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芍藥甘草湯緩解夜間腿部痙攣之病例報告

Nocturnal Leg Cramps Treated with Shao Yao Gan Cao Tang : A Case Report

摘要


本案例為一位54歲女性患者,3年前開始夜間出現右腿抽筋症狀,發作頻率及疼痛程度逐漸加重,影響睡眠,伴隨右腳小腿靜脈曲張分布範圍亦增加,患者先前曾自行到藥局購買肌肉鬆弛劑服用,其抽筋症狀可緩解,但由於擔心長期使用肌肉鬆弛劑的副作用,於2019/4/11開始到中醫門診就醫,服用中藥後,夜間腿部抽筋發生頻率及強度下降。八月初時因忙碌的關係未按時回診,有三週的時間未服用中藥,夜間腿部抽筋頻率逐漸回升,一週有6天晚上發生抽筋、VAS 6分。患者於2019/8/29回診,中醫辨證為肝陰虛、下焦氣血阻滯之痙病,以益肝陰、養肝血、舒筋活血為治則,患者服用芍藥甘草湯為主方的中藥後,其夜間腿部抽筋症狀大幅改善,持續回診服用中藥並追蹤,抽筋發生頻率及疼痛程度均顯著下降,頻率由週發生6次抽筋,降為二週僅發生1次,疼痛程度由VAS 6分降為3分。

並列摘要


This case is about a 54-year-old female who suffer from nocturnal leg cramps for 3 years with increasing frequency of onset and pain intensity. To relieve the discomfort, she took muscle relaxant for a while but considering the possible side effects of muscle relaxant, she turned to visit our Chinese medicine Department for help on April 11, 2019. After taking Chinese medicine, the patient's symptoms were alleviated. However, at the beginning of August, due to her busy schedule, she cannot return to clinic to follow treatment course until three weeks later. When she returned, her symptoms got worse presenting as onset frequency with 6 nights a week and the visual analog scale (VAS) score of 6. This patient was diagnosed as convulsive disease due to the deficiency of liver yin and the stagnation of qi and blood in lower jiao. Nourishing the liver yin, liver blood and relaxing the muscles were chosen as the major treatment strategy. The symptoms improved after the patient taking the formula which including Shao Yao Gan Cao Tang, the frequency and quantity of nocturnal leg cramps decreased significantly. The frequency of cramps decreased from 6 times a week to once every two weeks. The pain intensity of VAS score decreased from 6 to 3.

參考文獻


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Joannes Hallegraeff, Mathieu de Greef, Wim Krijnen and Cees van der Schans:Criteria in diagnosing nocturnal leg cramps : a systematic review. Hallegraeff et al. BMC Family Practice 2017;18(1):29
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