頑固性濕疹中醫驗案一例

濕疹是一種常見的過敏性炎症性皮膚病，其特點為多形性皮疹，滲出傾向，對稱分布，易于復發和慢性化，自覺劇烈搔癢。本病案為35歲女性，於前年秋冬交季時背部、臀部開始有皮膚癢痛情形，經西醫久治無效，改買坊間美容機構SPA淋巴按摩課程，約一個月後痊癒；今年二月以後皮膚不適情形再度出現，先由大腿內側發作，後來才延伸至手足伸肌彎窩處、兩側胸脅，腰臀處反不發，再去作SPA卻反加重病情，致兩側膝蓋又發。自述若使用涼性藥物塗抹則會較為舒服，洗完澡後、剛要擦拭前，會感到病灶處刺痛不已。患者工作壓力素大，眠差，於7月19日開始針對皮膚問題服用中藥，證屬正虛邪實，濕熱交雜；治則以健脾袪濕，扶正袪邪為主。歷經7月26日至8月23日約一個多月的中藥治療，以病灶外觀、病灶大小及形狀、病灶部位、數目及分布情形、病灶特徵、觸診時病灶硬度及壓痛與否為評估要點，於8月23日回診時手肘濕疹異狀處幾乎消失，患者之濕疹問題。

關鍵字

濕疹；健脾袪濕；體質；辨證論治

並列摘要

Eczema is a common allergic inflammatory skin disease. The characteristics of it are polymorphic skin rash, tendency of exudation, symmetrical distribution, and chronically recurrence. This is a case of 35 years old female, painful itching skin lesions over back and buttocks were noted between the autumn and winter of 2004. Western medicine treatment was requested, but little efficacy was observed. Symptoms were relieved after cosmetic lymphatic massage courses. Unfortunately, eruptions developed from inner sides of the thighs to bilateral hypochondrium, skin the of extensor surfaces of elbows and knees in the February of 2006. Cosmetic lymphatic massage courses induced flares of skin the of extensor surfaces of knees this time. Skin rash exacerbated after bath and was relieved after evaporating topical agent. Patient visited TCM OPD on July 19, 2006. According to the principle of treatment based on syndrome differentiation, herbs of invigorating spleen Qi, eliminating dampness and clearing heat were prescribed. Symptoms subsided after medication for about one month. The color, size, shape, location, numbers, distribution, characteristics, tenderness and hardness of the skin lesions were evaluating points. Lesions over the extensor surfaces of elbows disappeared on August 23, 2006. Treatment of Chinese medicine based on syndrome differentiation could apparently improve the condition of eczema patients.

並列關鍵字

eczema ； invigorating spleen for eliminating dampness ； constitution ； treatment based on syndrome differentiation

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頑固性濕疹中醫驗案一例

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