题名

出血性腦中風急性期中醫介入治療經驗-三個病例報告

并列篇名

Early TCM Interventional Treatment Experience of Hemorrhagic Stroke: Three Case Reports

DOI

10.6516/TJTCM.201909_22(2).0017

作者

鄭宇真(Yu-Chen Cheng);林昱廷(Yu-Ting Lin);陳建仲(Jian-Jung Chen);黃仲諄(Chung-Chun Huang)

关键词

中臟腑 ; 出血性腦中風 ; 急性期中醫介入 ; 中西醫結合治療 ; severe stroke ; hemorrhagic stroke ; early intervention ; integrated treatment of TCM and western medicine

期刊名称

中醫藥研究論叢

卷期/出版年月

22卷2期(2019 / 09 / 30)

页次

171 - 179

内容语文

繁體中文

中文摘要

腦血管疾病中出血性腦中風不但預後較差,並且在亞洲的發生率高於西方國家,造成家庭和國家龐大的醫療負擔,如何減少患者後遺症狀,加強肢體活動能力,使之恢復生活自理能力、降低社會照護成本是現醫療努力的目標。本病例報告為三個重度出血性腦中風中醫早期介入治療案例,經治療患者神經功能皆獲得改善。中醫治療上,根據本院多年臨床觀察治療經驗,歸納出「辨病」治療模式:急性期藉由恢復人體中焦氣機,改善腦部出血後的標症-氣逆痰瘀化火,治以化痰醒腦開竅。

英文摘要

Introduction: According to the American Stroke Association, Cerebrovascular accident(CVA) is the leading cause of disability and the fifth cause of death. Compared to ischemic stroke, hemorrhagic stroke leads to higher mortality and more severe disability. Patients with GCS scored 8 or below are defined as severe stroke, which might lead to poor outcome, increase social and economic burden. Early intervention of integrated treatment of TCM and western medicine for severe stroke is essential to decrease mortality and disability rate. Case description: We present three cases of severe hemorrhagic stroke, including aneurysm rupture, hypertensive cerebral hemorrhage and pontine hemorrhage. The initially GCS were all below 8, and all of them received Chinese medicine within four days after onset. After several months of treatment, their neurological function has improved. Discussion: In our experience, integrated treatment of TCM and western medicine can improve their self-care ability, and make better recovery for hemorrhagic stroke patients. Our hypothesis is that TCM can restore human qi circulation, and accelerate brain repair. We hope to share these cases of early TCM interventional treatment for stroke to reduce mortality and disability rate.

主题分类 醫藥衛生 > 中醫藥學
醫藥衛生 > 藥理醫學
参考文献
  1. Broderick, Joseph,Connolly, Sander,Feldmann, Edward,Hanley, Daniel,Kase, Carlos,Krieger, Derk,Mayberg, Marc,Morgenstern, Lewis,Ogilvy, Christopher S.,Vespa, Paul,Zuccarello, Mario(2007).Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group.Stroke,38(6),2001-2023.
  2. Chapleau, MW,Hajduczok, G,Sharma, RV,Wachtel, RE,Cunningham, JT,Sullivan, MJ,Abboud, FM(1995).Mechanisms of baroreceptor activation.Clinical and Experimental Hypertension,17(1-2),1-13.
  3. Feigin, VL,Lawes, CM,Bennett, DA,Barker-Collo, SL,Parag, V(2009).Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review.The Lancet Neurology.,8(4),355-369.
  4. Hong, KS,Bang, OY,Kang, DW,Yu, KH,Bae, HJ,Lee, JS,Heo, JH,Kwon, SU,Oh, CW,Lee, BC,Kim, JS,Yoon, BW(2013).Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the korean stroke society and clinical research center for stroke.Jounal of Stroke,15(1),2-20.
  5. Hu, HH,Sheng, WY,Chu, FL,Lan, CF,Chiang, BN(1992).Incidence of Stroke in Taiwan.Stroke,23,1237-1241.
  6. Lozano, R,Naghavi, M,Foreman, K,Lim, S,Shibuya, K,Aboyans, V,Abraham, J,Adair, T,Aggarwal, R,Ahn, SY,Alvarado, M,Anderson, HR,Anderson, LM,Andrews, KG,Atkinson, C,Baddour, LM,Barker-Collo, S,Bartels, DH,Bell, ML,Benjamin, EJ,Bennett, D,Bhalla, K,Bikbov, B,Bin Abdulhak, A,Birbeck, G,Blyth, F,Bolliger, I,Boufous, S,Bucello, C,Burch, M,Burney, P,Carapetis, J,Chen, H,Chou, D,Chugh, SS,Coffeng, LE,Colan, SD,Colquhoun, S,Colson, KE,Condon, J,Connor, MD,Cooper, LT,Corriere, M,Cortinovis, M,de Vaccaro, KC,Couser, W,Cowie, BC,Criqui, MH,Cross, M,Dabhadkar, KC,Dahodwala, N,De Leo, D,Degenhardt, L,Delossantos, A,Denenberg, J,Des Jarlais, DC,Dharmaratne, SD,Dorsey, ER,Driscoll, T,Duber, H,Ebel, B,Erwin, PJ,Espindola, P,Ezzati, M,Feigin, V,Flaxman, AD,Forouzanfar, MH,Fowkes, FG,Franklin, R,Fransen, M,Freeman, MK,Gabriel, SE,Gakidou, E,Gaspari, F,Gillum, RF,Gonzalez-Medina, D,Halasa, YA,Haring, D,Harrison, JE,Havmoeller, R,Hay, RJ,Hoen, B,Hotez, PJ,Hoy, D,Jacobsen, KH,James, SL,Jasrasaria, R,Jayaraman, S,Johns, N,Karthikeyan, G,Kassebaum, N,Keren, A,Khoo, JP,Knowlton, LM,Kobusingye, O,Koranteng, A,Krishnamurthi, R,Lipnick, M,Lipshultz, SE,Ohno, SL,Mabweijano, J,MacIntyre, MF,Mallinger, L,March, L,Marks, GB,Marks, R,Matsumori, A,Matzopoulos, R,Mayosi, BM,McAnulty, JH,McDermott, MM,McGrath, J,Mensah, GA,Merriman, TR,Michaud, C,Miller, M,Miller, TR,Mock, C,Mocumbi, AO,Mokdad, AA,Moran, A,Mulholland, K,Nair, MN,Naldi, L,Narayan, KM,Nasseri, K,Norman, P,O'Donnell, M,Omer, SB,Ortblad, K,Osborne, R,Ozgediz, D,Pahari, B,Pandian, JD,Rivero, AP,Padilla, RP,Perez-Ruiz, F,Perico, N,Phillips, D,Pierce, K,Pope, CA, 3rd,Porrini, E,Pourmalek, F,Raju, M,Ranganathan, D,Rehm, JT,Rein, DB,Remuzzi, G,Rivara, FP,Roberts, T,De León, FR,Rosenfeld, LC,Rushton, L,Sacco, RL,Salomon, JA,Sampson, U,Sanman, E,Schwebel, DC,Segui-Gomez, M,Shepard, DS,Singh, D,Singleton, J,Sliwa, K,Smith, E,Steer, A,Taylor, JA,Thomas, B,Tleyjeh, IM,Towbin, JA,Truelsen, T,Undurraga, EA,Venketasubramanian, N,Vijayakumar, L,Vos, T,Wagner, GR,Wang, M,Wang, W,Watt, K,Weinstock, MA,Weintraub, R,Wilkinson, JD,Woolf, AD,Wulf, S,Yeh, PH,Yip, P,Zabetian, A,Zheng, ZJ,Lopez, AD,Murray, CJ,AlMazroa, MA,Memish, ZA(2012).Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.Lancet,380(9859),2095-2128.
  7. Lusardi, TA,Wolf, JA,Putt, ME,Smith, DH,Meaney, DF(2004).Effect of acute calcium influx after mechanical stretch injury in vitro on the viability of hippocampal neurons.Journal of Neurotrauma.,21(1),61-72.
  8. Qureshi, AI,Ali, Z,Suri, MF,Shuaib, A,Baker, G,Todd, K,Guterman, LR,Hopkins, LN(2003).Extracellular glutamate and other amino acids in experimental intracerebral hemorrhage: an in vivo microdialysis study.Critical Care Medicine,31(5),1482-1489.
  9. Qureshi, AI,Mendelow, AD,Hanley, DF(2009).Intracerebral haemorrhage.Lancet,373,1632-1644.
  10. Qureshi, AI,Suri, MF,Ostrow, PT,Kim, SH,Ali, Z,Shatla, AA,Guterman, LR,Hopkins, LN(2003).Apoptosis as a form of cell death in intracerebral hemorrhage.Neurosurgery,52(5),1041-1048.
  11. Silbernagl, Stefan,Lang, Florian(2012).病理生理學手冊.台北:合記圖書出版社.
  12. Toyoda, K(2013).Epidemiology and registry studies of stroke in Japan.Journal of Stroke,15(1),21-26.
  13. van Asch, Charlotte J J,Luitse, Merel J A,Rinkel, Gabriël J E,van der Tweel, Ingeborg,Algra, Ale,Klijn, Catharina J M(2010).Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis.The Lancet Neurology,9(2),167-176.
  14. Xi, G,Keep, RF,Hoff, JT(2006).Mechanisms of brain injury after intracerebral hemorrhage.The Lancet Neurology.,5(1),53-63.
  15. Xi, G,Reiser, G,Keep, RF(2003).The role of thrombin and thrombin receptors in ischemic, hemorrhagic and traumatic brain injury: deleterious or protective?.Joural of Neurochemistry,84(1),3-9.
  16. 統計處(2018 年 6 月 15 日 )。「106年國人死因統計結果」。民 108 年 3 月24 日,取自:https://www.mohw.gov.tw/cp-3795-41794-1.html
  17. 陳靜美,陳建霖,王明傑,楊榮季(2014)。黃耆的臨床運用及藥理研究總結。台灣中醫臨床醫學雜誌,20(1),63-66。
  18. 謝慶良,林慧怡,李佳容,唐娜櫻,江素瑛,謝慶霄,林昭庚(2002)。鉤藤五種萃取物對 Kainic acid 誘發大鼠腦組織脂質過氧化作用效用之比較。臺灣中醫醫學雜誌,1(3),11-24。
被引用次数
  1. 鄭宇真,黃仲諄,陳冠澧,周仁傑(2022)。中西醫結合治療重度頭部外傷之病例報告。中醫藥研究論叢,25(1),73-83。