乌梅丸加减治疗艰难梭菌相关性腹泻验案  

A Case Report of Clostridium Difficile Associated Diarrhea Treated with Modified Wumei Pill(乌梅丸)

作　　者：章妍 王允亮[1] ZHANG Yan;WANG Yunliang(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学,北京100029

出　　处：《山东中医杂志》2023年第12期1338-1341,1360,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：北京中医药大学科研创新岐黄团队项目(编号:2019-JYB-TD004)。

摘　　要：报告1例以乌梅丸加减治疗艰难梭菌相关性腹泻的病案。患者间断腹泻3年,加重并发现艰难梭菌感染3月余,前期西医规范治疗效果不理想。根据患者症状表现及舌脉,中医辨证为肝脾不和、中焦虚寒证,治以疏肝健脾温中、柔肝涩肠止泻,予乌梅丸加减口服治疗。服药两月复查艰难梭菌谷氨酸脱氢酶抗原及毒素检测均转阴,腹泻、腹部怕凉、小便短等症状亦明显缓解。通过对本案诊疗经过分析及相关文献回顾,重点把握乌梅丸缓肝安中、寒热并施、通利枢机对艰难梭菌相关性腹泻的治疗意义,进而推广至临床治疗多种腹泻相关性疾病。A case of Clostridium difficile associated diarrhea(CDAD)treated with modified Wumei Pill(乌梅丸)was reported.The patient had suffered from intermittent diarrhea for 3 years,which was aggravated by clostridium difficile infection for more than 3 months.The early standard treatment of western medicine did not achieve satisfactory effect.According to symptoms,and tongue and pulse diagnosis,patients were diagnosed as disharmony between liver and spleen,deficient cold in middle energizer according to traditional Chinese medicine(TCM)syndrome differentiation,and treated with oral administration of modified Wumei Pill to sooth liver,invigorate spleen,warm the middle,soften liver,astringe intestines and stop diarrhea.Two months after treatment,the glutamate dehydrogenase antigen and toxin test of Clostridium difficile were tested negatively,and symptoms like diarrhea,cold aversion in abdomen and scanty urine were also significantly relieved.Through the analysis of the diagnosis and treatment of this case and the review of relevant literature,the significance of Wumei Pill in the treatment of CDAD by the characteristics of soothing and softening the liver,warming the middle,combined application of cold and heat,and regulating vital energy were mastered,and then it should be promoted to treat various diarrhea-related diseases in clinic,which is also the essence of the treating different diseases with same method.

关 键 词：乌梅丸 艰难梭菌 艰难梭菌相关性腹泻 中医治疗 病案 

分 类 号：R249[医药卫生—中医临床基础]