摘要
一位74歲婦女自覺感冒、頭痛，不久眼睛充血刺痛轉為結膜炎，服藥無效，頭痛更劇，8天以後右眼內眥周圍長出皰疹，迅速蔓延至右側額部頭頂部位，西醫診斷為額部帶狀皰疹，中醫稱為「蛇丹」、「蛇串瘡」、「蜘蛛瘡」，服藥後止痛效果不佳，建議配合針灸止痛，以減低麻醉鎮痛藥的副作用及其成癮性。中醫辨證為肝膽熱盛、氣滯濕阻、瘀血阻絡，兼感毒邪，給予龍膽瀉肝湯、一貫煎加減，並作毫針、耳針及頭皮針圍刺療法，住院27天症狀改善，皰疹疼痛範圍縮減二分之一，麻醉鎮痛劑藥量減少。本案例止痛療效顯著，中醫清熱解毒滋陰療法加上針刺療法應為關鍵性因素。
並列摘要
The patient is a 74-year-old female. She had experienced a common cold and headache. She also had hyperemia in her eyes, which later turned into conjunctivitis. Although she had taken medication, her symptoms persisted and the headache had become more severe. Eight days later, multiple papules appeared near the internal canthus of her right eye. They spread rapidly towards the right frontal and parietal regions. The patient was diagnosed as having herpes zoster. It is called ”she dan”, ”she chuan chuang” or ”zhi zhu chuan” in Chinese medicine. According to Chinese medicine thinking, medication has only a small analgesic effect; it recommends the use of acupuncture to minimize the dosage and side effects of analgesics, and to prevent addiction to such medication. The disease mechanism, as described by Chinese medicine, is ”over-heating of the liver and gallbladder”, ”Qi stagnation and dampish obstruction”, ”stasis of blood flow and vessel obstruction” and ”being toxified”. The patient was treated with ”long dan xie gan tang” and ”yi guan jian” combined with filiform needle ear acupuncture and scalp acupuncture. Her symptoms improved after 27 days of hospitalization. The affected area decreased to 1/2 of its original size and the dosage of analgesics taken was decreased. In this case, the effect of the treatment was significant. The mechanisms of ”heat-removal, detoxification and the enrichment of Yin” combined with acupuncture were the basis of the treatment.
延伸閱讀
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