中醫對腦中風的治療與西醫幹細胞研究關聯性之探討

中風(Stroke)，向來被視為國人的頭號隱形殺手。中老年人一旦與中風結緣，不僅晚景蒙上陰影，往往也會成為家庭的沉重負擔。中風不是一種單一的疾病，是各種血管性病因所引起的腦部局灶性損害的綜合征，可分為出血性和缺血性兩大類，包括腦梗死、腦出血和蛛網膜下腔出血等，屬於中醫學“中風病”範疇。中風是中老年人的常見病、多發病，具有發病急、發展快、變化多、發病率高、致殘率高、復發率高和病死率高等特點。中風的病死率在近幾十年雖略有下降，但仍然居高不下，國人的中風發生率仍高居全球之冠，已造成嚴重的經濟與社會問題。中風之所以可怕，是因為腦部神經細胞缺血死亡後，會產生出各種神經學症狀，包括肢體癱瘓（半身不遂）、感覺異常、意識模糊或昏迷、言語不清、嘴歪眼斜、流口水、暈眩、嘔吐、步態不穩、及大小便失禁等，缺損的神經細胞至今沒有任何西藥可以使之再生。近幾年，在台灣花蓮慈濟醫院神經醫療團隊的努力下，運用G-CSF誘發骨髓產生幹細胞CD34+並分泌至週邊血中，已成功的治療急慢性中風患者，使其受損的神經快速度修復並改善其神經症狀，為治療中風開出一條新的道路，為病患帶來曙光。然而中醫治療中風的方劑與治法流傳已久，在臨床上已有一些成效，在許多治療中風的方劑及單味藥其在科學化證據上，有不錯的成果。今天西醫在運用G-CSF上有突破性的發展，使中風病人的改善有超越以往的成績，在此我們中醫應在這樣的刺激下，乘著過去歷史上的成就，進一步向西醫的成就挑戰，希望能研究出比G-CSF更好用的藥物或方劑來。因此吾人想藉由一些論文的結果，推論出古代的中風方劑對於治療中風的療效是否也是經由促進幹細胞的生長來達到治療中風的目的，希望有拋磚引玉的作用，進而達成一些貢獻。

關鍵字

中風；幹細胞；中醫藥； G-CSF

並列摘要

Stroke (cerebrovascular accident) has long been regarded as the number one invisible killer in our society. Once stroke occurs in the middle-aged and elderly, their lives from that moment on out will oftentimes bring many insurmountable challenges and pose a heavy burden on their families. Stroke is not a single disease, but rather a variety of vascular diseases that manifest into a syndrome of focal lesions in the brain. Stroke can be differentiated into two types - hemorrhagic (rupture) and ischemic (vascular occlusion), and includes cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage. In Chinese medicine pathological terms, this condition is similarly called ＂wind strike (stroke).＂ Stroke is a common, frequently occurring pathology of the middle-aged and elderly population. It has the clinical features of rapid onset, rapid development, high incidence rate, high disability rate, high recurrence rate and high mortality. In recent decades the mortality rate of stroke has declined, but it still remains high. In fact, the incidence of stroke in Taiwan has reached among the highest in the world, causing serious economic and social problems. Stroke is such a devastating condition because the arterial blood supply to the cerebral tissue is impaired or completely cut off, resulting in the death of nerve cells in the brain. This will cause a variety of neurological deficits and nonspecific symptoms depending on the location of the lesion such as half-body paralysis (hemiplegia), paresthesia, confusion or coma, inhibited speech (dysphasia), squinting, drooling, dizziness, vomiting, gait instability, and incontinence among others. Currently, there are no Western medicine drugs or procedures available that can regenerate these damaged nerve cells. In recent years, a neurological team at Hualien Tzu Chi Hospital in Taiwan has used G-CSF to recruit CD34+ cells from bone marrow to peripheral blood. It has already proven effective for acute and chronic stroke patients promoting the rapid repair and regeneration of damaged nerves and resulting in improvement of neurological symptoms. This approach has shown great potential for opening up promising new pathways for the treatment of stroke patients. However, Chinese medicine medicinal formulas and other therapies that provide clinical efficacy have been passed down from times of antiquity. And there has been substantial scientific evidence based on experimental and clinical studies that these formulas and in some cases single medicinals offer positive results in the treatment of stroke. The recent development of the G-CSF breakthrough in Western medicine has enabled stroke patients to make improvements that surpass previous therapeutic approaches. The Chinese medicine community can use this as motivation to utilize the vast depth and breadth of accumulated achievements throughout Chinese medicine history to continue searching and discovering medicinals and formulas that can surpass G-CSF. Therefore, I aim to review the results of scientific papers to determine whether the efficacy of traditional Chinese medicine stroke formulas also involves the mechanism of promoting stem cell regeneration. My hope is that it may be possible for me to find some true gems in the rough that will offer meaningful contributions.

並列關鍵字

stroke ； stem cell ； Chinese medicine ； GCSF

參考文獻

Woei-Cherng Shyu, Shiun-Zong Lin, Hui-I Yang. Functional Recovery of Stroke Rats Induced by Granulocyte Colony-Stimulating Factor-Stimulated Stem Cells. Circulation. 2004; 110:1847-1854.

Google Scholar

Siminiak T, Kalawski R, Fiszer D, et. al. Autologous skeletal myoblast transplantation for the treatment of postinfarction myocardial injury: phase I clinical study with 12 months of follow-up. Am Heart J. 2004; 148(3):531-7.