帶狀皰疹疼痛之中藥療法病案報告

Traditional Chinese Medicine Treatment of Herpes Zoster Neuralgia-A Case Report

蔡曜鍵(Yao-Chien Tsai) ； 陳朝宗(Chao-Tsung Chen) ； 林舜穀(Shun-Gu Lin)

《中醫藥雜誌》 23卷2期 (2012/12) Pp. 253-263

https://doi.org/10.6940/JCM.201212_23(2).12

摘要

帶狀皰疹是中醫皮膚科常見的疾病，是由水痘帶狀皰疹病毒引發，發病部位的表皮上會出現劇痛的紅疹。水痘帶狀皰疹病毒會藏匿在神經細胞當中，在人體免疫力低落時恢復活躍並沿神經皮節侵犯。雖然病患大多在二到四個星期內會自行痊癒，但部分患者在紅疹消失後仍遺留有難忍的疼痛，且持續數月甚至數年。目前針對帶狀皰疹引起的疼痛治療，從口服止痛藥物到侵入性神經阻斷術等各種療法，但並沒有統一且有效的治療方式。本病案呈現一罹患帶狀皰疹並有嚴重疼痛的59歲女性病患，在第八頸神經皮節處有紅疹出現，並伴隨嚴重的疼痛及皮膚腫脹發熱症狀。在經歷中醫治療後，不但第二個禮拜水皰即已結痂，且一個月後疼痛完全消失而不再復發。本病案早期治療以十味敗毒散宣散風濕熱為主方，晚期則以人參養榮湯益氣養血，並配合地龍、威靈仙等辛竄通經藥物。希望本案例提供之治療策略與經驗能提供臨床中醫師參考。

關鍵字

帶狀皰疹 ； 中醫皮膚科 ； 神經皮節 ； 神經痛

並列摘要

Herpes zoster a common Cinese medicine dermatology disease caused by the varicella zoster virus (VZV), and leaded to exanthema with severe pain in diseased skin. Varicella-zoster virus generally remained dormant in nervous cells, and turned alive when one's immunity decreased, and attacked human body along the dermatome, and made patients suffered from severe pain. Presently, there were many treatments for herpes zoster pain includes oral prophylactic pain medications, local glucocorticoids injection, and peripheral nerves freezing; however there was no united and effective treatment. This case report showed a 59-year-ld female patient who suffered from severe pain of herpes zoster. The exanthema was showed on the part of her 8th cervical nerve dermatome skin with serious pain, local swelling and fever. After Chinese Medicine treatments, the herpes were callused in the second week; the pain was healed after a month and didn't relapse. After 4 weeks Chinese medicine treatments, not only the blisters already crusted, but also the pain completely disappeared. During treatment period, Clinical Chinese medicine doctor might consider a viable and acceptable treatment option for patients who suffer from herpes zoster.

並列關鍵字

Herpes zoster ； traditional Chinese medicine dermatology ； dermatomes ； neuralgia