腹脹合併黑苔中醫治療－病例報告

老年人消化系統功能紊亂或是減弱，常見以腹部脹滿為主要症狀。我們報導這位94的女性，有高血壓及心臟病史。患者脹氣已一年多，出現打嗝、矢氣，口乾口苦，飲食無味，沒有口水，食慾減退等症狀，並於三十多日前開始出現黑苔，因而至三總肝膽腸胃科就醫，經西醫師推薦至本院中醫部就診。中醫辨證為中焦濕熱，陰虛火旺。治則為化濁利濕、滋陰清熱。初期處方以清熱利濕，養陰潤燥為主；後期則以滋養肝腎之陰一貫煎加減養陰清熱藥治療。服藥後，腹脹明顯改善，黑苔也明顯改善。由此病例我們探討腹脹中醫病因、病機與治則，並討論腹脹合併黑苔可能的病機演變。

關鍵字

腹脹；腹滿；黑苔；濕熱

並列摘要

Abdominal fullness was a symptom that often display on elder one. This 94-yearold woman, who had history of hypertension and heart disease, suffered from abdominal fullness for 1 year with hiccup, flatus, dry and bitter mouth, tastelessness in the mouth, etc. Due to the above symptoms and the black hairy tongue, found for one month, she went to the clinic of Gastrointestinal Department at Tri-Service General Hospital for help, and was referred to our clinic. The syndrome differentiation by the TCM was pattern of center burner damp-heat and Ying deficiency with heat. The therapeutic principles were drain dampness turbidity, clean heat and enrich Ying. After treatment, the abdominal distention and black fur improved. From this case report, we discussed the cause, mechanism and principle of the abdominal distention, and the mechanism of abdominal distention with black hairy tongue.