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中西整合醫學雜誌

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篇名 中西醫結合治療缺氧性腦病變意識昏迷之病例報告
卷期 16:4
並列篇名 Lose Consciousness Caused by Hypoxic Encephalopathy Treated with Integrated Medicine-Case Report
作者 李奕璇戴有志
頁次 037-048
關鍵字 缺氧性腦病變神昏千金還魂湯滌痰湯針灸Hypoxic EncephalopathyComaQian-Jin-Huan-Hun-TangDi-Tan- TangAcupuncture
出刊日期 201412

中文摘要

本病例是位28歲的男性,於夜間外出跑步時突發呼吸心跳中止而路倒,由路人報警緊急施行心肺復甦術並電擊後送往急診,於急診急救後恢復生命徵象,送至加護病房照護。患者昏迷指數為3分(E1VeM1),西醫診斷為心跳驟停,心室顫動(Ventricular Fibrillation with sudden cardiac arreststatus),經心肺復甦術(cardiopulmonary resuscitation,簡稱CPR)急救後住院。住院第五天,家屬要求會診中醫治療。中醫診斷為神昏,其病因病機,乃素體脾虛,暑熱熱傷中焦元氣,風痰入腦絡瘀阻血脈所致。處方以千金還魂湯合滌痰湯加減,醒腦開竅祛痰,並輔以針灸治療。經中西醫結合治療一周後,病人成功拔除氣管(昏迷指數10分,E4V1M5)轉入普通病房,並於接受復健治療一個月之後順利出院(昏迷指數14分,E4V4M6)。

英文摘要

This case is a 28-year-old man, who down the road suddenly with cardiac arrest during he was jogging at night. A passerby called the police and CPCR with cardioversion were done. He gained pulse again after sending to the emergency room and then transferred to intensive care unit for further care with coma scale E1VeM1. The diagnosis is Ventricular Fibrillation with sudden cardiac arrest status post cardiopulmonary resuscitation. On the fifth day after admission, his family asked for combined therapy with Chinese medical treatment, when his coma scale was E2VEM4. The diagnosis of Chinese medicine is loss of consciousness with the pattern of constitution with spleen deficiency, external contraction of summer heat damaging middle burner source qi, and wind-phlegm stasis obstructing the brain collateral. We use modified formula with Qian-Jin-Huan-Hun-Tang and Di-Tan-Tang, accompanied with acupuncture therapy, for opening the orifices and dispelling phlegm. Under the combinational therapy for one week, the patient weaned tracheal tube successfully and was transferred to ordinary ward with coma scale E4V1M5. He started rehabilitation then and was discharged after one month with coma scale E4V4M6.

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