針藥並用治療梅核氣之病例報告

Treating Globus Sensation Using Acupuncture and Chinese Formula: A Case Report

10.6516/TJTCM.202009_23(2).0014

許睿杰(Jui-Chieh Hsu)；沈邑穎(Yi-Ying Shen)

梅核氣 ； 行氣解鬱 ； 化痰降逆 ； 五門十變 ； 臟腑別通 ； Globus sensation ； relieve stagnant liver qi ； transform phlegm and direct Qi downward ； Wu-Men-Shih-Bian ； Zang-Fu-Bie-Tong

中醫藥研究論叢

23卷2期（2020 / 09 / 30）

183 - 197

繁體中文

本病例是一位50歲男性，自覺咽喉異物感已有八個月，西醫診斷為胃食道逆流、食道疝氣等問題，經藥物治療後，由於症狀仍未改善，故患者前來本院就診，中醫診斷為肝鬱氣滯，脾胃升降失常，痰氣交阻於咽喉之症，此外患者於身體多處有疤痕存在，直接影響督脈、膀胱經與大腸經的經氣流行，運用通經理論中五門十變、臟腑別通與對應絡穴法推知亦影響到心經、肝經與腎經，以上許多經絡循行路徑經過咽喉、頸部或入絡腦，其功能也多與情緒調控相關，可推知疤痕的存在是引起咽喉異物感的原因之一，治療上採用行氣解鬱散結，化痰降逆的方劑為主軸來處理，我們同樣重視以針刺療法處理因疤痕所造成的經氣流行不暢，獲得療效，提出此報告供醫學界參考。

Our case is a fifty years old male with complaint of globus sensation for 8 months. He was diagnosed to have gastro-esophageal reflux disease and hiatal hernia by physician of Western medicine. Due to persistent symptom despite medical treatment, he visited Chinese medical department for further evaluation. According to the Traditional Chinese Medicin's syndrome differentiation, the patient is diagnosed with liver Qi stagnation, abnormal ascending and descending function of spleen and stomach and Qi stagnation and phlegm in the throat. Moreover, many scars were noted over the patient's head and extremities which could influencethe Qi flow of Governing vessel, bladder and large intestine meridians directly. The Wu-Men-Shih-Bian, Zang-Fu-Bie-Tong and Duei-Ying-Luo-Xue theories implied that the scars could also influence the heart, liver and kidney meridians. In addition, these meridians also travel through the throat, neck or brain. The functions of some of those meridians are related to emotional regulation. We hypothesize the formation of globus sensation is due to the existence of scars. The treatment for this patient includes formulas that can relieve stagnant liver qi, transform phlegm and direct Qi downward. While we acknowledge and value the use of acupuncture therapy to relieve the stagnation of meridian qi, our case report offers an additional/alternative method in managing the same condition. By the virtue of this case, we anticipated offering a reference for the medical doctors. With this case report, we would like to share an additional/alternative management in qi stagnation which is traditionally relieved by acupuncture therapy.

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