中醫治療膽結石胃脹之病例報告

膽結石是臨床上常見的疾病，與中醫典籍所記載的「膽脹」、「腹痛」、「脇痛」、「癖黃」類似，以中醫的觀點來看，其病因病機與「氣滯」、「濕」、「熱」有關，在五臟六腑中與肝、膽較為相關，且五行上木與土容易互相影響，因此亦與脾、胃有關。本病例為一位有膽結石、糖尿病、高血壓病史的64歲男性，因胃脹、上腹痛持續兩週而求診中醫。我們依照病人的症狀與四診的情況，再參考西醫病史與相關理學檢查，判斷病人由肝失疏泄、肝氣鬱滯開始，最後導致肝膽氣鬱，胃失和降、氣機鬱滯而生諸症，因此以疏肝利膽、理氣和胃的方法治療，在一週內緩解了病人的胃脹、上腹痛等症狀。

關鍵字

膽結石；胃脹；柴胡疏肝散；溫膽湯

並列摘要

Gallstone is a commonly clinical disease, which is more related to ＂gallbladder distension＂, ＂abdominal pain＂, ＂hypochondriac pain＂ and ＂jaundice＂ in the classics of traditional Chinese medicine. From the perspective of traditional Chinese medicine, it is related to ＂stagnation of qi＂, ＂dampness＂, and ＂heat＂, and is more related to the liver and gallbladder. Because of the relationship between wood and earth on the five elements, it is also related to the spleen and stomach. This case is about a 64-year-old man, with past history of gallstone disease, diabetes, and hypertension, who has suffered from stomach distension and upper abdominal pain for two weeks. Based on the patient's condition, past history, and physical examinations, we differentiated that his disease was caused by liver depression and qi stagnation, which led to the symptoms of liver-gallbladder qi depression, stomach qi failing to descend, and qi stagnation. Therefore, we treated it with the methods of soothing the liver, promoting gallbladder, regulating qi, and harmonizing the stomach. And all of the patient's symptoms, including stomach distension and upper abdominal pain, were relieved within a week.