中醫治療長期臥床病人胃出血病例報告

A Case Report of Gastrointestinal Bleeding Treated with Traditional Chinese Medicine in Bedridden Patient

徐司翰(Szu-Han Hsu) ； 趙曉玲(Hsao-Ling Chao) ； 吳宿真(Su-Jhen Wu) ； 林舜穀(Shun-Ku Lin)

《中醫藥研究論叢》 19卷1期 (2016/03) Pp. 127-135

https://doi.org/10.6516/TJTCM.2016.19(1)127

摘要

腸胃道出血是長期臥床病人常見的併發症，長期插管或有胃腸病史的患者更容易出現，不但降低生活品質，也會造成貧血、虛弱，甚至危及生命。本病案報告91歲胃出血女性，鼻胃管反抽出咖啡色殘渣，同時有胃脘部脹滿、灌食反抽量多、嚴重便秘。採用中藥治療溫中散寒輔以潤腸通便，以麻子仁丸配合安中散，經一個月治療後，出血情形明顯改善，而且在六個月內視鏡追蹤顯示出血點已經癒合，提供長期臥床並有胃出血患者的新治療選擇。

關鍵字

長期臥床 ； 中風 ； 胃出血 ； 中醫

並列摘要

Gastrointestinal bleeding is a common complication of bedridden patients, especially in patients with a history of long-term intubation or gastrointestinal comorbidity. Gastrointestinal bleeding might not only worse the quality of life, but also cause anemia or weakness. We presented a case report of the traditional Chinese medicine treatment of a 91-year-old woman with severe gastrointestinal bleeding, epigastric fullness, and severe constipation. After treatment with An- Zhong-San and Ma-Zi-Ren-Wan, bleeding situation decreased significantly. Besides, endoscopic follow-up after six months showed the bleeding wound has healed.

並列關鍵字

Bedridden ； Stroke ； Gastrointestinal Bleeding ； Traditional Chinese medicine

參考文獻

Balderas, V,Bhore, R,Lara, LF(2011).The hematocrit level in upper gastrointestinal hemorrhage: safety of endoscopy and outcomes.Am J Med.124,970.

Ben-Menachem, T,Fogel, R,Patel, RV(1994).Prophylaxis for stress-related gastric hemorrhage in the medical intensive care unit. A randomized, controlled, singleblind study.Ann Intern Med.121,568.

Boonpongmanee, S,Fleischer, DE,Pezzullo, JC(2004).The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated.Gastrointest Endosc.59,788.

Cook, DJ,Fuller, HD,Guyatt, GH(1994).Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group.N Engl J Med.330,377.

Forrest, JA,Finlayson, ND,Shearman, DJ(1974).Endoscopy in gastrointestinal bleeding.Lancet.2,394-397.