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咳嗽及咽喉腫痛之病例報告與臨床思路探討

Case Report and Clinical Thinking of Cough and Sore Throat

摘要


咽痛、咳嗽是冬季中醫門診常見的主訴之一,大部分的患者可以找出明確病因,經由中醫治療,通常症狀皆能緩解或完全消除。本病例討論一位35歲男性患者,因飲食習慣不良以及長期鼻涕倒流,發生扁桃腺發炎,服用西藥後仍咽喉腫痛咳嗽的中醫治療處置。初診處方以《傷寒論》中的小陷胸湯和蒼耳散為主方,隨證加減紫菀、葶藶子、陳皮和黃芩,並給予適當衛教。服用中藥調治,在兩次的門診治療後,其咽喉腫痛、咳嗽有痰已完全改善,患者對中藥療效相當滿意。

關鍵字

咳嗽 小陷胸湯 蒼耳散

並列摘要


Sore throat and cough are one of the common main complaints in the outpatient clinics of traditional Chinese medicine (TCM) in winter. Most patients can find a clear cause. After treatment with Chinese medicine, the symptoms can usually be relieved or completely eliminated. This case discusses the treatment of a 35-year-old male patient who suffered from tonsil inflammation due to poor eating habits and long-term nasal regurgitation. After taking western medicine, he still had a sore throat and cough. The first prescription was based on Xiao-Xian-Xiong-Tang and Cang-Er-Sang in Treatise on Febrile and Miscellaneous Diseases. Zi-Wan, Ting-Li-Zi, Chen-Pi and Baikal Skullcap were added and subtracted according to the symptoms, and patient education was given appropriately. After taking Chinese medicine for twice return visits, his symptoms, like sore throat and cough with sputum, have been cured. Over all, he is quite satisfied with the curative effect of traditional Chinese medicine.

並列關鍵字

Cough Xiao-Xian-Xiong-Tang Cang-Er-Sang

參考文獻


UpToDate: Evaluation of subacute and chronic cough in adults.
Kian Fan Chung, Ian D Pavord. Prevalence, pathogenesis, and causes of chronic cough. The Lancet. 371: 1364-1374, 2008 Apr 19.
李祥和、劉委彰、徐明治:基層醫療中咳嗽的診斷與處置。家庭醫學與基層醫療,24(5):173-177,2009。
Brendan J Canning, Anne B Chang, Donald C Bolser, Jaclyn A Smith, Stuart B Mazzone, Lorcan McGarvey. Anatomy and Neurophysiology of Cough: CHEST Guideline and Expert Panel Report. Chest. 146(6): 1633-1648, 2014.
Viktor Hanak, Thomas E Hartman, Jay H Ryu. Cough-induced rib fractures. Mayo Clinic Proceedings. 80(7): 879-82, 2005 Jul.

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