從一案例來探討小兒腦中風的病因病機－病例報告

From a Clinical Case to Explore the Pathogenesis of Young Stroke

黃霈文(Pei-Wun Huang) ； 張晉賢(Chin-Hsien Chang)

《北台灣中醫醫學雜誌》 6卷1期 (2014/06) Pp. 49-64

摘要

腦中風為一急性腦血管病，在臨床上根據病因病理不同分為缺血性及出血性兩大類。腦中風往往起病急驟且會表現出頭痛頭暈、意識障礙、偏癱、失語…等症狀。就中醫理論而言，腦中風的原因不外生活失節、情志過極、年齡體質、久病失調和外邪入中等幾個方面，本虛標實是其總病機。本案為7歲女童發生腦中風而右側肢體偏癱，其發生腦中風的明確病因尚未查出，但在經過西醫類固醇藥物並搭配針灸及復健共同治療後，肌力已完全恢復。本文目的為探討女童發生腦中風的原因及中醫病因病機，就西醫方面討論女童是否由於感染黴漿菌而發生腦中風的可能性，另就中醫方面討論毒邪與腦中風的關係。而小兒受到外感易從熱化的病理現象，亦可能是造成小兒腦中風的病因病機之一。

關鍵字

小兒 ； 腦中風 ； 黴漿菌 ； 毒邪

並列摘要

Stroke is an acute cerebrovascular disease. According to the clinical pathology of different etiology, stroke can be divided into two types: ischemic and hemorrhagic. Stroke often exhibit sudden onset of headache and dizziness, unconsciousness, hemiplegia, aphasia ... and other symptoms. On traditional Chinese medicine theory, the cause of stroke is nothing less than disturbance in life pattern, emotional stress, age, physical fitness, chronic illness disorders and external evils invading the body. Root vacuity and tip repletion are the main pathogenesis. This case is a seven-year-old girl suffered from stroke with right hemiplegia. Although it has not been clearly identified the cause of stroke occurrence, after accepting treatments of steroid, acupuncture, and rehabilitation, her muscle power has been completely recovered. This article aims to explore the cause of stroke and the etiology and pathogenesis of TCM about this girl. By the Western medicine side, we discuss the possibility of whether the stroke occurred in this girl was due to infection of mycoplasma. And by the traditional Chinese medicine side, discussion on the relationship between the toxin evil and stroke was also done. The special physiological conditions of children, the tendency to become heat pattern when invaded by external evils, is also the probable pathogenesis to facilitate stroke.

並列關鍵字

Pediatrics ； stroke ； mycoplasma ； toxin evil

參考文獻

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Griffiths, Dayna,Sturm, Jonathan(2011).Epidemiology and Etiology of Young Stroke.Stroke Research and Treatment.2011,1-9.

Jorge Moncayo-Gaete MD and Julien Bogousslavsky MD，Stroke in young adults， from the World Wide Web: http://www.medmerits.com/index.php/article/stroke_in_young_adults/P6。