中醫藥處置中風病患併發肺炎：一病例報告

Using Chinese Medicinals to Treat Aspiration Pneumonia in Stroke Patients

楊建中(Jian-Zhong Yang) ； 孫茂峰(Mao-Feng Sun) ； 洪金烈(Jin-Lie Hong)

《台灣中醫臨床醫學雜誌》 13卷1期 (2007/03) Pp. 7-14

https://doi.org/10.6968/TJCCM.200703.0007

摘要

中風(stroke)患者不論是在急性期、恢復期或後遺症期均易併發吸入性肺炎(aspiration pneumonia)，一般而言大約1/3的中風患者有可能合併肺炎，雖然現代醫學的治療成效已相當不錯，但過度應用抗生素，可能導致抗藥性菌種的產生而增加院內感染的機率，也易造成腸胃道的功能失調及影響肝、腎功能，因此中醫藥在此類患者肺炎的處理上可以扮演一定重要的角色。
長庚醫院針灸科收治了相當多的中風患者，在肺炎的處理上累積了一定的經驗。在病因上，發現痰飲通常是住院中的中風臥床患者引發肺炎的直接病因，肺藏的氣虛血鬱則為其間接病因。因此在治療上除了宣肺、清熱、祛寒等常態治法之外，應該重視化痰及活血法的使用。本文所介紹之病例即上述觀點之體現。

關鍵字

中風 ； 吸入性肺炎

並列摘要

People who suffered from stroke are quite susceptible to developing aspiration pneumonia during any period of its manifestation, be they in an acute stage, recovering or suffering from sequela associated with its effects. Generally speaking about 1/3 of patients who have had a stroke will develop aspiration pneumonia.
Although modern medicine can be quite effective in treating aspiration pneumonia, there is a heavy reliance on antibiotics which create resistant bacteria and increases the rate of iatrogenic infection. Additionally the use of antibiotics can lead to digestive problems as well as affect liver and kidney function. Chinese medicinals can therefore play an important part in the treatment of this illness.
Many stroke patients have been treated in the acupuncture department at Chang Gen hospital, and consequently the doctors there have accrued a great deal of experience in treating pneumonia. In terms of etiology, experience has shown that phlegm and rheum are direct factors in the development of pneumonia, while qi deficiency and blood constraint are indirect factors. Therefore in addition to the treatment principles of diffusing the lung qi, clearing heat, or expelling cold, treatments should emphasize transforming phlegm and invigorating the blood.

並列關鍵字

stroke ； aspiration pneumonia