中醫治療妊娠惡阻病例報告

妊娠後出現噁心嘔吐，頭暈厭食，或食入即吐者，為妊娠早期最常見的證候，一般三個月後即可逐漸消失，俗稱為孕吐、害喜，中醫稱之為「妊娠惡阻」，也稱「子病」、「病兒」、「阻病」等，是妊娠早期最常見的證候。本篇病例報告為40歲的孕婦，110年11月05日中醫門診時已懷孕8週，病患主述最近出現嘔吐的現象，嘔吐感強，難以控制，伴隨頭暈症狀，聞到較濃郁的食物氣味會誘發嘔吐症狀的發生，影響食慾，因此前來本院尋求治療。妊娠惡阻的主因有二，一為妊娠衝脈之氣亢盛，循氣街沿陽明胃經而上逆犯於胃，使胃失和降；二為肝脾失調，肝氣偏盛之下，克伐脾胃，本案經中醫辨證為衝脈之氣上逆，胃失和降，肝胃不和所致，以疏肝和胃，降逆止嘔為治療原則，處方以半夏厚朴湯加減為主，治療後症狀逐漸改善。

關鍵字

妊娠惡阻；孕吐；害喜；中醫

並列摘要

The patient reported the phenomenon of vomiting after dizziness recently, and strong sensation of vomiting, so the patient came to our clinic seeking treatment. According to the syndrome differentiation in traditional Chinese medicine, the qi of Chong Channel is counter-flowing, the stomach is out of harmony and the qi failed to descend, the liver and stomach are also not in harmony. The treatment aims to soothe the liver and stomach, reduce gastric reflux and stop vomiting, hence Banxia Houpu Tang has been prescribed, and the symptoms gradually improved after treatment. Nausea and vomiting, dizziness and loss of appetite, or vomiting after ingestion during pregnancy, also known as ＂morning sickness＂, ＂malign obstruction＂, ＂hyperemesis gravidarum＂ and etc., are the most common symptoms in early pregnancy, which usually disappear after three months. This case report is about a 40-year-old pregnant woman who was 8 weeks pregnant at the TCM clinic on the 5th of November, 2021. The patient reported that she had recently experienced vomiting, and the sensation, accompanied by dizziness, was strong and difficult to control. Strong scent of food would induce vomiting and affect her appetite, so she came seeking treatment. There are two main reasons for the malign obstruction, one is the hyperactivity of qi in the Chong channel during pregnancy, which the Qi goes up along the pathway, through the Yangming Stomach channel and against the stomach, causing the disorder of Qi in the stomach; the other is the disharmony of the liver and the spleen, where the stronger Qi in the liver subdued the spleen and the stomach . According to the TCM syndrome differentiation, this is identified as the upward reversal of the Qi in the Chong channel, hence the disorder of Qi in the stomach, and the disharmony of the liver and stomach leading to the symptoms. The principle of treatment is to soothe the liver and stomach disharmony, reduce the reversal and stop vomiting. The medicine prescribed is mainly based on Banxia Houpo Tang, and the symptoms gradually improved afterwards.