232.12 歸脾湯治療免疫性特發性血小板缺少症之病例報告
TJ TCM.23(2) : 159-168,2020
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歸脾湯治療免疫性特發性血小板缺少症之病例報告
A Case Report of Gui-Pi-Tang Used on the Patient with Idiopathic Thrombocytopenic Purpura
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莊凱雯1 陳文娟1* 李聰界1 羅綸謙2
1 財團法人彰化基督教醫院中醫部，彰化，台灣
2 中國醫藥大學附設醫院中醫部，台中，台灣
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【摘要】
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免疫性特發性血小板缺少症臨床上分為急性期和慢性期兩型，急性期好發於孩童，慢性期好發在成人，嚴重者有腸胃出血和腦內出血的風險。本病例為成人型的免疫性特發性血小板缺少症，在中醫屬於「血證」、「發斑」的範疇，此39 歲女性，血小板數目在2019/04/15 為35×10^3/μL，因血小板持續低下以及全身不定處不定時的瘀青密布，於同年05/27 至中醫門診，主訴全身瘀青。中醫診斷為紫癜，證屬脾氣虛兼腎陰虛，給予歸脾湯和仙鶴草、旱蓮草加減，以補養心脾氣血和養陰止血，06/10 血小板數目上升到64×10^3/μL，全身遍布的瘀青顏色轉淡、範圍縮減，為一中醫治療成人型免疫性特發性血小板缺少症的有效臨床病例。
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【關鍵詞】：紫癜、特異性免疫性血小板缺少、歸脾湯、仙鶴草、旱蓮草
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Kai-Wen Chuang1Wen-Jiuan Chen1*Tsung-Chieh Lee1Lun-Chien Lo2
1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
2China Medical University and Hospital, Department of Traditional Chinese Medicine Taichung, Taiwen
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【Summary】
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Immune idiopathic thrombocytopenia is clinically divided into acute phase and chronic phase. The acute phase occurs in children, and the chronic phase occurs in adults. In severe cases, there is a risk of gastrointestinal bleeding and intracerebral hemorrhage. This case is an adult-type immune idiopathic platelet deficiency. The number of platelets in this 39-year-old woman is 35×10^3/μL at 2019/04/15, because the platelets continued to be low and the body was indefinitely inaccurate petechiae. In the same year, from 05/27 to the Chinese medicine clinic, the main complaint was petechiae all over the body. The diagnosis of Chinese medicine is purpura, and the syndrome belongs to both spleen qi deficiency and kidney yin deficiency. It is given to Gui Pi Tang , Xian He Cao and Han Lian Cao to supplement and nourish heart and spleen and blood and nourish yin and stop bleeding. The number of platelets rises to 64×10^3/μL in 06/10. The color of the petechiae, which is spread throughout the body, is diminished and the range is reduced. It is an effective clinical case for the treatment of adult-type immune idiopathic platelet deficiency in a Chinese medicine practitioner.
【Keywords】idiopathic thrombocytopenic purpura, petechiae, Gui Pi Tang, Xian He Cao, Han Lian Cao
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