated with pleural effusion may include chest pain, short breathing and cough. It is classified as transudates or exudates. Exudates result from pleural and lung inflammation, tumor, or autoimmune disease. It takes time to search for pathogens before and during diagnosis. In the meantime, treating with traditional Chinese medicine (TCM) can have better outcome compared with western medicine alone for cause unknown pleural effusion. In the TCM, it is termed as the ＂phlegm-rheum＂ or the ＂thoracic retention of fluid＂ or ＂excessive fluid in the hypochondrium and epigastrium＂. Most of them caused by imbalance of hydrostatic and osmotic forces across a semipermeable membrane. This case is a forty-nine-year-old female who had tuberculosis and sicca syndrome suffered from chest pain and dyspnea lasting one and a half months. During recent half year, she was nervous and exhausted from taking care of sick family. After treating with antibiotics and drainage, she still had short and painful breathing. The Chest man consulted our TCM apartment on 2019/07/12. The diagnosis after pattern identification were the evil enter shao yang, phlegm and fluid retention in the chest and qi-blood vacuity. After treatment with Chai Hu Gui Zhi Tang and Wu Lin San for the purpose of support right and eliminating dampness and diuresis, the patient's chest pain relieved in one week and the pleural effusion didn't recur after drainage. This case provides that Chinese medicine have excellent therapeutically effects in remove dampness and phlegm. This case shows the etiology and pathogenesis of pleural effusion, and also reflects the pattern identification and treatment of individual in traditional Chinese medicine.

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