{"id":4975,"date":"2017-02-06T00:00:00","date_gmt":"2017-02-05T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=4887b2a3dbc7a96c4bdff645f72e7262"},"modified":"2018-08-21T15:26:29","modified_gmt":"2018-08-21T07:26:29","slug":"%e9%86%ab%e5%be%b9%e4%b8%ad%e8%a5%bf%ef%bc%9a%e7%96%91%e9%9b%a3%e9%9b%9c%e7%97%87","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e9%86%ab%e5%be%b9%e4%b8%ad%e8%a5%bf%ef%bc%9a%e7%96%91%e9%9b%a3%e9%9b%9c%e7%97%87\/","title":{"rendered":"\u91ab\u5fb9\u4e2d\u897f\uff1a\u7591\u96e3\u96dc\u75c7"},"content":{"rendered":"

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【明報專訊】80歲蘇女士來診，過去一個月感到體內震、寒及心跳，一星期約發作三次，病發時甚至臉也震及身體發熱。復發之間無徵狀。她這年紀已有糖尿病、血壓高及膽固醇高，但都控制得很好，以前並沒試過出現這類徵狀。西醫做過各種檢驗，包括心臟及電腦掃描，但找不到病因。中醫臨牀證型初看也沒什麼明顯，也沒有特別痛點，脈象偏細，舌苔微膩舌邊暗黑。以往20多年身體不算太差，容易倦及暈，有耳鳴但不是特別嚴重，骨節不太差，背有時痛及上樓梯時膝痛，睡眠質素偏差，容易發脾氣。<\/p>\n

徵狀不明顯 西醫束手無策 <\/p>\n

這些震動徵狀，西醫束手無策，中醫則根據多方面臨牀徵狀辨證。看這病人顯證不多，說話時聲線震，見心跳若以為心血虛但舌沒此象；如視為年老腎氣虛但病人說話中氣好；如考慮肝鬱但舌只是微暗。見她眼瞼向外下墜，又有脾氣差及牙骱緊，乃斷證為肝血不足，治療以養肝血而處方溫膽湯加味。病人一星期後氣機疏暢，身和面震、心跳及耳鳴皆大大減輕，尚有輕微背痛；再一星期後病人進展更佳，聲線也不再震。<\/p>\n

另一名50歲女士，之前勞累，但退休已五個月，精神肉體狀况復元頗佳。但來診那日中午在坐車時，突然感到眼前影像持續向左移，停車後影像移動現象仍維持5至6分鐘。她沒頭暈頭痛，沒感冒徵狀，睡眠超過8個鐘，大便正常。來診血壓正常，骨頭肌肉也沒有什麼，眼壓正常，舌診沒特殊，脈滑。她就好像之前那病人一樣沒有什麼顯證，唯一是眼部向右望時有不規則微震，但電腦掃描正常。<\/p>\n

中西互相啟發 掌握治療方向<\/p>\n

這病人情况一如上述老婦，病徵困擾辛苦，但西醫檢驗沒特別之處。細問下，這女士平時用電腦多，常用電腦看視頻。求診前一晚曾訓練眼睛十字操，以來診當日徵狀看，相信是以往勞損退休已算復元，但一直用眼多而眼未恢復，這日眼睛肌肉疲勞抽筋至影響徵狀發作。推及上一名80歲老婦也是每日打電腦遊戲一個鐘以上，亦相信是與肌肉疲勞抽筋有關。<\/p>\n

找到難症病人的根源問題，是很令人興奮，也屬挑戰性。常聽到病人於西醫未必得到實在診斷，看中醫找根源醫治希望有好的效果。但是有些疑難雜症需用中西醫互相啟發的思維，藉着細節才可以掌握治療的方向。<\/p>\n

文：香港醫學專科學院院士、浸會大學中醫藥學院榮譽教授余秋良<\/p>\n

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