中西醫結合治療重度頭部外傷之病例報告

Combined Therapy of Traditional Chinese Medicine and Western Medicine in Severe Traumatic Brain Injury: A Case Report

陳冠澧(Kuan-Li Chen) ； 鄭宇真(Yu-Chen Chang) ； 周仁傑(Ren-J Chou) ； 黃仲諄(Chung-Chun Huang)

《中醫藥研究論叢》 25卷1期 (2022/03) Pp. 73-83

https://doi.org/10.6516/TJTCM.202203_25(1).0006

摘要

創傷性腦損傷（Traumatic brain injury, TBI）為因撞擊、頭顱穿刺等外傷所造成的腦部組織損傷，嚴重性TBI病人的病情好轉機率僅為25～33%，更有高達33%的死亡率，後續照護也造成大量經濟及醫療資源的消耗。本篇為一重度（GCS：6）TBI病人，在台中慈濟醫院以袪痰化瘀開竅為治療核心，使用溫膽湯為主方加減用藥，進行中西醫共同照護，病患於3個月後GCS恢復至15分，並於5個月後移除鼻胃管，自主進食，可以助行器行走並自理生活。藉此病例提出以祛痰化瘀開竅法作為治療顱腦損傷的治療思路，及腦中風治療上的相異之處，提供各位醫師同道參考。

關鍵字

創傷性腦損傷 ； 重度腦損傷 ； 祛痰化瘀開竅法 ； 中西醫共治

並列摘要

Traumatic brain injury (TBI) is damage to the brain tissue caused by injuries such as impact and head puncture. Then it will induce a series of inflammatory reactions, cell edema, and eventually, brain cell damage and necrosis. Among them, only 25~33% of severe TBI patients have positive results, and there is a mortality rate as high as 33%. Follow-up care also causes a lot of consumption of economic and medical resources. Based on years of experience in combining care with Western medicine consultation, Taichung Tzu Chi Hospital has developed the method of dispel phlegm, transform turbidity and resuscitation as the core of treatment. This article introduces a case of a patient with severe TBI. After 3 months of Traditional Chinese medicine and Western medicine combined therapy, the patient recovered from coma (GCS: 6) to full consciousness (GSC: 15). After 5 months of treatment, the nasogastric tube was removed. When discharged, the patient took food spontaneously, and walked with crutches. The detailed history of this case is as follows.

並列關鍵字

Traumatic Brain Injury ； Dispel Phlegm ； Transform Turbidity ； Resuscitation ； Traditional Chinese Medicine

參考文獻

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