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中樞性垂足:腦部創傷後之病例報告

Central Foot Drop after Traumatic Brain Injury: A Case Report

摘要


垂足是一種常見的臨床狀態,其特徵是小腿前腔室肌肉無法主動收縮或維持正中姿勢,導致無法在踝關節做出背屈的動作。本案為一名因創傷性腦外傷後出現急性中樞性垂足的病人。針灸治療策略以「治痿獨取陽明」為核心。針灸穴位於足陽明經和督脈上,並根據中醫的病因病機理論選擇了額外的針灸點,病人還接受了中草藥治療,這些治療遵循活血化瘀、清熱除濕、補養心肝的原則。經過四週的治療,病人的垂足狀況有所改善;七週後,可主動做出部分足部背屈動作;十一週後,病人在監督下能夠獨立行走並出院。

並列摘要


Foot drop is a common clinical condition characterized by the inability of the anterior compartment muscles of the lower leg to actively contract or maintain a neutral position, resulting in an inability to perform dorsiflexion at the ankle. This case involves a patient who developed acute foot drop due to a central cause following a traumatic brain injury. The acupuncture treatment strategy focused on the principle of "treating Wei (痿) Syndrome"-also known as muscular flaccidity or atrophy of the limbs-by targeting the Yangming meridian. The acupuncture points were located on the Foot-Yangming Meridian and Governor Vessel, with additional points selected based on TCM etiology and pathogenesis theory. The patient was also treated with herbal medications, guided by principles that involved invigorating blood circulation, eliminating heat and dampness, and nourishing the heart and liver. After four weeks of treatment, the patient's foot drop condition improved; after seven weeks, partial dorsiflexion of the foot was achieved; and after eleven weeks, the patient was able to walk independently under supervision and was discharged.

參考文獻


王薏茜,王顏和(2008).垂足─常見的原因與鑑別診斷.臺灣醫界.51(3),26-32.
李柏賢,張晉賢(2009).針刺療法治療腓神經病變之垂足病例.中醫藥雜誌.20(1 & 2),79-85.
Lee, Yu-shan,Wang, Pao-yu(2009).Foot Drop Caused by a Brain Tumor: A Case Report.臺灣神經學雜誌.18(2),130-131.
Hou, Tian-shu,Feng, Min,Wu, Qiao-feng(2011).The Analysis of "Treatment for Flaccidity Aims at YangMing Meridian" and Clinical Application of Acupuncture.甘肅中醫.24(5),3-4.
王清任(清)。醫林改錯(卷上,通竅活血湯所治症目)。

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