中藥合併針灸治療妥瑞症病例報告

本病例為6歲男童，有早產病史，反覆出現清喉嚨、扭鼻子與眨眼症狀已2年，起初西醫兒科臆斷為過敏性鼻炎，使用鼻噴劑後症狀可稍微緩解，但仍反覆。而後經兒童身心科醫師診斷為妥瑞症，並開立西藥clonidine，男童服用後出現嚴重嗜睡情形，雙親因而決定尋求中醫治療。來診時清喉嚨、扭鼻子、眨眼與聳肩情形明顯，較固執易怒，注意力容易不集中，體格瘦弱，餐後當下有欲如廁感。經中醫辨證為肝陽化風，上擾心神，中藥方選抑肝散與甘麥大棗湯加減，針灸穴位選百會穴配合神庭穴，至四診時共歷時一個月療程，上述症狀已完全消失，後續守方續治再追蹤一個月，男童狀況穩定並無復發。本病例透過耶魯抽動症整體嚴重程度量表（Yale Global Tic Severity Scale）評估為輕度妥瑞症，最終治療效益達95%以上。

關鍵字

妥瑞症；抑肝散；甘麥大棗湯；百會；中醫

並列摘要

This case is a 6-year-old boy who has a birth history of preterm. He has seen symptoms of clearing his throat, twisting his nose, and blinking since 2 years ago. The symptoms became more obvious in January, 2021. He was initially diagnosed with allergic rhinitis by Western pediatricians. After the patient used nasal spray, the symptoms were slightly relieved but repeated. During the same month, the pediatrician of the psychiatry department diagnosed him with Tourette syndrome and prescribed clonidine for him. Because the boy became severely drowsy after taking clonidine, his parents decided to seek Chinese medicine treatment. At the first visit, clearing the throat, twisting the nose, blinking, and shrugging the shoulder were seen. He was stubborn, irritable, scatterbrained, and thin. The boy had a bowel movement twice a day, and felt bowel movement immediately after the meal. According to traditional Chinese medicine pattern identification, he is recognized as liver yang transforming into wind, harassing the heart spirit (肝陽化風，上擾心神). The traditional Chinese medicine prescriptions are Yi-Gan San and Gan-Mai-Da-Zao Tang. Acupuncture points are Baihui and Shenting. It took one month with 4 treatments from the first visit, and the above symptoms were completely gone. Then he came to our OPD to follow-up one month without relapse. This case was assessed as mild Tourette syndrome by the Yale Global Tic Severity Scale (YGTSS), and the final therapeutic efficiency was more than 95%.

並列關鍵字

Tourette syndrome ； Yi-Gan San ； Gan-Mai-Da-Zao Tang ； Baihui ； Chinese medicine

國際替代計量

中藥合併針灸治療妥瑞症病例報告

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