米勒費雪症候群（Miller Fisher syndrome）中醫治療

Chinese Medical Therapy on Miller Fisher Syndrome

王政結(Tseng-Chieh Wang)

《北台灣中醫醫學雜誌》 3卷1期 (2011/12) Pp. 41-50

https://doi.org/10.30127/BTWZYYXZZ.201112.0004

摘要

脫髓鞘疾病（demyelination）是指一類以髓鞘喪失或變薄而軸索相對完好的疾病。其病理變化是神經纖維的髓鞘脫失而神經細胞相對保持完整、使神經衝動的傳送受到影響，可發生于中樞神經系統或周圍神經系統。臨床上將此類疾病分為髓鞘形成障礙型和髓鞘破壞型。髓鞘形成障礙型脫髓鞘疾病是遺傳代謝缺陷引起的髓鞘形成障礙，主要包括髓鞘磷脂代謝異常引起的腦白質營養不良，如腦白質海綿樣變性、腎上腺白質營養不良等；髓鞘破壞型脫髓鞘疾病是後天獲得的脫髓鞘疾病，如多發性硬化症（multiple sclerosis MS）、急性多發性神經根炎（Acute polyradiculoneuritis），又稱為格林－巴利氏症候群（Guillain-Barré Syndrome）。米勒費雪症候群屬急性神經根炎這類的疾病，許多人感冒快好了，四肢卻發麻，可要當心得了米勒費雪症候群。其典型症狀是肌腱反射消失（areflexia）、眼肌運動障礙（ophthalmoplegia）及共濟失調（ataxia），這些症狀顯示是周邊神經、顱神經及小腦功能的異常。臨床治療包括類固醇、血漿置換及靜脈注射免疫球蛋白（intravenous immunoglobulin）；中醫在急性期以解表清熱為主，後期則以補氣補血或加補陽以修復神經鞘膜。

關鍵字

脫髓鞘疾病 ； 多發性硬化症 ； 格林－巴利氏症候群（Guillain-Barré Syndrome） ； 米勒費雪症候群（Miller Fisher syndrome）

並列摘要

Demylination disease is categorized as a neural myeline defect or neural myeline thinning disease while neural axon is relatively intact. Its pathogenesis is the demylination of neural fiber while neural cell remains intact, which would influences the transmission of neural impulse, and it occurs in the central nervous system or peripheral nervous system. Clinically it is categorized into of myelinaiton dysfunction type and myelinaiton destruction type. Myelinaiton dysfunction type diseases are caused by genetic metabolic dysfunction in the formation of neural myelin, including the cranial white matter malnutrition caused mainly by metabolic dysfunction of myelin phospholipids like spongiform metatrophy of cranial white matter or adrenal white matter malnutrition. Myelinaiton destruction type is an acquired demylination diseases like multiple sclerosis (MS), acute polyradiculoneuritis (also known as Guillain-Barré Syndrome). Miller Fisher syndrome belongs to the category of acute neuritis. Those who present limb numbness after recovering from influenza should be aware of inflicting of Miller Fisher syndrome. Its typical symptoms include tendon areflexia, ophthalmoplegia and ataxia. These symptoms reveal the dysfunction of peripheral neural system, cranial nerves and cerebellum. Clinical treatment of Miller Fisher syndrome includes corticosteroid injection, plamopheresis and intravenous immunoglobulin. In the early stage of Chinese medical herbal therapeutics resolving exterior heat is the main policy; at late stage of treating Miller Fisher syndrome, tonifying qi (bioenergy) and blood plus nourishing Yang (exterior body energy) would be adopted to remedy myelin sheath of nerves.

並列關鍵字

Demylination Diseases ； Multiple Sclerosis