- 期刊
Integrative Western Medicine and Traditional Chinese Medicine to Treat Severe Obstructive Sleep Apnea: A Case Report
整合中西醫治療重度阻塞性睡眠呼吸中止症兒童之病例報告
摘要
Obstructive sleep apnea (OSA) affects 1%-6 % of children worldwide and has the highest incidence in those between the ages of 2 and 6 years. Surgery is the first-line treatment for moderate to severe OSA resulting from adenoid-tonsillar hypertrophy. Some parents will hesitate and seek traditional Chinese medicine (TCM) for help. This 4-year-10-month-old boy with allergic rhinitis had suffered from snoring and nasal congestion for more than 2 years. He had been diagnosed with OSA and adenoid hypertrophy by the pediatric physician. Polysomnography (PSG) showed that apnea-hypopnea index (AHI) was 18.9. The score of the Chinese versions of the pediatric OSA- 18 questionnaire was 55. Through treatment with intranasal corticosteroid, Montelukast (singulair), Chinese herbal medicine, and laser acupuncture for 63 days, nasal congestion and snoring improved. The OSA-18 score improved to 29. The follow-up PSG showed that AHI was 1.4. The severity of OSA improved from severe to mild. OSA is a common disease that leads to severe comorbid including neurocognitive function, cardiovascular, and metabolic diseases. In this case, integrative Western medicine and TCM can decrease the severity of OSA and improve quality of life. More studies are needed to prove the effect of Chinese medicine treatment on pediatric OSA.
並列摘要
阻塞性睡眠呼吸中止症在兒童之盛行率為1%－6%且好發於2至6歲之兒童。目前中重度阻塞性睡眠呼吸中止症若合併有腺樣體或扁桃體腫大之首要治療方式為手術，但有些家長仍會猶豫轉而尋求中醫治療。此位4歲10個月大男孩有過敏性鼻炎病史，反覆鼻塞、打呼已兩年餘，因症狀加重兩週至中醫門診求診。此患者經兒童過敏科醫師診斷為重度阻塞性睡眠呼吸中止症合併腺樣體腫大，整夜睡眠多項生理功能檢查呼吸暫停低通氣指數為18。經過63天鼻內類固醇、西藥欣流與科學中藥、雷射針灸治療後，患者鼻塞與打呼改善。以中文版兒童阻塞性睡眠呼吸中止生活品質問卷評估，得分由55分降低至29分，睡眠檢查追蹤呼吸暫停低通氣指數為1.4，阻塞性睡眠呼吸中止症嚴重度由重度改善為輕度。睡眠呼吸中止症候群可能會造成嚴重後遺症，影響兒童的神經認知功能、代謝功能以及心血管系統。在這個案例中，合併中西醫治療對年幼之患者能改善阻塞性睡眠呼吸中止症之嚴重度，未來需要進行臨床試驗研究證實中醫治療兒童阻塞性睡眠呼吸中止症之成效。