【力報專欄:惠澤世人】中醫治肝硬化腹水  | 呂澤康中醫博士文

 

肝硬化腹水是肝硬化失代償期的重要臨床標志,以肝功能損害及門靜脈高壓為主,並常出現嚴重併發症。

臨床上中醫常遇到多為經西醫藥物治療後不滿意或多次排放腹水後又復發之頑固性腹水患者,報導指出約50%患者在半年內死亡。中醫自《內經》已有記載,古稱“臌脹”。中醫治療腹水以辨證論治為主,方法包括:健脾、補腎、疏肝、宣肺、清熱、活血化瘀或通腑等。孟河醫派奠基人費伯雄在《醫醇賸義》:“臌脹者,腹脹,身皆大,大與膚脹等,色蒼黃,腹筋起,此其候也...腹起青筋,則肝邪熾盛,而脾土敗壞,症勢甚危。當扶土抑木,兼化陰邪,扶抑歸化湯主之。”近代名中醫趙紹琴(其父為清朝御醫)教授以柴胡、黃芩、川棟子、杏仁、藿香、佩蘭等普通藥材治癒一個肝脾腫大腹水的病人,病人肝脾均有較大幅度回縮,更可恢復輕量工作,正常生活。

另外,針灸治療腹水,在宋代的醫籍已有大量記載,明代《針灸大成》還載述了治腹水的奇穴。臨床常用為理氣通水的穴位為水分、氣海、中極、關元或足三里等。針灸有助促進肝功能恢復,提高藥物生物利用度,減少口服藥的毒副作用。

必須提醒讀者,乙肝病人應積極配合西醫用藥指示,多份研究指出:乙肝病人服藥後可有效地控制病毒,避免形成肝硬化或肝癌。作為醫生,最為了解中西醫之優缺點,不必存有門戶之見,應以患者福祉為首,給予他們最佳的治療建議。

澳門 | 力報專欄 | 惠澤世人 | 作者:呂澤康 中醫博士

 
 
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中醫治肝硬化腹水