與中醫經脈循行相關的心肌梗塞臨床病案一則

Meridian Related Myocardial Infarction-A Cae Report

蔡德豐(Te-Feng Tsai)

《台灣中醫臨床醫學雜誌》 14卷4期 (2008/12) Pp. 308-315

https://doi.org/10.6968/TJCCM.200812.0308

摘要

一位41歲男性96年8月因突發性胸痛至某醫學中心急診，檢查發現爲心肌梗塞，經緊急施行冠狀動脈氣球擴張術(PTCA)及支架置放術(stenting)後5日出院。之後長期服用西藥Bokey, Crestor, Hyzaar, Isormol及Dilatrend，血壓持續控制在130/80-90mmHg。來診時主訴，自心臟手術後幾乎每晚約7點（心包經脈循行時辰）起發作胸悶、心虛、心慌及驚悸感已11個月，求診西醫一直無法改善，故在家人陪伴下至本科就診，觀其體型中等，面色淡白，語緩，聲低沉，暈眩、疲倦，腰背酸痛，平日畏冷，寸脈伏、關尺脈沉細數無力，舌質淡白，舌下絡脈粗大、色淡紫，證屬：心陰陽虛衰、心脈痹阻之證，治以養陰益氣、溫通心陽、活血化瘀的炙甘草湯、血府逐瘀湯合丹參爲主。患者自覺最不適的夜間胸悶、心慌以及驚悸感（心包經症狀），經三週治療症狀獲得顯著的改善，但畏寒及小便不利之現象仍在，故在心陽虛的基礎上加入濟生腎氣丸加強補腎陽以鞏固療效。再經三週治療後畏寒、頭暈眩、疲累甚則嘔吐等改善明顯，目前持續以原方治療，取得滿意療效。

關鍵字

心包經經脈循行 ； 心肌梗塞 ； 炙甘草湯 ； 丹參 ； 溫通心陽 ； 活血化瘀

並列摘要

A 41-year-old male patient was admitted to emergency department in August 2007 due to sudden chest pain. He was diagnosed with myocardial infarction, and was discharged from hospital five days after PTCA and Stenting. He has been taking Bokey, Crestor, Hyzaar, Isomol and Dilatrend since with blood pressure 130/80-90 mmHg. When he visited our department, his chief complaint is tight chest, palpitation, and anxiety at 7pm everyday (Pericardium meridian starts to flow) for 11 months, and was not improved with Western medicine. His body type is medium, and his complexion is pale. His voice is low with moderate speed. He also had symptoms such as dizziness, fatigue, sore and tender low back and aversion to cold. His cun pulse is hidden, and guan and chi pulse are deep, thready, rapid and weak. His tongue is pale with enlarged sublingual veins. TCM diagnosis is deficiency of heart yin and yang with obstruction of heart vessels. The treatment principle is to nourish yin and supplement qi, warm heart yang, and improve blood circulation to remove blood stasis. ZhiGanCaoTang, XueFuZhuYuTang and DanShen are prescribed. Most symptoms are improved after 3 weeks of treatment. However, since the patient still has aversion to cold and difficult urination, JiShengShenQiWan is added to strengthen the kidney yang. His aversion to cold, dizziness, fatigue and vomit have significantly improved after another 3 weeks of treatment. The result is satisfactory.

並列關鍵字

Circulation of Pericardium meridian ； myocardial infarction ； ZhiGanCaoTang ； warm heart yang ； improve blood circulation and remove blood stasis