杏蘇散加減治療支氣管擴張症血痰：病例報告與文獻回顧

支氣管擴張症為支氣管發生不完全可逆擴張及管壁受損，表現為有痰的慢性咳嗽、血痰、呼吸困難，病情常遷延，進入慢性發炎與反覆感染的惡性循環。本病例為一48歲女性，久咳四個月，伴隨疲憊、體重減輕，因咳血就醫，檢查發現有支氣管擴張，肺纖維化及實質樣病變，常規西藥治療後，咳血痰症狀持續，後期出現胸悶胸痛及喘、心悸。經辨證屬痰瘀阻肺，兼有肺腎虧虛，處方用幼科杏蘇散配合仙鶴草、三七等，以清熱化痰排膿、祛瘀生新，之後，血痰及其餘症狀獲得明顯緩解，顯示中醫辨證思維對改善支擴症血痰有所助益。

關鍵字

支氣管擴張症； Bronchiectasis ；杏蘇散加減；痰瘀阻肺；化瘀止血

並列摘要

Bronchiectasis is an incompletely reversible dilation of the bronchi and damage to the tube wall, manifested by inflamed and easily collapsible airways, resulting in chronic cough with sputum, bloody sputum, and difficulty breathing. The case is a 48-year-oldwoman with occasional cough for four months, accompanied by fatigue and weight loss. She eventually sought medical treatment for hemoptysis and examination revealed bronchiectasis, pulmonary fibrosis, and parenchymal lesions. After conventional western medicine treatment, the symptoms of hemoptysis and sputum persisted. There was chest tightness, chest pain, difficulty breathing, and palpitations happened. According to the differentiation of the TCM syndrome, it belongs to Phlegm and Blood Stasis Blocking the Lung, along with Lung and Kidney Qi Deficiency. The prescription uses Xing Su San (Pediatric) combined with Agrimonia pilosa Ldb. and Panax notoginseng, etc., with the purpose of clearing heat, resolving phlegm, expelling pus, removing blood stasis and regenerating. Blood phlegm and other symptoms are significantly relieved after three weeks. The result reaveals the effectiveness of differential pattern concept of TCM in treating Bronchiectasis.