264.6 中西醫結合治療小腦中風後眩暈之病例報告
TJ TCM.26(4) : 73-81, 2023
DOI : 10.6516/TJTCM.202309_26(4).0006
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中西醫結合治療小腦中風後眩暈之病例報告
Combined Therapy of Traditional Chinese Medicine and Western Medicine in Dizziness after Cerebellar Stroke: A Case Report
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林坤緯 1 鄭群耀 1,* 謝紹安 1
1 佛教慈濟醫療財團法人台中慈濟醫院中醫部，台中，台灣
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【摘要】
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中風等腦血管疾病是我國國人十大死因之一，在其中小腦中風屬於較罕見之疾病，表現亦與一般中風會出現之肢體無力、麻木等不同，而是以眩暈、共濟失調為主要症狀，治療與一般中風相同以復健為主。回顧中醫歷代文獻，對於一般中風出現之半側癱瘓、感覺異常論述詳細且資料豐富，然而在小腦中風這部分卻少有文獻論治，只能從眩暈等症狀進行搜尋，且較難找到關於眩暈與其他共濟失調症狀關聯之論述。本例患者是小腦缺血性中風病患，發病後有嚴重眩暈、步態不穩、共濟失調等症狀，基於現代醫學對於解剖與中風病理機轉之認識，我們以外風、痰瘀論治此患者，開立小續命湯加減方合併大黃蟅蟲丸組合之科學中藥。並搭配基於解剖學投射之頭皮針，對於小腦投射區域進行針刺治療，首次針灸治療後，對於患者進行神經學檢查，患者共濟失調之狀況（ 辨距失調等）立刻可見顯著改善。患者在持續接受中醫住院會診治療期間，眩暈、步態不穩等症狀得到顯著改善，以共濟失調障礙評估量表（SARA）進行 神經學檢查評估，量表指標也有提升。故分享此案例與醫師同道分享。
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【關鍵詞】小腦中風、共濟失調、眩暈、頭皮針、中西醫結合治療
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Kuen-wei Lin1 Chun-yao Cheng1,* Shao-an, Hsieh1
1 Department of Chinese Medicine, Taichung Tzu Chi Hospital , Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
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【Summary】
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Strokes are one of the top ten causes of death in Taiwan, and among them, cerebellar stroke is a relatively rare disease. Typical symptoms of common strokes are weakness and numbness of limbs. On the other hand, symptoms of cerebellar strokes, which are dizziness and ataxia, are different from those of common strokes. However, their main treatments are both rehabilitations. So far, there has been extensive literature on treatments for common strokes, yet little on cerebellar strokes. Therefore, Chinese Medicine doctors can only search for studies on cerebellar stroke with few keywords, such as dizziness, let alone the association of dizziness with other ataxia symptoms. In this case, our team treated the cerebellar stroke patient from the perspective of Chinese Medicine, modern anatomy, and pathology. The patient’s symptoms, such as dizziness and ataxia, improved significantly after the treatment. The detailed history of this case is as follows.
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【Keywords】
dizziness, ataxia, cerebellar stroke, Chinese Medicine, acupuncture
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