中醫藥研究論叢

262.5 肌肉與關節對應取穴治療中風急性後期患者肌肉痙攣之病例報告
TJ TCM.26(2) : 51-58, 2023
DOI : 10.6516/TJTCM.202306_26(2).0005
 
肌肉與關節對應取穴治療中風急性後期患者肌肉痙攣之病例報告
Muscle and joint corresponding acupuncture for the treatment of muscle spasm in patients with stroke post-acute care
徐敬閔1 吳佩芸1
1 臺北市立聯合醫院仁愛院區中醫科,台北,台灣
【摘要】
中風後的肌肉痙攣與張力增大是中醫會診及門診極為常見的求診原因,
主要成因為肌肉一直處於收縮的狀態,而過強的肌肉張力不僅會產生疼痛、
緊繃與僵硬等不舒服的感覺,也會導致病人在日常生活中必要的行為活動
無法順利完成。本病例報告為一中風後導致右側偏癱一個月之男性病患的中
醫診治過程。主要的症狀為右半部偏癱無力、肌膚麻木。醫師經臨床評估與
病因病機四要素的分析之後,決定採取疏經通絡兼行氣活血的治療方法,並
嘗試由肌肉與經穴對應的角度下手,針對攣縮或無力的肌肉來選取適合的穴
位。病人經一個月的治療後,在巴氏量表及美國國家衛生院腦中風評估表
(National Institute of Health Stroke Scale, NIH Stroke Scale)上的項目均有明
顯的進步與改善。本病例呈現與主流之專注於經絡循行的取穴策略不同的治
療方法,並對於中風後接受急性後期整合照護的患者取得一定的成效,供先
進同道參酌討論。
【關鍵詞】針灸;中風併發症;肌肉痙攣;肌肉張力過高
 
Ching-Min Hsu1Pei-Yun Wu1
1Taipei City Hospital, RenAi branch
【Summary】
Muscle spasms and hypertonicity in patients with stroke are common in Chinese medicine clinics and consultations. Hypertonicity not only causes pain, tightness, and stiffness but decreases the mobility in stroke patients. This case reported the treatment in a stroke patient with right hemiplegia for a month. There were symptoms including right side muscle weakness and skin numbness. Based on activating qi and promoting blood circulation, we used acupuncture to stimulate muscles and acupuncture points that aim to adjust contracted or weak muscles. After a month of treatment, it showed a significant progression in this patient on the NIH stroke scale and Barthel scale. Our study provides a different aspect of treatment from the mainstream therapy which selects acupoints along the channel, and it reveals a significant progression in the patient that received post-acute integrated care after stroke.
 
【Keywords】acupuncture; complications after stroke; hypertonicity; muscle spasm