中風之中西結合治療辨病案

Case Report-Treatment Integrated with Western and Chinese Medicine Based onDisease Differentiation of Stroke

陳威傑(Wei-Chieh Chen)；莊筱梅(Hsiao-Mei Chuang)；馮瀞儀(Ching-Yi Feng)；康玉典(Yu-Tien Kang)

中風 ； 外風 ； 內風 ； 半身不遂 ； Stroke ； Exogenous wind-evil ； Endogenous wind-evil ； Hemiplegia

臺灣中醫醫學雜誌

15卷2期（2017 / 09 / 30）

31 - 39

繁體中文

中風是臨床上常見的疾病，西醫大致上可分為缺血性和出血性中風兩大類，根據大腦損傷程度和位置的不同，症狀上的表現可以呈現多元變化，而常以口眼歪斜、半身不遂及猝然昏仆為表現，如果無及時進一步處理，往往會造成生命的危害和死亡。本案例是一位38歲年輕女性突然左側肢體無力、語言不流利和眩暈，經西醫確診為缺血性中風，於病發三天後會診中醫尋求輔助治療。經辨證病因為外感風邪，以處理外感觀點切入，治則為祛風通竅通絡養陰方式用藥。介入後病患神經學症狀快速改善，並於服藥後第八天順利出院。我們試著以外風角度連結現代醫學理論，給予外風造成中風有更多深入的解讀，期待未來能夠有更多臨床經驗，做為今後治療參考。

Stroke is prevalent clinically, which is classified into two major categories: ischemic and hemorrhagic stroke. According to the degree and site of brain impairments, the clinical manifestations of stroke are diverse. The common presentations of stroke are hemiplegia, facial paralysis and loss of consciousness. It may lead to significant morbidity and death if further management is not provided timely. This was a 38-year-old female patient, who was diagnosed of ischemic stroke, with initial presentation of left side weakness, dysarthria and vertigo. Traditional Medicine department was consulted three days after onset. Through differentiation, the cause of stroke was exogenous wind-evil. Based on it, we adopted dispelling wind and inducing resuscitation, activating the channels and nourishing yin as principle of treatment. After Chinese medical treatment, neurological symptoms were improved significantly. The patient recovered smoothly and was discharged from hospital after 8-day of Chinese medical treatment. In this study, we try to build a bridge between Chinese medical concept of exogenous wind-evil and Western medical theory, so as to interpret deeper meaning of stroke caused by exogenous wind-evil. We look forward to more precious clinical practices to confirm their relation in the future and provide discussion and reference for other doctors.

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