歸脾湯改善缺鐵性貧血臨床病例報告

Improved Iron-Deficiency Anemia by Gui Pi Tang Treatment: A Case Report

邱慧芳(Hui-Fang Chiu) ； 張宏州(Hung-Chou Chang)

《中西整合醫學雜誌》 13卷2期 (2011/06) Pp. 23-31

https://doi.org/10.29613/JICWM.201106.0003

摘要

這位31歲女性病患因爲近一個月來頭暈症狀加重，至中醫門診尋求治療。患者主訴自生產後容易有頭暈的症狀十年有餘，休息後改善，平日不以爲意，就診前一個多月頭暈頻率增加，併發眼前一片漆黑，尤以久坐工作起身後容易發生。平日月經週期規律，但經血淋漓，時日較長。其面色恍白，舌淡黯不鮮，有朱點，舌邊有齒痕，苔薄白，脈弦細數。實驗室檢查檢出血色素僅6.4mg/dl、MCV 62.3 fl、血清鐵8ug/dl，診斷爲缺鐵性貧血，中醫證屬氣血虧虛，處方歸脾湯隨證加減治療。血色素由6.4mg/dl上升爲8.8mg/di，臨床症狀獲得改善。本病例整合中西醫辨證與辨病思維以明確診斷，病患因腸胃不適放棄鐵劑治療，單純經中藥處方治療療效明確，本文詳細記載思辨過程與實證，希望有助於中西醫整合臨床實證之建立。

關鍵字

中醫藥 ； 頭暈 ； 缺鐵性貧血 ； 歸脾湯 ； 中西醫整合

並列摘要

This 31 year-old female patient was sick with dizziness and getting more seriously in the past one month. She visited our outpatient department and received Chinese Medicine treatment. She had suffered from dizziness for ten years after delivery, and the symptom was subsided after rest, so she did not pay attention on it. In the past one month, her dizziness was more frequently and seriously, especially when postural change-blackout happened due to standing from squeeze posture. Her menstrual cycle was regular but dribbling menstrual blood usually prolonged for more than one week bothered her much. The objective finding includes pale looking, pale tongue with thin white fur and teeth-mark, thin & string-like pulse. The laboratory test revealed that hemoglobin, MCV and serum iron only 6.4 mg/dl, 62.3 fi, 8 ug/dl respectively. Iron-deficiency anemia was diagnosed.The identification pattern of Chinese Medicine was qi-blood-deficiency and gui pi tang of Chinese Medicine was prescribed. Due to epigastric discomfort, she gave up iron supplement therapy. After the treatment by Chinese Medical formula alone, the levels of hemoglobin rose from 6.4 mg/dl to 8.8 mg/dl and the clinical symptoms were greatly improved. In this case, we integrated the thinking process of Chinese and Western Medicine and made disease diagnosis and Chinese Medicine pattern identification simultaneously. The treatment effect of Chinese Medicine is obvious, and there were clinical objective data for evidences. We hope the case report is helpful to develop the clinical evidence-base of the integrated Chinese and western medicine.

並列關鍵字

Chinese Medicine ； Dizziness ； Iron-Deficiency Anemia ； Gui Pi Tang ； Integrated Chinese and Western Medicine