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兒童嚴重特殊傳染性肺炎(COVID-19)之中西整合照護病例報告

A Case Report of Pediatric COVID-19 with Integrated Treatment of Western and Traditional Chinese Medicine

摘要


2021年5月台灣嚴重特殊傳染性肺炎(COVID-19)社區疫情爆發,兒童感染新型冠狀病毒(SARS-CoV-2)的數量亦隨之增加。雖兒童感染SARS-CoV-2的症狀較輕微,住院率與死亡率較低,然而疫病傳變迅速,臨床仍須盡早介入以截斷病勢,避免病情轉為危重症。本病例為一名1歲7個月男性幼兒,腹瀉一周後經檢測確診感染SARS-CoV-2並入院隔離治療,因腹瀉症狀持續,會診中醫協助治療,經中醫辨證為外感疫戾之氣,邪入太陰肺脾,濕滯內停,以藿香正氣散加減配合西醫整腸菌與輸液,經治療後臨床症狀改善,病毒循環數閥值(Cycle Threshold, Ct 值)達解除隔離標準,順利出院。

並列摘要


In May 2021, the community outbreak of Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Taiwan caused an increase in the number of children infected. This case report describes a 1-year-7-month-old boy who presented with mild cough and diarrhea. COVID-19 Polymerase chain reaction (PCR) was positive and the initial Cycle Threshold (Ct value) was 16. He was admitted and isolated to the hospital while supportive treatment was given. However, diarrhea persisted, Traditional Chinese medicine was consulted for integrative care. The COVID-19 belongs to plague in TCM with the etiology of epidemic factor exposure. He was diagnosed with cold-damp constraint in the lung and spleen. After treatment with modified Huo Xiang Zheng Qi San, the clinical symptoms improved while the Ct value (37.89) reached de-isolation standard and he was successfully discharged.

參考文獻


Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM: Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020; 382(13): 1199-1207.
Control CfD, Prevention. CDC COVID data tracker: demographic trends of COVID-19 cases and deaths in the US reported to CDC 2020. (https://covid.cdc.gov/covid-data-tracker/#pediatric-data)
Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB: Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020; 16(3): 240-246.
Rehman S, Majeed T, Azam Ansari M, Ali U, Sabit H, Al-Suhaimi EA: Current Scenario of COVID-19 in Pediatric Age Group and Physiology of Immune and Thymus response. Saudi J Biol Sci. 2020; 27(10): 2567-2573.
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