飛蚊症中醫治療病例報告

這位老年男性病患自一個月前開始出現眼前飛蚊狀黑點成片，雙眼有閃光，過勞則易發，目內熱刺癢感，隨即就診於台北三總醫院，診斷為飛蚊症，併開立眼科外用藥使用，但使用藥物後飛蚊症並未有任何改善，惟目中熱癢刺感略為減輕。且感冒時易於目珠脹痛：故於92年3月19日來本院中醫部尋求進一步治療。來診時但見雙目內白睛近兩毗處有數縷粗大紅絲，雙眼下目胞色略晦暗：且自訴晨起易口乾苦，平素喜飲冷。目易流淚酸澀。腰酸，無法久坐：夜尿2~3行，量多，尿解不淨。多思則易頭痛，頸項痛；舌色淡紅，邊多齒痕，苔薄白。脈弦尺弱。中醫辨證為肝腎陰虛，肝火上炎。診斷為「蠅翅黑花」。處方以滋陰降火的知柏地黃丸為主，加減清肝熱的黃苓、夏枯草、菊花，涼血活血引火下行的赤芍、牛膝。服藥七日後自覺目內閃電感的出現時間已減少，十四日後飛蚊症已明顯改善，原成片飛蚊已無，僅餘夜間偶點狀飛蚊。同時白天目內有閃電感僅餘偶有點狀閃光，目內熱刺癢感也減輕。服藥至一月，點狀飛蚊現象改善逾90%, 雙眼閃光消失，其他兼症同時順利緩解。

關鍵字

飛蚊症；肝腎陰虛；蠅翅黑花；滋陰降火

並列摘要

A month previously, an elderly male patient had begun to see numerous patches of dark spots before his eyes, as well as spark like flashes of light. The symptoms were especially noticeable when fatigued and included prickly heat and itching sensations in the eyes. Soon afterward the patient went to San Zong hospital in Taipei and was diagnosed with Floaters. He was prescribed an external medication but after application there was no improvement except for some minor relief of the prickly heat and itching sensations. Furthermore when the patient caught a cold his eyeballs would feel distended and painful. On March 19, 2003 the patient came to this hospital’s Chinese medicine department in hopes of making progress in his treatment. Upon examination it was discovered that on the medial part of the sclera were numerous inflamed blood vessels and he had slightly dark circles under the eyes. The patient reported having dryness and a bitter taste in his mouth, preference for cold drinks and eyes that were sore and tear easily. Other symptoms included lumbar soreness with inability to sit for long periods, copious nocturnal urination 2-3 times per night, with incomplete discharge, as well as head and neck pain after prolonged thinking. His tongue was light red with scalloped edges and thin white fur. His pulse was wiry and the cubit pulse weak. The pattern identification was given as liver and kidney yin vacuity with liver fire flaring upwards. With a diagnosis of “fly wings and black flowers” (a reference to floaters). The formula was based on zhi bai di huang wan to enrich yin and downbear fire, with the addition of huang qin, xia ku cao and ju hua to clear liver heat, and chi shao and niu xi to conduct fire downwards. After taking the herbs for seven days the patient felt that there had been a reduction in the duration of time in seeing sparks and after fourteen days the patches of floaters had disappeared and only at night would he occasionally see small spots of floaters. At the same time, during the day he only periodically saw sparks and the prickly heat and itchiness had diminished. After taking the herbs for one month the condition of seeing floaters had improved 90% while visions of sparks had disappeared and the rest of his symptoms were gradually resolving.

並列關鍵字

floaters ； liver and kidney yin vacuity ； fly wings and black flowers ； enrich yin and downbear fire

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飛蚊症中醫治療病例報告

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