题名

中風後失語症之針灸介入結合語言治療：病例報告

并列篇名

Integrated Treatment of Acupuncture and Speech Therapy for Post-stroke Aphasia: a Case Report

作者

林伯儔(Po-Chou Lin)；林正德(Cheng-Te Lin)；阮膺旭(Ying-Hsu Juan)

关键词

中風 ； 失語症 ； 針灸 ； stroke ； aphasia ； acupuncture

期刊名称

中西整合醫學雜誌

卷期/出版年月

24卷1期（2022 / 06 / 30）

页次

49 - 68

内容语文

英文
中文摘要

腦血管疾病於民國109年為國人第四大死因，失語症為常見的中風後遺症之一，語言的理解或表達損傷常造成病人嚴重的社交障礙，嚴重的影響生活品質。本病例為一位55歲男性，語言理解與表達困難已兩天。於2019／07／25因身冒冷汗，怕冷，胸悶，頭暈與無法流暢表達而至急診就診，診斷為左側大腦梗塞（middle cerebral artery infarction），遂住院接受治療。病患意識正常，日常生活自主，但無法言語表達且聽覺與閱讀理解差。平素飲食習慣為重口味且偏好紅肉攝取，有高血壓與高血脂病史。菸齡35年，飲酒小酌。整體面色舌唇暗紅，舌質偏乾，苔黃膩，舌下絡脈明顯怒張。脈弦滑。中醫證型為痰瘀阻絡化熱，上蒙清竅。經中、西醫結合治療後，語言功能逐漸恢復，在簡明失語症測驗中大多數分測驗皆有顯著進步。
英文摘要

Cerebrovascular disease is the fourth leading cause of death in Taiwan in 2020, and aphasia is one of the common sequelae after stroke. Impairment of language understanding or expression often causes severe social problems in patients and seriously affects the quality of life. This was a case of 55-year-old male who has difficulties in language understanding and expressing for two days. He went to the emergency department due to cold sweating, chills, chest tightness, dizziness and inability of expressing on 2019/07/25. At that time, he was diagnosed with a left cerebral infarction and was hospitalized for further treatment. The patient's consciousness was clear and was independent in ADL. But he was unable to express in words and had difficulties in hearing and reading comprehension. The patient's usual diet was heavy taste and preference for red meat, and had a history of hypertension and hyperlipidemia without medical control. He had 35 years of smoking history and often had a drink before sleeping. The overall complexion of his appearance was dark red, the tongue was dry, the coating was yellow and greasy, and the sublingual veins were obviously irritated. He was diagnosed with phlegm and blood stasis blocking collaterals with heat transmission and confused orifices in Chinese medicine syndrome type. After the treatment with integrated Chinese and Western medicine, his language function gradually recovered, and most of the subtests in the Concise Chinese Aphasia Test showed significant improvement.
主题分类 醫藥衛生 > 醫藥總論
醫藥衛生 > 中醫藥學
参考文献
  1. 沈郁欣,陳彥淇,洪裕強(2019)。中風後失語症的中醫藥治療探討。中醫內科醫學雜誌，17(2)，1-10。
    連結：
  2. 蔡宗宏,楊進(2005)。中藥黃耆的現代研究與應用。中華推拿與現代康復科學雜誌，2(1)，33-38。
    連結：
  3. Uptodate, Aphasia: Prognosis and treatment (website: https://www.uptodate.com/)
  4. 衛生福利部 (website: https://dep.mohw.gov.tw/DOS/lp-5069-113-xCat-y109.html)
  5. WHO (website: https://www.who.int/)
  6. AHA(2021).Predictors of Poststroke Aphasia Recovery.Stroke,52(5),1778-1787.
  7. Guzik, A,Bushnell, C(2017).Stroke epidemiology and risk factor management.Continuum,23,15-39.
  8. Hankey, GJ,Macleod, M,Gorelick, PB,Chen, C(2019).Warlow's Stroke: Practical Management.USA:Wiley-Blackwell.
  9. Hegyi, Gabriella,Szigeti, Gyula P.(2012).Rehabilitation of Stroke Patients Using Yamamoto New Scalp Acupuncture: A Pilot Study.THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,18,971-977.
  10. Kaluza, J,Wolk, A,Larsson, SC(2012).Red Meat Consumption and Risk of Stroke.Stroke,43,2556-2560.
  11. Liu, CH,Tsai, CH,Li, TC,Yang, YW,Huang, WS,Lu, MK(2016).Effects of the traditional Chinese herb Astragalus membranaceus in patients with poststroke fatigue: A doubleblind, randomized, controlled preliminary study.Journal of Ethnopharmacology,194(24),954-962.
  12. Liu, SH,Jiang, Y,Wang, N,Yan, H,Chen, L,Gao, JC,Zhang, JP,Qu, SS,Liu, SY,Liu, G,Huang, Y,Chen, J(2021).Scalp acupuncture enhances local brain regions functionalactivities and functional connections between cerebralhemispheres in acute ischemic stroke patients.The Anatomical Record,1-14.
  13. Liu, Z,Huang, J,Xu, Y(2021).Costeffectiveness of speech and language therapy plus scalp acupuncture versus speech and language therapy alone for community-based patients with Broca’s aphasia after stroke: a post hoc analysis of data from a randomised controlled trial.BMJ Open,11,e046609.
  14. Moss, A,Nicholas, M(2006).Language rehabilitation in chronic aphasia and time postonset: a review of single-subject data.Stroke,37(12),3043-3051.
  15. O’Donnell, CJ,Larson, MG,Feng, D,Sutherland, PA,Lindpaintner, K,Myers, RH(2001).Genetic and environmental contributions to platelet aggregation: the Framingham Heart Study.Circulation,103(25),3051-3056.
  16. Quinn, TJ,Dawson, J,Walters, MR(2011).Sugar and Stroke: Cerebrovascular Disease and Blood Glucose Control.CardiovascularTherapeutics,29,e31-e42.
  17. Rosenberg, MD,Song, H(2020).Predicting post-stroke aphasia from brain imaging.nature human behaviour,4,675-676.
  18. van Oers, CAMM,van der Worp, HB,Kappelle, LJ(2018).Etiology of language network changes during recovery of aphasia after stroke.Scientific Reports,8,856.
  19. Wu, Ping,Mills, Edward,Moher, David,Seely, Dugald(2010).Acupuncture in Poststroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Trials.Stroke,41,e171-e179.
  20. Young, NY,Min, YS,Gwang, CP,Chang, SN,Jae, YH,Myung, RC,Jae, HK(2018).Meta-analysis on randomized controlled trials for scalp acupuncture treatment of stroke: A systematic review.Journal of Traditionl Chinese Medicine,38(4),465-479.
  21. Zhu, SQ,Qi, L,Rui, YF,Li, RX,He, XP,Xie, ZP(2008).Astragaloside IV inhibits spontaneous synaptic transmission and synchronized Ca2+ oscillations on hippocampal neurons.Acta Pharmacol Sin,29(1),57-64.
  22. 王嘉鐸,蔡泊意(2018)。中風後失語症的語言復健─穿顱磁刺激與限制性誘導治療。台灣聽力語言學會電子學報，80
  23. 田安然(2019).中西醫結合義理探要.台灣:知音.
  24. 吳俊漢,楊添麟,劉耕豪,陳銘賢,蔡培癸,沈建忠,李克成,游智勝(2007)。101 例原發性高血壓患者的中醫體質辨證研究。中醫藥雜誌，18(3-4)，113-119。
  25. 吳國定(1977).內經解剖生理學.台北:國立中國醫藥研究所.
  26. 邱弘毅(2018)。腦中風之現況與流行病學特徵。台灣中風醫誌，15(3)
  27. 張伯臾(2010).中醫內科學.台北:知音出版社.
  28. 梁君瑋,莊智翔(2010)。從功能性核磁共振顯影看針刺的作用機制。臺灣中醫臨床醫學雜誌，16(2)，120-124。
  29. 陳必誠(2018).現代中醫導論要略.台中:華格那.
  30. 陳淑華,呂萬安(2009)。高血壓西醫臨床表現與中醫辨證分型之相關性。北市醫學雜誌，6(2)，103-116。
  31. 楊東輝,王欽鵬(2008)。從痰瘀論治高脂血症的研究進展。實用中醫內科雜誌，22(6)，116-117。
  32. 劉威,李燕梅(2013)。中風失語症病機概述。中國臨床研究，24，121-122。
  33. 錢小奇(2002)。試論高血脂的病因病機。天津中醫，19(6)，50。
  34. 顏正華(2011).中藥學.台北:知音出版社.
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