缺氧性腦病變之濕溫病案

一位41歲已婚的男性，因急性心肌梗塞導致缺氧性腦病變，當時昏迷指數（glasgow coma scale）分數為4 分，經治療超過一個月仍未見改善，因此會診中醫治療。此病患中醫診斷為神昏，病因病機為素體脾虛，痰濕內盛，外感濕熱引動致痹阻心脈、蒙蔽心包，處方以三仁湯合大承氣湯加減，宣化濕邪，通腑瀉熱。經中西醫結合治療一個月後，病患達到昏迷指數10分（E4VtM6），病情穩定順利出院。

關鍵字

缺氧性腦病變；急性心肌梗塞；濕溫病；三仁湯；大承氣湯

並列摘要

A 41-year-old married man had acute myocardial infarction induced hypoxic encephalopathy with coma scale 4 (E2VeM2). There was no improvement in the coma scale after Western medical treatment in these month, then asked for Chinese medicine consultation. The diagnosis of Chinese medicine is loss of consciousness with the pattern of constitution with spleen deficiency and full of phlegm, external contraction of damp and heat blocking the channel of heart and blinding pericardium. We use modified formula with San-Ren-Tang and Da-Cheng-Qi-Tang for diffuse dampness and drain heat to catharsis. After one month of Western and Chinese medicine treatment, coma scale was improved to E4VtM6. Due to stable condition, he was discharged smoothly.