中醫治療周邊神經創傷案例之臨床療效

中醫對於周邊神經的損傷辨證還是用《傷寒論》的手段，先使用是「辨病」論治的方法定位在肢體及周邊神經的受損，可選用如乳沒四物湯、身痛逐瘀湯、復元活血湯等等傷科方劑。或用內科治療中風的方劑如補陽還五湯、歸耆建中湯、黃耆五物湯等等。其次再運用論中陰陽表裡寒熱虛實等「八綱辨證」的手段來區分創傷的性質及機體的正氣。以神經而言不管是中樞神經或周邊神經，凡無法自我修復便是機體的氣虛、陽虛。機體受到外力造成的創傷後，神經也會受到相當損傷，此時一定會有血腫、血瘀的現象。甚至因為創傷也會影響內臟正常代謝，因此經常會兼有痰飲與水蓄。本病例的辨證就是－陽虛血瘀兼有水蓄。最後在選定方劑後使用了「辨症」手段來增減藥物，以加強神經修護及再生能力。在周邊神經受傷常用的藥物，如上肢神經受傷會加入麻黃、桂枝、桑枝、薑黃等藥物。下肢神經受傷用牛膝、杜仲、骨碎補、續斷等。也可以加入中樞神經創傷常用的藥物如川七、地龍等等。

關鍵字

補陽還五湯；育生補陽還五湯；神經癱；神經痿；指癱；指痿

並列摘要

Chinese medicine dialectical for the peripheral nerve injury syndrome is also used ＂Shang Han Lun＂ means, the first use of ＂ treatment based on disease differentiation ＂ on the method of positioning in the limbs and peripheral nerve damage. Can be used as the Ru-Mo Si-Wu Tang, Shen tong Zhu-Yu Tang, Fu- Yuan Huo-Xue Tang and so on injury prescription. Or the use of medical treatment of stroke prescriptions such as Bu-Yang Huan-Wu Tang, Gui-Qi Jian-Zhong Tang, Huangqi Wu-wu Tang and so on. Followed by the use of the ＂eight principles＂ means to distinguish between the nature of the trauma and the body's righteousness. In terms of nerve, whether central nervous system or peripheral nerve, where can not self-repair is the body's Qi, Yang. The body caused by external trauma, the nerve will be quite damage, this time there will be hematoma, blood stasis phenomenon. Even because injuries can affect internal organs normal metabolism, and therefore often both phlegm-fluid retention and stagnated fluid syndrome. The case of syndrome differentiation is - Yang deficiency and blood stasis and stagnated fluid syndrome. Finally, after the use of selected prescription ＂Bianzheng＂ means to increase or decrease the drug to enhance nerve repair and regeneration. In the Zhou Bian nerve injury commonly used drugs, such as upper extremity nerve injury will be added ephedra, Guizhi, Sangbai-pi, Turmeric and other drugs. Lower limb nerve injury with Achyranthes, Eucommia, Rhizoma Drynariae, Dipsacus and so on. Can also be added to the central nervous system trauma commonly used drugs such as Sichuan seven, Earthworm and so on.