虛勞中醫治療病例報告

Traditional Chinese Medicine in the Treatment of Chronic Fatigue Syndrome : A Case Report

10.6718/TJCM.202403_30(1).0014

林芳誼(Fang-Yi Lin)；王玟玲(Wen-Ling Wang)

慢性疲勞症候群 ； 虛勞 ； 氣陰兩虛 ； Chronic Fatigue Syndrome ； tiredness ； dual vacuity of qi and yin

台北市中醫醫學雜誌

30卷1期（2024 / 03 / 17）

125 - 132

繁體中文;英文

慢性疲勞症候群（Chronic fatigue syndrome, CFS）又稱為肌痛性腦脊髓炎（Myalgic encephalomyelitis, ME）是一種常見但致病機轉仍未明的疾病，許多研究提到可能和中樞神經、自律神經、免疫系統和能量代謝有關。此個案為65歲女性，自一年前起晨起頭重痛、頭暈，伴隨明顯身倦感、全身痠痛與眼乾。近期的抽血檢驗皮質醇（Cortisol）和促甲狀腺激素（TSH）無異常。經辨證論治，中醫病名為虛勞，證型診斷為氣陰兩虛型，治則為補脾氣、滋肝陰，中藥處方以杞菊地黃丸和加味逍遙散加減。中醫典籍記載虛勞最早見於《素問∙通評虛實論》：「邪氣盛則實，精氣奪則虛。」而明代《理虛元鑒》提出：「治虛有三本，肺、脾、腎是也。」然而，現代人虛勞常與情志問題有關，故病機以木氣失調為主、中土失運為次，日久引起火金水三氣失司，此與古代醫家治療虛勞重視肺、脾、腎三臟的想法不同，顯現出時空環境改變病因病機也隨之更迭。

Chronic fatigue syndrome, also known as myalgic encephalomyelitis, is an illness of uncertain cause. While many theories indicate that the central and autonomic nervous systems, the immune system, and energy metabolism may be involved, these findings have not yet led to a clear understanding of pathophysiology or to a diagnostic test of adequate sensitivity and specificity. In this case, a 65-year-old female has been suffered from dizziness, headache, head pressure with an overall feeling of fatigue, soreness, and dry eyes. Recent lab data showed cortisol and TSH levels were in the normal range. The pattern type is dual vacuity of qi and yin. The principle of treatment is to supplement qi and to enrich yin. The prescription is Lycium Berry, Chrysanthemum, and Rehmannia Pill combined with Supplemented Free Wanderer Powder. In ancient Chinese books, chronic fatigue syndrome mainly involved the lung, spleen, and kidney. Modern people with chronic fatigue syndrome, however, are caused by emotional distress and the liver qi should be taken into consideration.