創傷性腦損傷的中西醫結合療法之探討

創傷性腦損傷（Traumatic brain injury, TBI）泛指頭部受到外力直接或間接之傷害而導致腦組織或腦神經受到不同程度的損傷。頭部外傷常見原因包括車禍、跌倒、遭人攻擊，及在工作場所、家中和運動時受傷等。根據衛福部的統計，事故傷害為2019年國人十大死因中的第六位。若單看年齡層1～24歲的死亡原因，則以事故傷害居首位。交通意外雖然只佔TBI的25%，但通常會造成較嚴重的傷害。例如因頭部外傷死亡的病人，有60%是由於交通意外引起，其中一半到院前就已死亡。許多嚴重的腦外傷患者又有明顯的肢體殘疾和其他神經功能損傷、意識障礙等後遺症，造成了家庭沉重的負擔。本文簡介創傷性腦損傷的分類、病理及近代醫學之治療方式，並探討在腦壓高、顱內出血或腦震盪後遺症狀等不同情況下，中西醫結合的治療方針。

關鍵字

中西結合治療；創傷性腦損傷；中醫辨證論治

並列摘要

Traumatic brain injury, TBI is referred to as the injury in the head due to direct or indirect impact which leads to a wide range of damage in the brain tissue or central nerve system. Common causes of head trauma include auto accident, fall, attack and injury on the job, injury at home and sports injury, etc. According to the statistics of the Ministry of Health and Welfare, accidental injury is placed on the 6th of the cause of death in the year 2019. However, if we look at the cause of death in the age group of 1 to 24 year old, accidental injury is placed in the first place. Although auto accident only accounts for 25% of TBI, it usually results in more severe injury and outcome. 60% of the death due to head injury was caused by auto accidents. Half of the survivors result in out-of-hospital cardiac arrest. Among the many head injuries are left with evident physical disabilities, central and peripheral nerve damage, and conscious disorder which lies heavily on the families and caretakers. This research introduces the categorization, the pathology, and the treatments available for TBI. We will also discuss the integrated treatments of TCM and conventional medicine for elevated intracranial pressure, intracranial hemorrhage, and concussion.