夜尿的中醫治療病例報告

Treatment of Nocturia by Traditional Chinese Medicine: A Case Report

陳囿任(Yu-Jen Chen) ； 林在裕(Tsai-Yu Lin)

《中醫內科醫學雜誌》 17卷1期 (2019/06) Pp. 67-76

https://doi.org/10.7102/JTCIM.201906_17(1).0006

摘要

夜尿，即夜間頻尿，指一個人在夜間睡眠中需要頻繁起來小便，是年長者睡眠中斷的主要原因之一。本篇病例是一名57歲中年男性患者，因夜尿問題至臺北榮民總醫院就醫檢查診斷為良性攝護腺肥大症（BPH）。患者前來臺北市立聯合醫院中興院區中醫科門診尋求治療，中醫辨證診斷為「腎陽虛衰、癥瘕積聚」，故以濟生腎氣丸合桂枝茯苓丸補腎助陽、消積散癥，以期恢復腎與膀胱臟腑氣化機能，減少夜間爬起來小便的次數；約治療三周後夜尿次數減為3次，服藥兩個月後夜尿情形減至兩次，改善了患者睡眠品質。夜尿問題除了干擾睡眠影響隔天日常活動外，更可能加重多種慢性疾病的惡化與夜間起床跌倒骨折的風險，在目前高齡化社會中是個非常值得關注的議題。

關鍵字

夜尿 ； 腎陽虛 ； 癥瘕積聚 ； 濟生腎氣丸 ； 桂枝茯苓丸

並列摘要

Nocturia, that is, excessive urination at night, is one of the main causes of sleep interruption in a person who needs frequent urination at night. This article presents a case of a 57 year old male, suffering from nocturia, with benign prostatic hyperplasia(BPH) diagnosed at Taipei Veterans General Hospital. The patient came to the Department of Traditional Chinese Medicine of Zhongxing Branch of Taipei City Hospital for treatment. Traditional Chinese Medicine doctor diagnosed the patient with ＂kidney yang deficiency and accumulation-aggregation＂, recommended Ji Sheng Shen Qi Wan and Gui Zhi Fu Ling Wan, treating with both tonifying kidney -assisting yang and mass-eliminating, improving kidney and bladder qi transformation to lessen sleep-period interruption and promoting the qualities of life. After three weeks of treatment, the frequency of nocturia has decreased to three times a night. Moreover, the symptom has decreased to twice a night two months later, which improved the patient's quality of sleeping. The recent research revealing nocturia, disrupting the restorative part of sleep, can aggravate the deterioration of various chronic diseases and increase the risk of fractures, also a concerning topic in the aging society nowadays.

並列關鍵字

Nocturia ； Kidney yang deficiency ； Aggregation-accumulation ； Ji Sheng Shen Qi Wan ； Gui Zhi Fu Ling Wan

參考文獻

Van-Kerrebroeck Philip, Abrams Paul, Chaikin David, Donovan Jenny, Fonda David, Jackson Simon, Jennum Poul, Johnson Theodore, Lose Gunnar, Mattiasson Anders, Robertson Gary, Weiss Jeff. The standardisation of terminology in nocturia: Report from the standardisation subcommittee of the International ontinence Society. Neurourology and Urodynamics 2002;21(2):179-183.

Weiss Jeffrey P, Blaivas Jerry G, Stembe,Doron S, Brooks Maria M. Nocturia in adults: Etiology and classification. Neurourol Urodyn 1998;17(5):467-72.

陳芋樺，郭漢崇。排尿日誌之記錄判讀與應用。慈濟醫學雜誌 2005；17(1)：15-21

李芳嬋，周雅琪，米阿娜，蔣林。老年人夜尿症研究概況。大眾科技醫藥與衛生 2018；20(06)：88-90。