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出血性腦中風急性期中醫介入治療經驗-三個病例報告

Early TCM Interventional Treatment Experience of Hemorrhagic Stroke: Three Case Reports

摘要


腦血管疾病中出血性腦中風不但預後較差,並且在亞洲的發生率高於西方國家,造成家庭和國家龐大的醫療負擔,如何減少患者後遺症狀,加強肢體活動能力,使之恢復生活自理能力、降低社會照護成本是現醫療努力的目標。本病例報告為三個重度出血性腦中風中醫早期介入治療案例,經治療患者神經功能皆獲得改善。中醫治療上,根據本院多年臨床觀察治療經驗,歸納出「辨病」治療模式:急性期藉由恢復人體中焦氣機,改善腦部出血後的標症-氣逆痰瘀化火,治以化痰醒腦開竅。

並列摘要


Introduction: According to the American Stroke Association, Cerebrovascular accident(CVA) is the leading cause of disability and the fifth cause of death. Compared to ischemic stroke, hemorrhagic stroke leads to higher mortality and more severe disability. Patients with GCS scored 8 or below are defined as severe stroke, which might lead to poor outcome, increase social and economic burden. Early intervention of integrated treatment of TCM and western medicine for severe stroke is essential to decrease mortality and disability rate. Case description: We present three cases of severe hemorrhagic stroke, including aneurysm rupture, hypertensive cerebral hemorrhage and pontine hemorrhage. The initially GCS were all below 8, and all of them received Chinese medicine within four days after onset. After several months of treatment, their neurological function has improved. Discussion: In our experience, integrated treatment of TCM and western medicine can improve their self-care ability, and make better recovery for hemorrhagic stroke patients. Our hypothesis is that TCM can restore human qi circulation, and accelerate brain repair. We hope to share these cases of early TCM interventional treatment for stroke to reduce mortality and disability rate.

參考文獻


統計處(2018 年 6 月 15 日 )。「106年國人死因統計結果」。民 108 年 3 月24 日,取自:https://www.mohw.gov.tw/cp-3795-41794-1.html
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY,Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH,Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S,Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S,Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC,Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E,Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B,Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N,Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R,Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K,Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA 3rd, Porrini E, Pourmalek F, Raju M, Ranganathan D,Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL,Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA,Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR,
Qureshi AI, Mendelow AD, Hanley DF: Intracerebral haemorrhage. Lancet. 2009; 373: 1632-1644.
Hu HH, Sheng WY, Chu FL, Lan CF, Chiang BN: Incidence of Stroke in Taiwan. Stroke. 1992; 23: 1237-1241.
Joseph Broderick, Sander Connolly, Edward Feldmann, Daniel Hanley, Carlos Kase, Derk Krieger, Marc Mayberg, Lewis Morgenstern, Christopher S. Ogilvy, Paul Vespa, Mario Zuccarello: Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke. 2007; 38(6): 2001-2023.

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