中醫治療腹脹之病例報告

Traditional Chinese Medicine Treatment of Bloating-A Case Report

10.6718/TJCM.202203_28(1).0008

顧綵甄(Tsai-Chen Guh)；葉家豪(Chia-Hao Yeh)

腹脹氣 ； 柴胡疏肝散 ； 香砂六君子湯 ； Bloating ； Chai Hu Shu Gan San ； Xiang Sha Liu Jun Zi Tang

台北市中醫醫學雜誌

28卷1期（2022 / 03 / 30）

61 - 68

繁體中文

腹脹是常見的臨床症狀，許多疾病都可能導致腹脹的出現，特別是腸胃道系統的疾病，如功能性消化不良、大腸激躁症、慢性便秘、消化性潰瘍⋯等等都可能導致腹脹氣，致病機轉為腸腔內的氣體或二氧化碳異常累積、心理壓力過大影響腸道的蠕動等等，一般認為情緒壓力和飲食習慣是會導致症狀加劇的重要因子。脹氣在中醫的觀點來說，屬於「胃脹」、「痞滿」、「胃脘痛」的範疇，和肝、脾胃、大腸有密不可分的關係，病位在胃、大腸。本案例是一位胃脹不適，有胃潰瘍病史的患者，飯後胃脹不適加劇，腹部悶痛，腹部自覺有酸酸的感覺，經中醫辨證論治後為肝鬱脾虛，故以疏肝解鬱、益氣健脾為治則，處方用柴胡疏肝散及香砂六君子湯加減治療，經過中藥調理後其症狀緩解。

Bloating is a common symptom in clinical. There are many diseases that may cause bloating, such as diseases that related to digestion system. For example, functional dyspepsia, irritable bowel syndrome, chronic constipation and peptic ulcer disease, etc. All these diseases may cause bloating. Bloating may be produced by different mechanisms, such as abnormal accumulation of luminal gas or fluid and psychological pressure that infect the peristalsis of bowel. It is generally believed that emotional stress and eating habits are important factors that will lead to aggravation of symptoms. From the point of view of traditional Chinese medicine, flatulence belongs to the categories of ＂stomach bloating＂, ＂fullness＂ and ＂epigastric pain＂. It is highly related to liver, spleen and stomach. The disease location is stomach and large intestine. This case is a patient with stomach bloating and discomfort with a history of gastric ulcer. The stomach bloating aggravates after meals, the abdomen is full of oppressive pain and the patient feels sour in the stomach. After TCM syndrome differentiation, it is liver stagnation and spleen deficiency. Therefore, the treatment principle is to disperse stagnated liver and relieve depression, also to replenish qi and strengthen the spleen. The prescription is Chai Hu Shu Gan San and Xiang Sha Liu Jun Zi Tang plus single herbs. The symptoms are relieved after the treatments.

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