瀰漫性軸突損傷中西醫合併治療病案報告

A Case Report of Integrated Chinese and Western Medicine Treatment in Traumatic Diffuse Axonal Injury

周昀璇(Yun-Hsuan Chou)；江佩蓉(Pei-Jung Chiang)

創傷性腦損傷 ； 瀰漫性軸突損傷 ； 中藥治療 ； 針灸 ； Traumatic brain injury (TBI) ； Diffuse axonal injury (DAI) ； Chinese medicine treatment ； Acupuncture

中華針灸醫學會雜誌

23卷3-4期（2020 / 12 / 01）

12 - 24

繁體中文

瀰漫性軸突損傷（DAI）是最嚴重的創傷性腦損傷（TBI），預後不佳，致死率高。本病例為一位十七歲男性患者，車禍腦傷後，陷入重度昏迷，昏迷指數（Glasgow coma scale, GCS）為E1V1M3，影像學檢查診斷為第三級瀰漫性軸突損傷，並且合併肋骨斷裂造成氣血胸的狀況，因意識持續不清（GCS:E2VtM4）、四肢拘急及四肢肌力低下，故於第10天會診中醫，先以平肝熄風治則給予中藥及針刺治療，後轉以養心肝血治療，三週後病況穩定，昏迷指數進步至12分（GCS:E4V3M5），並出院至復健醫院持續治療。

This is a 17-year-old male struck by a car. He subsequently became comatose with a traumatic head injury, and was referred to our hospital. At our ED, his conscious level was E1V1M3. CXR showed right 6th, 7th, 8th rib fractures with right hemopneumothorax. The MRI scan revealed multiple hemorrhagic lesions in the corpus callosum, cortical medullary junction of bilateral cerebral hemisphere, left thalamus and right midbrain, compatible with grade III diffuse axonal injury (DAI). The patient started Chinese medicine treatment on the 10th day of admission. After receiving oral traditional Chinese herbal medicine and acupuncture as treatment 10 times, his consciousness level improved gradually. In addition, his respiratory pattern was smooth in ambient air. After one month, he was discharged to a rehabilitation hospital in order to access stronger rehabilitation programs.

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