慢性潰瘍性結腸炎的中醫治療案例

慢性潰瘍性結腸炎是一種慢性非傳染性疾病，為腸道黏膜層與黏膜下層病變，導致腸道長時間反覆發炎、潰瘍、出血，位置常發生於乙狀結腸、直腸甚至全大腸。成因未明，至今研究多與感染、遺傳、食物過敏、情緒壓力、自身免疫等因素有關。主要臨床症狀為腹痛、腹瀉、大便有黏液及血便。本篇病例為一位38 歲男性於台北馬偕醫院診斷患有慢性潰瘍性結腸炎，前來本院中醫科門診尋求治療，中醫辨證診斷為「濕熱內蘊為標，肝鬱氣滯為本」，故以槐花散清利濕熱、理血止血治其標，以白芨收斂生肌，阿膠止血補血等中藥治療，待患者結腸的潰瘍傷口及出血狀況改善後，再以疏肝理氣之法治其本。約2.5個月治療後，內視鏡影像檢查對照治療前後病灶處有顯著改善。慢性潰瘍性結腸炎不容易治癒且時常反覆發作，本病例的治療經驗可觀察出中藥之介入可有效治療腸黏膜發炎、潰瘍、出血情形，改善病人症狀及生活品質，是值得推展的治療選項。

關鍵字

慢性潰瘍性結腸炎；槐花散；白芨；阿膠

並列摘要

Ulcerative colitis is a noninfective disease causes by chronic inflammation. Inflammatory media will disturb the growth of mucosa and submucosa, result in ulcer and advance bleeding. Pathological changes can be seen in all parts of large intestine. The cause of ulcerative colitis remains unclear, hypothesis of etiology of disease various, including infection, gene, allergy, emotional stress, autoimmune, etc. Main clinical signs and symptoms are colicky abdominal pain, diarrhea, and stool with mucus and bloody stools. This article presents a case of a 38-year-old male with ulcerative colitis diagnosed at Taipei MacKay Memorial Hospital. He came to the division of Traditional Chinese Medicine of our hospital for alternative treatment. Traditional Chinese Medicine doctor diagnosed the patient with ＂internal dampness-heat as the tip and liver depression and qi stagnation as the root＂. He was treated by Huai Hua San to clean his intestinal dampness heat, regulate his blood to stop bleeding to treat the tip. Moreover, the aforementioned treatment was coupled by bletilla striata to promote tissue regeneration and close wound, and donkey-hide gelatin to tonify blood to treat the root. After treated for 2.5 months, endoscope follow-up found the patient recovers remarkably. Accordingly, we aim to introduce Traditional Chinese Medicine as an alternative treatment of ulcerative colitis.

並列關鍵字

Chronic ulcerative colitis ； Huai Hua San ； bletilla striata ； donkey-hide gelatin

參考文獻

Kornbluth, A,Sachar, DB,The Practice Parameters Committee of the American College of Gastroenterology(2010).Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee.The American Journal of Gastroenterology.105(3),501-523.

Google Scholar

Samuel, S,Bruining, DH,Loftus, EV, Jr,Thia, KT,Schroeder, KW,Tremaine, WJ,Faubion, WA,Kane, SV,Pardi, DS,de Groen, PC,Harmsen, WS,Zinsmeister, AR,Sandborn, WJ(2013).Validation of the ulcerative colitis colonoscopic index of severity and its correlation with disease activity measures.Clinical Gastroenterology and Hepatology.11,49-54.