急性胃痛會診中醫之病例報告

Treating Acute Epigastric Pain with Traditional Chinese Medicine: A Case Report

游鎧縵1江佩蓉1,*

1臺中榮民總醫院傳統醫學部，台中，台灣

本病例為一位56歲女性，因急性腎盂腎炎入院，藥物滴注後作急性胃痛，

經西醫檢查已排除可能導致胃脘疼痛的急性病症。因服用止痛藥、胃藥後，胃

痛(NRS:8-9)、胃脘悶脹、食慾不振等症狀均無改善，故於住院第2天會診中醫

。診斷為病中情志不舒，致肝氣鬱結、橫逆犯胃之胃痛。先以清熱止痛、和胃

降逆為治則，予以針灸改善急性疼痛(第一次針灸後NRS：6-7)；再以半夏瀉心

湯重用甘草，調和腸胃、健脾益氣。會診期間西醫胃藥並無新增，胃部症狀逐

次改善，至兩週後出院前，已無任何不適。

【關鍵詞】胃痛、肝胃不和、針灸止痛

A 56-year-old woman was admitted to the hospital due to acute pyelonephritis. She developed acute epigastric pain after drug infusion. Western medical examination has ruled out acute conditions that may cause epigastric pain. Yet, symptoms including epigastric pain (Numerical Rating Scale: 8-9), epigastric distension, and loss of appetite did not improve after taking analgesics and stomach medicine. Hence she asked for consulting traditional Chinese medicine on the second day of hospitalization. The diagnosis of traditional Chines medicine was that the patient was emotionally disturbed by the discomfort, which led to the stagnation of liver qi and then invading the stomach, thus caused epigastric pain. The therapeutic principle was clearing heat to relive pain, and downbearing erflow to harmonize stomach in the beginning. Acupuncture was given (NRS after the first acupuncture: 6-7) firstly. Banxia Xiexin Decoction with added licorice was then given for harmonizing the intestines and stomach, and fortifying the spleen and boosting qi. No new western gastric medicines were added during the consultation. The gastric symptoms had gradually improved, and no discomfort was noted by the time she was discharged two weeks later.

【Keywords】Epigastric Pain； Disharmony between the Liver and Stomach； Acupuncture for Pain Relief