本案例25 歲的林小姐，自95年12月開始每逢經期即出現咳血的症狀，經成大醫院電腦斷層檢查，診斷為肺子宮內膜異位症。從中醫的觀點來看本病是屬於經行吐衄的範疇，又稱為倒經或逆經。依病患的臨床表現，屬於肝鬱化熱、肝腎陰血虧虛、肝陽上亢的證型，而衝脈附於肝，行經期衝脈氣盛，肝經鬱火夾衝氣上逆灼傷肺絡，故導致經行咳血。故治療宜區分行經期與經後期隨證用藥。經後期以滋養肝腎之陰、疏肝理氣、清熱平肝為主來治其本；行經期則加強平衝降逆，活血化瘀之品以治其標。服藥前三個月經行咳血量明顯減少，第四個月以後經行咳血症狀消失。

A 25 year-old female suffered from hymoptysis during menstruation dated back December 2006. She was diagnosed with endometriosis after CT scan. This symptom belongs to hematemesis and epistaxis during menstruation in TCM, and is often called reversed menstruation. According to patient’s clinical symptoms, the syndrome belongs to stagnant heat in liver, uprising liver yang, and deficient liver and kidney yin and blood. Because Chong meridian attaches to liver meridian, and its energy is abundant during menstruation, hemoptysis during menstruation is the result from damaged lung meridian due to stagnant liver fire flaring up with Chong meridian. Therefore, it’s better to divide treatment into two stages: menstruation and post-menstruation. The root cause is treated with principles of nourishing liver and kidney yin, relieve stagnant liver qi, and clear liver heat in the post-menstruation stage; symptoms are treated with smooth chong meridian, and activate blood to dissolve stasis in the menstruation stage. After taking herbs for 3 months, patient’s hemoptysis
reduced significantly, and disappeared after the forth month.