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脊髓損傷中西醫學證治綜論

A Literature Review of Spinal Cord Injury with Western Medicine and Traditional Chinese Medicine Treatment

摘要


脊髓損傷,是脊髓因外力、壓迫、缺血等各種原因造成損傷,因受傷部位與受傷程度不同,可能會造成四肢自主運動癱瘓、感覺喪失、呼吸、消化、心血管、生殖泌尿等系統之功能異常等症狀。本文回顧了脊髓損傷之流行病學、發生原因、評估方法、病理機轉、治療方式與預後分析。在西醫治療方面可分為急性期與慢性期,急性期多以減少脊髓壓迫源為目的,慢性期則以藥物與復健治療使神經修復與控制併發症。一些新的術式與治療方法如幹細胞療法等目前都在臨床試驗階段。中醫方面的文獻搜索結果是以中藥、針灸與電針作為治療脊髓損傷的主流方法,以抗發炎、抗氧化、抗細胞凋亡與促進神經再生等主要功用來治療機髓損傷。作者藉由回顧脊髓損傷之西醫與中醫文獻,以及國內出版的相關書籍,統整中西醫學對脊髓損傷的認識與治療現況,提供給臨床醫師參考。

關鍵字

脊髓損傷 中醫 針灸 電針 中藥

並列摘要


Spinal Cord Injury occurs when the spinal cord is damaged due to external force, compression, ischemia, or other reasons. Depending on the location and severity of the injury, symptoms such as paralysis of voluntary limb movement, loss of sensation, and dysfunction in respiratory, digestive, cardiovascular, reproductive, and urinary systems may occur. This article reviews the epidemiology, causes, assessment methods, pathological mechanisms, treatment options, and prognosis analysis of Spinal Cord Injury. In Western Medicine, treatment is divided into acute and chronic phases. The acute phase primarily aims to reduce spinal cord compression, while the chronic phase focuses on nerve repair and management of complications through medication and rehabilitation. Emerging treatments such as stem cell therapy are currently in clinical trials. In Traditional Chinese Medicine(TCM), the literature primarily focuses on the use of Chinese Herbal Medicine, acupuncture, and electroacupuncture as mainstream treatments for Spinal Cord Injury. These treatments aim to alleviate inflammation, oxidative stress, cell apoptosis, and promote nerve regeneration. By reviewing both Western and TCM literature, as well as domestic publications, the authors consolidate the understanding and current treatment approaches of Spinal Cord Injury in both medical traditions, providing guidance for clinical practitioners.

參考文獻


古丹。李氏外傷創傷的獨特辨症診斷法、以時間與部位為主:脊椎創傷所引起截癱為例。傳統醫學雜誌。2005;16:202-209。
Wu JC, Chen YC, Liu L, et al. Effects of age, gender, and socio-economic status on the incidence of spinal cord injury: an assessment using the eleven-year comprehensive nationwide database of Taiwan. J. Neurotrauma., 2012; 29(5): 889-97.
Chien LC, Wu JC, Chen YC, et al. Age, sex, and socio-economic status affect the incidence of pediatric spinal cord injury: an eleven-year national cohort study. PLoS One., 2012; 7(6): e39264.
Moore AP, Blumhardt LD. A prospective survey of the causes of non-traumatic spasticparaparesis and tetraparesis in 585 patients. Spinal Cord., 1997; 35:361.
Rupp R, Biering-Sørensen F, Burns SP, et al. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil. 2021; 27(2): 1-22.

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