糖尿病性胃癱中西醫整合治療病例報告

Treatment of Diabetic Gastroparesis with Combination of Traditional Chinese Medicine and Western Medicine: A Case Report

馮瀞儀(Ching-Yi Feng) ； 周書慧(Shu-Huey Chou) ； 林時逸(Shih-Yi Lin) ； 李奕德(I-Te Lee) ； 宋育民(Yuh-Min Song) ； 王俊興(Jun-Sing Wang) ； 蔡嘉一(Chia-Yi Tsai)

《中醫藥雜誌》 28卷2期 (2017/12) Pp. 39-50

https://doi.org/10.3966/241139642017122802004

摘要

本病例為一位28歲第一型糖尿病病史13年的女性患者曾多次因糖尿病酮酸中毒入院治療，本次因噁心嘔吐入院，嘔吐情形於急性血糖升高時（＞300 mg/dL）症狀加重，胃排空試驗顯示胃排空時間延長，診斷為糖尿病胃癱（diabetic gastroparesis）。因反覆嘔吐住院五個月後會診中醫，診斷為脾腎陽虛，邪實在胃，兼肝鬱，經針灸內庭、太衝、豐隆與口服中藥附子理中湯加減治療後症狀獲得明顯緩解，於會診後五周出院，可提供中西醫結合治療糖尿病胃癱的參考。

關鍵字

糖尿病性胃癱 ； 嘔吐 ； 針灸 ； 中藥 ； 中西醫結合

並列摘要

The case, a 28-year-old female with 13 years of type 1 diabetes mellitus, has been admitted for diabetic ketoacidosis multiple times. This time she was admitted due to nausea and vomiting. Vomiting was exacerbated as blood glucose increased (＞300 mg/ dL). Furthermore, gastric emptying study showed prolonged gastric emptying time. She was diagnosed as diabetic gastropresis. Five months later, she requested Chinese Medicine for curing refractory vomiting. She was diagnosed as ＂spleen-kidney yang deficiency syndrome, sthenia pathogenic factor in stomach, accompanied with liver qi depression.＂ The symptoms above improved significantly after treatment with acupuncture at ST44, LR3, ST40 and prescription of Chinese herbal drug modified Fu- Zi-Li-Zhong decoction.

並列關鍵字

Diabetic gastroparesis ； vomiting ； acupuncture ； Chinese herbal drugs ； integrated traditional Chinese and Western medicine

參考文獻

Camilleri, M,Bharucha, AE,Farrugia, G(2011).Epidemiology, Mechanisms and management of diabetic gastroparesis.Clin. Gastroenterol. Hepatol..9,5-12.

Kofod-Andersen, K,Tarnow, L(2012).Prevalence of gastroparesis-related symptoms in an unselected cohort of patients with Type 1 diabetes.J. Diabetes Complications.26,89-93.

Farmer, AD,Kadirkamanathan, SS,Aziz, Q(2012).Diabetic gastroparesis: pathophysiology, evaluation and management.Br. J. Hosp. Med..73,451-456.

Jaffe, JK,Paladugu, S,Gaughan, JP,Parkman, HP(2011).Characteristics of nausea and its effects on quality of life in diabetic and idiopathic gastroparesis.J. Clin. Gastroenterol..45,317-321.

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