這是一位移居新加坡多年的 35 歲女性，過去有二尖瓣及三尖瓣脫垂、過敏性鼻炎與椎間盤突出的病史。這一個月以來由於喘促時作，期間曾數次進出急診，也接受過西醫治療，但症狀反覆發作。前來本院中醫部求診的主訴為晨起呼吸喘促突作、併見心悸且欲嘔，患者平素易煩躁、易緊張，自專科開始即時發呃逆，飯後易噯氣，食慾不佳，納少，易疲倦，口唇色淡，面色微黃無華，體型瘦，口不苦但易乾，欲飲水，但喝水就想吐，大便溏，小便短少，四肢冰冷，腹部觸診發現胸脅心下痞滿痛、腹直肌痞硬痛，右胸脅下扣診有振水聲；中醫診斷主症為喘症，病因乃脾虛失運，中焦水停，水氣凌心所致，次症為呃逆與噯氣，病因為肝氣橫逆犯胃，胃失和降所致，治療上以溫陽健脾兼以化氣行水為主；疏理肝氣、調暢氣機兼以降逆和胃為輔。

This is a 35-year-old female with history of prolapsed mitral and tricuspid valves, allergic rhinitis and HIVD. She has immigrated to Singapore for many years. She has suffered several incidents of asthma attack in the past month, and has been in and out ER many times with allopathic treatment. She came to our TCM department for help. The main complaints are morning asthma attacks with palpitation and nausea. The patient often feels agitated and nervous. She has frequent hiccups and belching after meals, poor appetite and fatigue. Her lips are pale, and her complexion has a tint of yellow. She is of thin build. She doesn’t have bitter taste in the mouth, but she feels dry mouth with a desire to drink water. However, she feels nauseated after drinking water. Stool is loose, quantity of urine is less, cold limbs. Abdominal palpation shows distending pain and lump in the chest region with stiffed Rectus Abdominis, and water sound at right hypochondrial region. The main TCM diagnosis is asthma due to deficient spleen with water retention and water invading heart. The secondary diagnosis is hiccup and belching due to invasion of liver qi to stomach, and disharmony of stomach qi. The main treatment is to warm spleen yang to transport water; sooth liver
qi to harmonize stomach.