端午前後 腸病毒肆虐 奇美醫中醫助解熱毒化腸道濕氣
2023-06-05 記者 蘇旋/報導
農曆五月初五為一年一度的端午節,端午前後,臺灣氣候悶熱潮濕,也是腸病毒等許多濕熱疫病蠢蠢欲動的時節,腸病毒蓄勢待發!中醫因此發展出一套驅毒避邪的方法,奇美醫院治療腸病毒,從根源改善、預防,降低感染風險!
案例:5歲的李小妹妹,原本就因過敏性鼻炎而長期於奇美醫療財團法人奇美醫院中醫部總醫師莊照宇門診調理。本次至中醫回診時,莊總醫師依家長陳述,診察發現李小妹妹今日微燒(37.5度)、咽喉痛、口破、腹痛、舌紅苔白膩,且合併四肢起水泡紅疹等疑似腸病毒症狀,當下雖無西醫確診,但診斷這些症狀屬於中醫外感風熱夾脾胃濕熱證型,故開立銀翹散合甘露消毒丹為主的內服中藥處方給她服用,治療3天後症狀明顯改善,仍謹慎囑咐家長隨時留意若出現腸病毒重症徵兆,應儘速再就醫,切勿掉以輕心。
奇美醫療財團法人奇美醫院中醫部總醫師莊照宇表示,中醫認為腸病毒屬於溫病疫癘,風邪熱毒兼夾濕邪侵犯人體而發病。腸病毒為一群病毒的總稱,主要流行於每年3到5月,達到高峰後,又逐漸趨緩。依據疾病管制署資料,今(2023)年全國腸病毒門急診就診人次由3月初的2,332人次/週增加至5月的11,916人次/週,迄今已累積突破6萬人次(62,865人次),顯示國內正處於腸病毒流行期,整體疫情傳播風險上升且高於2017年以來同期。目前腸病毒71型輕症累計已10例;腸病毒感染併發重症病例累計則到3例。
感染腸病毒雖然可能出現腸胃道症狀,例如腹痛、腹瀉,但比例並不高;腸病毒的「腸」,是代表此類病毒經由「腸道」感染,大多透過糞口、飛沫或接觸傳播,故不一定有腸胃道症狀。腸病毒一般潛伏期約3至5天,最常出現的症狀反而是咽喉痛、發燒,甚至合併口腔黏膜、牙齦、舌頭以及手腳掌出現水泡潰瘍等疱疹性咽峽炎與手足口症之典型特徵。最容易感染腸病毒的年齡層落在5歲以下小朋友,同時這階段也需特別留意腸病毒重症的出現。
莊照宇醫師指出,針對腸病毒的治療,中醫常採用「瀉脾清熱、解毒透疹」的治療原則,初期發燒、咽喉紅痛,選擇銀翹散合麻杏甘石湯;若咽喉腫痛明顯,影響進食吞嚥,可改為普濟消毒飲,配合外用的吹喉散,以有效縮短病程,避免小朋友脫水或營養失衡;針對口咽及手足部的水泡,若合併腹悶脹、胃口不佳,則可用甘露消毒丹合藿香正氣散,酌加薏仁、茯苓、桑白皮化水濕,以及銀花、牡丹皮、清血熱。若小朋友原先有癲癇、熱性痙攣病史,甚至處方可提前加入鉤藤、燈心草等清心肝鬱熱,穩定神經系統。針對5歲以下小朋友,也提醒家長特別注意腸病毒重症表現,一旦小朋友出現嗜睡、意識不清、肌躍型抽搐、持續嘔吐、心跳呼吸急促等徵兆,需即早就醫。
莊照宇說明,對於腸病毒的預防方面,由於酒精對腸病毒無效,因此宣導洗手、戴口罩,甚至用漂白水做居家消毒,預防效果會更佳。由於腸病毒經由腸道感染繁殖,故平素加強腸胃道的免疫防護很是重要。中藥保健茶飲方面,可選擇金銀花、連翹、藿香、扁豆、薄荷等解熱毒化腸胃濕氣。配合穴道按摩如合谷、曲池、魚際、神門、陰陵泉等通暢身體循環。飲食方面,也要盡量少食用烤、炸、辣、甜食等高熱量食物,並配合適當運動與水分補充,方能有助於免疫力提升,降低腸病毒感染與傳播的風險。
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