背景：台灣地處亞熱帶，地小人稠，夏季氣候高溫炎熱，民眾常發生熱中暑。現代研究指出，早在熱衰竭發生的同時，高熱造成的全身發炎反應就開始醖釀，如果沒有立即治療，最終可能演變成熱中暑，甚至多重器官衰竭甚或死亡，所以當患者有輕微症狀時就應立即處理，以免拖延治療時機。中醫典籍記載“太陽中暍”之症候即指現代醫學之熱衰竭及熱休克現象，而拔罐是常見用於中暑的自然療法之一。 目的：本研究乃透過文獻搜尋及查證，進行「中暑」古代病名彙整及治療之重點整理，並以科學實驗方法驗證拔罐對於減緩熱衰竭的效果。 方法：1.典籍探討部份:以《中華醫典》資料庫為研究工具逐一比對進行中暑古病名彙整，資料內容包括病因病機、學說理論、方劑藥物及針灸的使用等各類論述。2.臨床實驗部份: 36位太陽中暍患者分為實驗組及對照組各18人，實驗組以拔罐方式刺激背部穴位，比較刺激前後之血壓、脈搏及體表溫度變化等數值之變化，並利用問卷量表評估受試者自覺改善狀況。 結果：1.典籍探討部份：彙整與中暑相關之典籍共四十二本，古病名二十二個及外治法十種。2.臨床實驗部份：實驗組治療前後在收縮壓與體表溫度上有統計上差異，對照組前後測之血壓與體表溫度則無明顯變化。問卷分析結果發現太陽中暍患者的脈象以沉脈 (佔50%)居多；症候中以頭痛、倦怠疲勞及筋骨痠痛、口渴、頭暈佔多數；致病因素則以戶外勞動、氣候變化為主。處理完背部穴位後，感覺減輕最多的症狀為頭痛 (佔78%)，其次為倦怠疲勞、頭暈、筋骨痠痛。 結論：本研究對太陽中暍進行詳盡之典籍探討，並以臨床實驗驗證拔罐處理可緩解太陽中暍患者之症狀，其結果可作為輔助療法之參考。 Background: People often suffer from heat stroke in summer. Modern research indicates that high fever and systemic inflammatory response syndrome (SIRS) are symptoms of heat exhaustion. If not immediately treated, it may eventually evolve into heat stroke, causing multiple organ failure and death. Therefore, it is often recommended that patients with mild symptoms be treated immediately. In Traditional Chinese Medical literature, heat stroke is referred to as “Tai-Yang-Chung-Ho ”. Cupping is one of the complementary methods people use to treat heat exhaustion and heat stroke. Aim: The objective of this research was firstly to collect Traditional Chinese Medical literature related to heat stroke and, secondly to evaluate the effects of cupping on patients with heat stroke. Methods: We made a content analysis of the definition, etiology, pathology, syndrome differentiation, guidelines, acupuncture therapy and herbs documenting heat stroke in Traditional Chinese Medical literatures. In addition, thirty-six heat exhaustion patients were divided into two groups and a single-blind study was designed to evaluate the effects of cupping. Results: A review of the Traditional Chinese Medical literature found forty-two articles related to heat stroke. In addition, twenty-two ancient names referring to heat stroke and ten external therapeutic methods were also found. Experimental results showed that cupping of the acupuncture points in the upper backs of patients reduced their symptoms of heat stroke. Furthermore, significant differences were found between the systolic pressure and body temperatures of heat stroke patients before and after cupping. Conclusions: A detailed literature review and analysis of the Traditional Chinese Medical literature was carried out. In addition, experimental results show that cupping relieves the symptoms of heat exhaustion. The results can be used as a reference for complementary therapy for heat stroke.
