潰瘍性結腸炎之中藥治療病例報告

Treatment of Ulcerative Colitis with Traditional Chinese Medicine (TCM): A Case Report

10.6718/TJCM.202309_29(2).0003

梁曦(Liang Hsi)；陳俊良(Jiun-Liang Chen)；陳星諭(Hsing-Yu Chen)

潰瘍性結腸炎 ； 中醫 ； Ulcerative colitis ； traditional Chinese medicine (TCM)

台北市中醫醫學雜誌

29卷2期（2023 / 09 / 30）

39 - 48

繁體中文;英文

本病例是一位六十餘歲男性，過去有高血壓及腦中風病史，使用高血壓藥物及抗凝血劑控制追蹤中。患者在2020年1月，因間歇性血便兩週伴隨腹痛至林口長庚院求診，經大腸鏡、切片及電腦斷層檢查，診斷潰瘍性結腸炎，並有肛周膿瘍。後續患者轉院至本院急診就診，當時再次大腸鏡檢查發現全結腸炎及巨結腸狀況，合併有檢驗白血球及發炎指數升高（WBC 17.6k, Seg 95%, CRP 62.21），明顯貧血（Hb 6.6），於2020/01/17進行全結腸切除手術合併終端迴腸造口術。術後病患於胃腸肝膽科追蹤，除了口服Mesalazine治療，也接受生物製劑vedolizumab及Adalimumab治療。術後一年餘，患者肛門周圍仍持續有膿血分泌物，肛門內側有疼痛感，下腹時有異物下墜感，於2021/03/15求診中醫內科，希望藉由中藥改善以上問題。中藥治療以清熱利濕，化濁止血概念為主，經過12個月中藥治療，患者肛門周圍膿血分泌物以及肛門內側疼痛感已穩定改善，且下腹時有異物下墜感已大幅減緩。

A 60-year-old Taiwanese male with hypertension and hemorrhagic stroke history, presented to Linkou Chang-Gung Memorial Hospital proctology department with hematochezia and abdominal pain for two weeks in January 2020. Examination including colonoscopy, biopsy, and abdominal CT resulted in diagnosis of ulcerative colitis with peri-anal abscess. The patient received a total colectomy with end ileostomy on 2020/01/17 because subsequent colonoscopy showed extensive ulcerative colitis with megacolon complication. After operation, the patient had received oral Mesalazine, Vedolizumab and Adalimumab from a gastroenterologist. Due to persistent rectal mucus discharge with blood, rectal pain and tenesmus despite the treatment, he presented to our center of tradition Chinese medicine's clinic inquiring about traditional Chinese medicine treatment for symptoms relief. The principle of treatment for this case is "clearing heat and promoting diuresis, promoting hemostasis and removing turbid pathogen". The patient's rectal pain, frequent rectal discharge with blood and tenesmus got improved after receiving the tradition Chinese medicine over 12 months. This case is suggestive that traditional Chinese medicine may be a helpful treatment of patients with ulcerative colitis, rectal pain and mucus discharge symptoms.

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