中西醫結合治療先兆早產之病例報告

A case report about the treatment of threatened preterm labor with integrated traditional Chinese and western medicine

曾瑋涵(Wei-Han Tseng)；龔彥穎(Yen-Ying Kung)；陳方佩(Fang-Pey Chen)；張凱惟(Kei-Wei Chang)

安胎 ； 溫中散寒 ； 安中散 ； Tocolysis ； Warming spleen and stomach for dispelling cold ； An Zhong San

北台灣中醫醫學雜誌

15卷1期（2023 / 03 / 01）

53 - 75

繁體中文;英文

早產對於即將迎接新生命的父母而言一直是一大擔憂，即使是醫療較先進的國家如美國，根據統計在2021年約有1/10的新生兒早產，不僅佔週產期死亡率的多數，出生後面臨各項病症的機率也較高，因此多數父母與醫療方在妊娠期間若遇到早產跡象，仍希望盡可能使胎兒平安待到足月才生產。西醫治療先兆早產視胎兒週數予以類固醇或硫酸鎂等確保胎兒發育成熟，若宮縮頻繁則會予以宮縮抑制劑，配合補充孕酮或視情況使用其他藥物。但宮縮抑制劑常引起母體不適，因此在美國婦產科醫學會的指引中已不推薦以抑制急性早產為目的使用。許多民眾在面臨該問題時亦會尋求中醫協助，本案例即利用中醫辨證論治原則施治，使一已入院安胎近四週的患者得以穩定病情，調降西醫安胎藥物並順利出院，日後亦足月生產，母子均安。冀由分享治療該病例之相關思考，作為臨床中醫師在治療先兆早產時的參照。

Preterm labor has always been a major concern for those parents to be. Even in countries with the most advanced healthcare such as the United States, according to statistics, about 1 in 10 newborns were premature infants in 2021. The preemies not only account for the majority of perinatal mortality, but also result in the higher probability of facing various diseases after birth. Hence, when threatened preterm labor occurs, most parents and medical practitioners try hard to inhibit preterm birth so as to have a full term baby. Steroids or magnesium sulfate is used depending on the gestational age to ensure that the fetus is well-developed. Tocolytics, progesterone or other drugs may be given in view of frequent uterine contraction. However, tocolytics often cause maternal discomfort. As a consequence, in the guidelines of the American College of Obstetricians and Gynecologists, it is no longer recommended to use in purpose of inhibiting acute preterm labor. When faced with this problem, many people will seek the assistance of traditional Chinese medicine (TCM) as well. In this case, we utilized the principle of TCM, namely, pattern identification as the basis for determining treatment, to treat the patient who had been admitted to the hospital for nearly four weeks due to threatened preterm labor. We successfully stabilized her condition, and thus the dose of anti-abortion drugs gradually reduced. The patient safely discharged from the hospital in the end. A few months later, the delivery was quite smooth. Both mother and baby were intact. Through sharing ideas about this case, we hope that we can offer some information about the treatment of threatened preterm labor for clinical TCM doctors.

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