先兆性流產中醫治療病例報告

Case Study of Traditional Chinese Medicine Treatment on Threatened Abortion

陳怡文(Yi-Wen Chen)

《台灣中醫臨床醫學雜誌》 13卷3期 (2007/10) Pp. 217-222

https://doi.org/10.6968/TJCCM.200710.0217

摘要

36歲女性病患於懷孕13週時再次發生陰道出血，超音波檢查發現胎盤下有血塊，診斷爲胎盤早期剝離，給予黃體素(Duphaston)及止血藥(Transamin)治療，服藥後出血量雖減少但未完全停止，且伴隨兩少腹抽痛。中醫初診主訴易頭暈，夜尿頻數，大便偏硬，口乾舌燥，情緒憂慮。右脈細弦數尺弱，左脈沉滑數尺弱。舌質胖大邊有齒痕，舌色淡紅，舌苔白厚。中醫診爲胎動不安，證屬腎氣虛，胎元不固，兼有肝鬱血瘀。治療以補腎益氣爲主，佐以柔肝解鬱、化瘀止血。服中藥4天之後出血停止，超音波追蹤血塊縮小，服中藥18天後胎盤下血塊消失。

關鍵字

先兆性流產 ； 胎漏 ； 胎動不安

並列摘要

A 36-year old female patient has vaginal bleeding again during the 13(superscript th) week of pregnancy.Ultrasound shows clot attached to placenta. The diagnosis is early detachment of placenta with treatment of lutein (Duphaston) and styptic (Transamin). After medication, bleeding reduces but not stops completely, and abdominal cramp appears. The chief complaints in first TCM visit are dizziness, frequent nocturnal urine, hard stools, dry mouth, and depressed mood. Right pulse is thready, wiry and rapid with weak cubit-pulse; left pulse is deep, slippery and rapid with weak cubit-pulse. Tongue is chubby with teeth-marks, and the color is light with white and thick coating. TCM diagnosis is fetal irritability of deficient Kidney Qi that can't stabilize fetus, obstruction ofliver and blood stasis. Treatment principles are to replenish Kidney Qi, to soothe liver Qi, and remove blood stasis to stop bleeding. Bleeding stops after taking Chinese herbs for 4 days, and ultrasound shows reduced clot size. Clot disappeared after taking Chinese herbs for 18 days.

並列關鍵字

threatened abortion ； TaiLou ； fetal irritability