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桃紅四物湯治療急性下肢腔室症候群之病例報告

A Case Report of Acute Lower Extremity Compartment Syndrome Treated with Tao-Hong-Si-Wu-Tang

摘要


本病例為一位57歲男性,2018年10月30日因車禍導致右側脛骨骨折併發急性腔室症候群之案例。2018年10月31日由本院骨科部進行開放性復位及內固定手術(Open reduction internal fixation, ORIF)後,術後給予抗生素、止痛劑與肌肉鬆弛劑,患者右小腿仍持續腫脹與疼痛,症狀影響睡眠,於術後第六天,2018年11月5日,會診中醫協助治療。本案例辨證為氣血瘀滯、水濕內聚,治以活血化瘀,利水滲濕,選用桃紅四物湯加味,搭配西藥常規治療,服中藥後第三天,患處明顯消腫,一週後,患者疼痛減低,可下床持輔助器自行活動。目前因中醫藥治療急性腔室症候群之相關文獻較少,故透過此病例,探討桃紅四物湯在腔室症候群的初步論治。

並列摘要


The patient is a 57-year-old man with right tibial fracture combined with acute compartment syndrome from a car accident. Therefore,treated with surgery by open reduction internal fixation. After operation, the patient was admitted for antibiotics, pain reliever but still suffering from pain with constant swelling on right leg and lead to sleep disturbances. The patient was referred to Traditional Chinese Medicine consultation on the 6th day after surgery. Patient was admitted traditional medicine treatment with Tao-Hong-Si-Wu-Tang (桃紅四物湯) along with continuous original regular medication. The patient's swelling subsided after three days treatment, one week later the pain start to relieve and the patient was able to walk with crutch. There are still limited clinical research with regard to acute compartment syndrome treatment with Tao-Hong-Si-Wu-Tang therefore we still need to collect more evidence but leverage this case as preliminary report.

參考文獻


Garner MR, Taylor SA, Gausden E, Lyden JP. (2014). Compartment syndrome: diagnosis, management, and unique concerns in the twenty-first century. Hss j, 10(2), 143-52.
Wall, C. J., Lynch, J., Harris, I. A., Richardson, M. D., Brand, C., Lowe, A. J., Sugrue, M., & Liverpool (Sydney) and Royal Melbourne Hospitals (2010). Clinical practice guidelines for the management of acute limb compartment syndrome following trauma. ANZ journal of surgery, 80(3), 151-156.
von Keudell, A. G., Weaver, M. J., Appleton, P. T., Bae, D. S., Dyer, G., Heng, M., Jupiter, J. B., & Vrahas, M. S. (2015). Diagnosis and treatment of acute extremity compartment syndrome. Lancet (London, England), 386(10000), 1299-1310.
Via, A. G., Oliva, F., Spoliti, M., & Maffulli, N. (2015). Acute compartment syndrome. Muscles, ligaments and tendons journal, 5(1), 18-22.
Thomas, C. h., Athanasiov, A., Wullschleger, M., & Schuetz, M. (2009). Current concepts in tibial plateau fractures. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca, 76(5), 363-373.

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