針灸輔助治療住院復健中的缺血性腦中風患者：病例報告

Complementary Acupuncture With Rehabilitation in a Hospitalized Ischemic Stroke Patient: A Case Report

簡士傑(Shih-Chieh Jian) ； 張淑媚(Shu-Mei Chang) ； 謝仕福(Shi-Fu Hsieh)

《醫學與健康期刊》 8卷1期 (2019/03) Pp. 143-149

摘要

一位78歲女性患者晨醒出現右側肢體偏癱及麻木、步態不穩、輕微構音及吞嚥困難等症狀。就醫後診為左大腦缺血性中風及基底核區小洞性腦梗塞（Lacunar infarcts over basal ganglia）。後續於病房接受雙重抗血小板藥物治療（Dual Anti-platelet Agents，DAPT）、復健及中醫針灸治療。診斷後一個月轉至本院復健科住院治療三週，因患者符合西醫住院病患中醫特定疾病輔助醫療計畫資格，故同時接受針灸治療。其後於中醫科門診追蹤治療2.5個月，美國國家衛生院中風量表（National Institutes of Health Stroke Scale, NIHSS）降至5分、巴氏量表（Barthel Index）恢復到70分。個案診斷後就輔以中醫治療，恢復良好，可提供腦中風住院復健患者作為輔助醫療參考。

關鍵字

針灸 ； 缺血性腦中風 ； 住院復健 ； 輔助治療

並列摘要

A 78 year-old woman was found right limbs weakness and numbness, unsteady gait, mild dysarthria and dysphagia after awaken. Left hemisphere ischemic stroke was likely and lacunar infarcts over basal ganglia were found. She has received dual antiplatelet therapy (DAPT), rehabilitation, and complementary acupuncture treatment at the ward. One month after diagnosis, she was transferred to our hospital for further rehabilitation with complementary acupuncture treatment for 3 weeks. She was enrolled in a health project for hospitalized patients with cerebrovascular events, generated by the National Health Insurance Authority (NHIA). She has kept acupuncture treatment at our outpatient department of Traditional Chinese Medicine for two and a half months; the National Institutes of Health Stroke Scale (NIHSS) decreased to 5 points and the Barthel Index increased to 70 points. The patient has received complementary acupuncture treatment soon after the stroke occurred, with adequate clinical improvement, who might be an example for patients hospitalized with cerebrovascular events.

並列關鍵字

Acupuncture ； Ischemic stroke ； Hospitalized rehabilitation ； Complementary therapy

參考文獻

Schlegel DJ, Tanne D, Demchuk AM, et al.: Prediction of hospital disposition after thrombolysis for acute ischemic stroke using the National Institutes of Health Stroke Scale. Arch. Neurol. 2004;61:1061-4.

徐永南、洪雅琳、郭憲文、陳穎潔：腦中風患者個案管理模式之住院成本估計與效果之評價。台灣醫學2009；13：331-40。Hsu YN, Hung YL, Kuo HW, Chen YC: Evaluation of the Efficacy and Hospital Cost Among Stroke Patients with Case Management Model. Formosan Journal of Medicine 2009;13:331-40. [In Chinese: English abstract]

蔡宜秀、孫明輝、洪麗珍、郭憲文：影響某區域醫院缺血性腦中風初患病患住院醫療費用之相關因素。中臺灣醫學科學雜誌 2008；13：143-51。Tsai YX, Sun MF, Hung LC, Kuo HW: Factors Affecting the Medical Costs of Caring for Patients with Acute Ischemic Stroke. Mid-Taiwan J Med 2008;13:143-51. [In Chinese: English abstract]

洪毓珮、邱駿清、吳淳惠、廖宏哲、吳宏乾：台灣中風會診針刺的療效評估。中醫藥研究論叢 2009；12：129-43。Hung YP, Chiu CC, Wu CH, Liao HC, Wu HC: The Study on the Assessment of Chinese Medicine Therapeutic Effect in Stroke Patients with Acupuncture Co-management in Taiwan. Taipei Journal of Traditional Chinese Medicine 2009;12:129-43. [In Chinese: English abstract]

吳靜麗、吳黎明、黃柏銘：中醫輔助治療照護中風後遺症。中華針灸醫學會雜誌 2012；15：19-25。Wu JL, Wu LM, Huang BM: Pilot Scheme of Health Policy in Stroke with Complementary and Alternative Medicine of Traditional Chinese Medicine. Journal of Chinese Medical Association of Acupuncture 2012;15: 19-25. [In Chinese: English abstract]