- 期刊
淺談西醫嬰兒腸絞痛和中醫小兒夜啼之相關性與其治療
Discussing the Relationship between Infantile- Colic of Western Medicine and Infantile- Morbid-Night-Crying of Traditional Chinese Medicine (TCM) and Treatments
摘要
嬰兒腸絞痛是以嬰兒長時間異常哭鬧為主要臨床表現的常見疾病。西醫目前針對嬰兒腸絞痛之確診需使用排除性診斷（diagnosis of exclusion），藉由詳細的病史詢問與理學檢查去排除造成嬰兒異常哭泣（excessive crying）的器質性原因，然而持續性嬰兒啼哭只有不到5%是由於器質性原因所造成，且後續的治療手段十分有限。本文首先詳細介紹西醫嬰兒腸絞痛與中醫小兒夜啼的定義、診斷、治療、預後等內容，針對小兒夜啼的辨證論治，我們根據現有文獻重新整理並歸納出五個主要證型，包含脾經虛寒、傷食積滯、心肝積熱、心肝血虛與驚恐傷神。藉由比較嬰兒腸絞痛與小兒夜啼的相似性，我們提出了「西醫嬰兒腸絞痛在中醫的相對應疾病應該是小兒夜啼」之觀點。除了目前西醫嬰兒腸絞痛的心理與食療方法外，針刺合谷穴亦為治療嬰兒腸絞痛的一個可行方案，針刺深度宜淺，留針時間宜短。在治療小兒夜啼的中藥單味藥包含蟬蛻、鉤藤、薄荷、燈芯草、白花蛇舌草、白殭蠶、天竹黃，其他療法如驗方、推拿、外用貼敷、針灸、食療等也是可以嘗試的治療方式。綜合以上論述，我們最後於本文針對異常啼哭的嬰兒提出中西醫結合的治療方案。本文的結論認為西醫嬰兒腸絞痛或是小兒夜啼，在排除了可能有的器質性病變之後，除了目前常規的西醫衛教與食療方式之外，中醫的輔助治療或許是一個可以用來改善小兒夜啼的療法。而中醫介入的成效需要更多的臨床研究與觀察。
並列摘要
Infantile-colic is a common disease in which an infant suffers from prolonged and excessive crying or fussing. Infantile-colic is a diagnosis of exclusion that is made after performing a detailed history and physical examination to rule out organic causes, which account for less than 5 percent of excessive crying infants. Moreover, the following treatment of infantile-colic is limited. In this paper, we detailedly described the definitions, diagnosis, treatments and prognosis of infantile-colic of Western medicine and infantile-morbid-night-crying of TCM. We analyzed many articles and sum up five main patterns for infantile-morbid-night-crying: spleen deficiency cold, food accumulation, heart and liver heat, heart and liver blood deficiency, and fright. We also compared the similarity between these two diseases and proposed that infantile-colic of Western medicine may just be infantile-morbid-night-crying of TCM. Besides parental reassurance and dietary education, minimal acupuncture at LI4 is also a possible option for treating infantile-colic. For infantile-morbid-night-crying, the common treatments included: single herbs, formulas, tuina, plaster therapy, acupuncture and moxibustion, and diet therapy. Finally, we proposed a treatment protocol of integrative (Chinese and Western) Medicine for infants with excessive crying. We conclude that, for infantile-colic or infantile-morbid-night-crying, after the possible organic causes are excluded, not only health and dietary education of Western medicine but also adjuvant treatments of Chinese medicine can be possible ways to ease infantile-morbid-night-crying. The efficacy of Chinese medicine should be verified by clinical trials or follow-up observations in the future.