中醫藥研究論叢

251.6 中西醫結合治療重度頭部外傷之病例報告
 TJ TCM.25(1) : 73-84, 2022
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1 鄭宇真2 周仁傑2 黃仲諄2*
童綜合醫療社團法人童綜合醫院中醫科,台中,台灣
佛教慈濟醫療財團法人台中慈濟醫院中醫部,台中,台灣
【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。
【關鍵詞】創傷性腦損傷、重度腦損傷、祛痰化瘀開竅法、中西醫共治
Kuan-Li Chen1Yu-Chen Chang2Ren-J Chou2Chung-Chun Huang2*
1Department of Chinese Medicine, Tungs Taichung MetroHarbor Hospital, Taichung, Taiwan
2Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taichung, Taiwan
【Summary】
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.
【Keywords】Traumatic Brain Injury; Dispel Phlegm; Transform Turbidity;
Resuscitation; Traditional Chinese Medicine