台北中醫醫學雜誌

102.4 頑固型便祕以非瀉下劑為主方治療三例

 

頑固型便祕以非瀉下劑為主方治療三例
Three Cases of Non-classic Laxative
Treatment of Chronic Refractory Constipation
侯耀華1* 鄒騰樟1
1 蘆山風澤中醫診所,桃園,台灣
【摘要】
全球便祕的盛行率約有20%,治療常以瀉下潤腸劑作為短期通便的選擇,但久用效率降低且需要增劑,也不能處理便祕患者常連帶之腹脹、腹痛、呃逆等腸胃症狀。本篇蒐集三個不同年齡層頑固型便祕患者,以兼顧上下消化道排空能力及穩定神經系統作為考量,依照中醫整體辨證論治法調理,先調整脾胃異常症狀後,再改善便秘,結果可以減少長期使用瀉下劑患者的使用劑量,並改善便祕及連帶症狀。使用方藥包括瀉心湯類方:以半夏、生薑(乾薑)為主軸。行氣疏肝類方:以枳殼、厚朴、枳實、柴胡、香附等為主軸。溫陽健脾類方:以理中輩、四君子輩加減。可以做為治療便祕時的思考方向與辨證論治選擇。
【關鍵詞】中藥、臨床診療、頑固型便祕、腸躁症
Yao-Hua Hou1* Teng-Chang Tsou1
1Lushan Fengze Chinese Medicine Clinic, Taoyuan, Taiwan
【Summary】
The prevalence of constipation is about 20% around the world. The common medical therapies are laxative and secretagogues. However, it is only useful for short-term treatment and do not resolve comorbidities such as abdominal fullness, stomachache, hiccup, nor gastroesophageal reflux. Here are three cases of chronic refractory constipation patients in three age groups. By regulating the transit of upper and lower gastrointestinal system and sedating nerve system associating to the gastrointestinal system with the wholistic treatment principle of tradition Chinese medicine, cases reduce their dosage of laxative, and relive comorbidities. The use of Chinese medicine are: Xiexin tang, such as pinellia and ginger, drug for conduct Qi and dispersing liver, such as fructus aurantii, fructus aurantii immaturus, mangnolia officinalis, radix bupleuri and cyperus rotundus, etc., durg for warm yang and tonifying spleen, such as ginseng, atractylodes rhizome, poria cocos, liquorice, ginger etc.. This strategy could be an option for chronic constipation treatment.
【Keywords】
Chinese medicine, clinical management, chronic refractory constipation, irritable bowel syndrome