中醫治癒良性陣發性眩暈之病例報告

良性陣發性眩暈是中醫臨床常遇到的疾病，在整個人口族群中約有2%左右的盛行率，病患常常會突然感覺到天旋地轉，伴隨噁心甚至嘔吐等感覺，並且難以維持靜止的姿勢和步行的平衡。眩暈嚴重時也會干擾到患者的正常作息，工作甚至是生活能力。雖然大部分的患者都能夠自行緩解，但仍因為反覆的發作與難熬的症狀而深感痛苦。患者大多希望能夠尋求有效的治療方法，希冀醫師能盡快解除暈眩症狀。本病例報告提出一個良性陣發性眩暈患者的治療案例，由嚴重暈眩而需要中斷工作，變換姿勢也會感覺暈眩更嚴重，甚至因暈眩嘔吐數次，經過一週的中藥配合針灸治療之後，症狀即以大幅緩解，再治療一週後眩暈症狀已完全解除，且後續追蹤未再復發。作者提供此病案之臨症處方思路，希望對臨床中醫師有所助益。

關鍵字

良性陣發性眩暈；天麻鉤藤散；歸脾湯；益氣聰明湯

並列摘要

With the lifetime prevalence approximately 2% within normal population, Benign Paroxysmal Positional Vertigo (BPPV) is a commonly presented disorder in traditional Chinese medicine (TCM) outpatient departments. Patients often experience episodes of illusory movement associated with nausea and vomiting, leading to difficulty on posture-maintaining or motion-balancing. Even though the symptom is self-limited and self-relieving in most patients, recurrent episodes of vertigo can be quite disturbing to individuals' social, occupational, or other important areas of functioning. It is preferable for BPPV-affected population to find more effective ways to ameliorate symptoms and lower the recurrent rates. Here we present a case of severe occupationally-disruptive BPPV in a 56-year-old lady that was significantly alleviated by herbal powder and acupuncture over the course of two weeks without further relapses. The diagnostic process and treatment formula are provided in this case report for TCM clinicians, in hope of benefiting future TCM doctors and clinical workers.