針灸結合灸療膏治療出血性中風術後病例報告一例

The treatment of acupuncture combine moxibustion cream on hemorrhagic stroke post operation therapy：A case report

王先德(Xian-De Wang)；唐偉誠(Wei-Chen Tang)

出血性腦中風 ； 針灸 ； 灸療膏 ； hemorrhagic stroke ； acupuncture ； moxibustion cream

中華針灸醫學會雜誌

18卷2-4期（2015 / 12 / 01）

15 - 25

繁體中文

本病例為一位74 歲女性，有高血壓、氣喘、高血壓性心臟病等病史，2015 年1 月4 日時突發右側肢體無力及言語模糊而至本院急診就醫，斷層掃描檢查發現在左腦的額、頂、顳葉有實質性的出血，後緊急進行手術移除顱內血塊，術後住進加護病房，家屬於2015 年1 月7 日會診中醫。第一次會診時望病人意識不清，體削瘦，眼胞凹陷，喉中痰音聲重並裝上呼吸器，扣診其腹部呈鼓音；因病人插管，故無法診舌，右脈細無力，左脈沉滑弱無力。中醫辨證為中風，中臟腑，脾胃虛弱為本，痰瘀閉阻腦絡為標，治以醒腦開竅、祛瘀通絡、溫通氣機為主，方針使用體針合併灸療膏治療，病人症狀漸獲改善，並於2015 年2 月16 日順利出院。藉由此案例的治療過程來分享針灸合併灸療膏治療出血性腦中風術後之療效，以期提供同道治療的參考。

A 74 years old female who has past history of hypertention,asthma,hypertensive cardio vescular disease. She was transferred to enmergency room due to acute onset of right side limbs weakness and slurred speech on 2015-01-04,the computerized tomography showed hemorrhage at left frontal,parietal,and temporal lobe of brain,then emergency surgery was performed to remove intracranial blood clots.Post operation,patient was transferred to intensive care unit for further treatment,and the patient's family consult Department of Chinese medicine for combined care on 2015-01-07.At the first consultation,the patient's consciousness was not clear,with emaciated body, hollow eyelid and large number of sputum in throat.She also loaded on respirator to help her to breath,and doing the abdominal percussion showed tympanic sound. Because of intubation ,we could not see her tongue,the right pulse was powerless, fine,and sunken,the left pulse was powerless,sunken,and slippery.The Chinese medical diagnosis was apoplexy involving the viscera,spleen and stomach vacuity was the root,blockade of phlegm and static blood of the brain vessels was tip.The main treatment was awake the brain and opening the orifices,dispelling stasis and activate the vessels,warm and promote the Qi circulation.After the treatment of acupuncture combine moxibustion cream,patient's symptoms were improved,and discharged at 2015-02-16.By this case treatment process,we share the efficacy of acupuncture combine moxibustion cream on hemorrhagic stroke post operation therapy to provide a reference to our comrades.

1. Xu, Qingyan.,Yang, Jinsheng.,Wang, Liang.,Deng, Zi.,Wang, Yingying.,Yang, Li.,Wu, Peng.,Li, Liang.(2014).Use of laser speckle contrast imaging to reveal changes in temperature and blood perfusion in the skin of healthy subjects after administration of heated moxa sticks and Daiwenjiu ointment.Journal of Traditional Chinese Medicine,34(4),455-459.
2. 胡漢華(2008).台灣腦中風防治指引 2008.台灣腦中風學會.
3. 高尚社(2011)。國醫大師任繼學教授辨治腦出血驗案賞析。中國中醫藥現代遠程教育，9(8)，7-9。
4. 張紅梅,陳雪功,馬樹田(2007)。中醫灸法治療中風概述。廣州醫藥，38(3)，56-57。
5. 張莉莎,林炳茂(2011)。十二井穴麥粒灸法治療中風偏癱療效觀察。中外醫學研究，9(15)，74-75。
6. 張鑒梅,徐麗(2010)。重灸法在中風脫証治療中的量效觀察─《圓運動的古中醫學》理論臨床驗證。中國民族民間醫藥，16，131。
7. 潘相安(2007)。中風病病因病機的探討及治療。中華中醫藥學刊，25(1)，138-141。