胎動不安合併子懸之中西醫結合治療病例報告

Treatment of Postpartum Preterm Labor with Zi-xuan by Integrative Medicine: A Case Report

10.6516/TJTCM.202206_25(2).0005

許雅婷(Ya-Ting Hsu)；陳怡伶(Yi-Lin Chen)；廖苑伶(Yuan-Ling Liao)；林亞萱(Ya-Hsuan Lin)；吳炫璋(Hsien-Chang Wu)

早產 ； 胎動不安 ； 子懸 ； 安胎 ； 中西醫結合治療 ； preterm labor ； Zi-xuan ； tocolysis ； Integrative Medicine

中醫藥研究論叢

25卷2期（2022 / 06 / 30）

69 - 81

繁體中文

35歲孕婦，G1P0A0，2020/01/04（妊娠週數為23+2週）陰道有水狀分泌物流出，無宮縮感，子宮頸長度為2.16公分，因子宮頸閉鎖不全且子宮頸長度持續性縮短，安排住院安胎，施打安胎針劑（Ritodrine）。住院期間孕婦持續有胸腹脹滿、心煩少寐等的症狀，服用西藥後仍症狀反覆，2020/03/06（妊娠週數為32+2週）會診中醫治療，辨證為肝胃不和、心肝血虛有熱之胎動不安合併子懸，配合疏肝理氣，滋陰清熱，養血安胎中藥治療後，不僅宮縮頻率減少、安胎針劑劑量減少且腹脹、眠差等主要症狀與簡式健康量表分數均改善，孕婦於妊娠週數35+5週自然產下一健康男嬰。由此病例我們討論中西醫合療安胎的療效與注意事項，以供臨床醫師參考。

A 35-year-old pregnant woman (G1P0A0) had watery vaginal discharge on 2020/01/04 at a gestational age (GA) of 23+2 weeks, with a cervical length of 2.16 cm and no uterine contraction. Due to cervical incompetence with progressive shortening of cervical length, she was admitted to our hospital to receive tocolytic treatment (ritodrine). During hospitalization, the patient suffered from abdominal distension and poor sleep quality, which kept recurring even after taking Western medicine. She received traditional Chinese medicine (TCM) treatment for symptom relief on 2020/03/06 at a GA of 32+2 weeks. The TCM differential diagnosis revealed Zi-xuan with liver-stomach disharmony and heart and liver blood deficiency with heat. The TCM treatment dispersed and rectified the stagnated liver Qi, nourished yin, cleared heat, and tonified the blood to prevent miscarriage. Following the TCM treatment, the uterine contraction frequency and tocolytic drug dosage were reduced. The main symptoms (i.e., abdominal distension and poor sleep) and the simple health scale scores improved. Finally, she gave birth to a healthy baby boy at a GA of 35+5 weeks. From this case, the efficacy and precautions in combining the TCM and Western medicine treatments for tocolysis can be discussed.

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