再生不良性貧血 慢性期患者宜活血

[joelin]

http://tw.news.yahoo.com/article/url/d/ ... 2iebj.html

文／王致統


「奇怪！怎麼每天早上，刷牙的時候，牙齦都會流血？而且最近越來越覺得疲倦，但是肝功能檢查又沒有問題，倒底我的身體怎麼了？」這種情形有可能是罹患再生不良性貧血。


此病患者常四處就醫，仍無法解決問題，主要是病例數不多，且不好診斷也不易治療的自體免疫疾病。


有可能是人體接觸到一些特殊的因子，激發了體內的免疫細胞，去攻擊骨髓幹細胞，進而使骨髓無法生產紅血球、白血球及血小板，而造成種種病變。嚴重時，會有大出血及感染的情況，治療往往不盡理想，常讓病人沮喪不已。


中醫學認為，再生不良貧血是因為先天不足、煩勞過度、脾胃虛弱、腎精虧損，合併外感邪毒傷及氣血臟腑，影響到腎、脾、肝及骨髓。


在慢性期屬於虛勞及血虛的範疇，應從腎的陰陽做辨症論治，以滋陰濟陽、補腎填精為主，常用人參、黃耆補骨脂、淫羊藿、肉蓯蓉、女貞子、旱蓮草。


慢性期的再生不良性貧血病人有不同程度血瘀、血虛的狀況，適當加入一些活血補血藥，包括當歸、川七、雞血藤、桃仁，往往帶給久病的病人極大的改善。


但是急性期屬於急勞髓枯血熱，應以三才封髓丹合犀角地黃湯（可用水牛角代替），一方面清血熱，一方面顧護陰液，以求涼血解毒。


醫師在替患者針灸時，可以選用膈俞、脾俞、腎俞、血海等穴位，補腎、健脾、補血，若有血熱時，加合谷大椎，有肝鬱的症狀加太衝、行間。


平時的預防保健上，若是肝炎患者一定要保持心情舒暢，平時也要加強鍛鍊，因為許多繼發性的再生不良性貧血都是起源於肝炎。再者要避免一些有毒物質的接觸，包括放射線、藥物等。重症病人起居室要隔離，定時以紫外線消毒，避免不必要的感染。


（作者為彰化市玉衡中醫診所副院長）

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