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針刺緩解粒線體疾病病童疑似肌陣攣發作之病例報告

A Case Report of Acupuncture Alleviate Suspected Myoclonic Seizure on Child with Mitochondrial Disease

摘要


一名滿六足歲的病童患有粒線體疾病、難治性發作(refractory seizure)與智能遲滯(mental Retardation)之病史。病童自出生4 個月大時開始反覆發作,發作型態不定,主要表現腿部肌肉抽動伴隨眼雙眼上吊,或四肢肌肉抽動伴隨鐘擺式眼球震顫(pendular nystagmus),持續時間亦不固定。該病童於103年7月14日開始於臺北榮民總醫院傳統醫學部門診進行針刺治療,經過中醫四診診斷後,辨證為腎精虧損、腦髓失養、脾失健運、肝風內動,而整理釐清其治則為醒腦開竅、補脾益腎、補虛熄風。自10月28日出院至隔年的1月2日,在針刺治療的同時,未曾再有大發作被觀察到,並成功減少Phenobarbital的用量。本病例報告顯示針刺有可能緩解粒線體肌病(mitochondrial myopathy)造成的發作,提供另一種中西醫整合療法的思維與方法。

並列摘要


This six-year-old patient has the history of mitochondrial disease, refractory seizure and mental retardation. Seizure attack since four-month-old he has suffered from. The pattern of his seizure is variable and unstable. It could be muscle twitch of both side of legs accompanying upward gaze, or muscle twitch of limbs with pendular nystagmus. The duration of seizure attack is also unstable. This patient has received acupuncture therapy at Center for Traditional Medicine of Taipei Veterans General Hospital since July 14, 2014. After the induction of four diagnostic methods from Traditional Chinese Medicine (TCM), syndrome differentiation was kidney-essence deficiency, brain dystrophy, dysfunction of spleen in transportation, and endogenous liver wind. Therapeutic principle was "activating spirit to resuscitate brain therapeusis" (Xingnao Kaiqiao), reinforcing spleen and kidney and supplementing vacuity to extinguish wind. Since 10/28 discharged to 1/2 of the following year, there wasn't any generalized seizure been observed with acupuncture therapies, and the dosage of Phenobarbital was reducd successfully. This case demonstrates that acupuncture has the potential to alleviate the seizure attack of mitochondrial disease, and provides us another thinking and method of integrated therapy including both TCM and Western Medicine.

參考文獻


黃錦章、徐昌鴻(2009)。粒線體疾病與粒線體DNA缺乏症候群。台灣神經學學會神經學雜誌。18(4),287-295。
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Schon, EA,DiMauro, S,Hirano, M(2012).Human mitochondrial DNA: roles of inherited and somatic mutations.Nature reviews Genetics.13(12),878-890.
Gibson, Kate,Halliday, Jane L.,Kirby, Denise M.,Yaplito-Lee, Joy,Thorburn, David R.,Boneh, Avihu(2008).Mitochondrial oxidative phosphorylation disorders presenting in neonates: clinical manifestations and enzymatic and molecular diagnoses.Pediatrics.122(5),1003-1008.
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