242.11 阴阳辨证合并肉毒杆菌注射指引针刺治疗中风後上肢痉挛病例报告
TJ TCM.24(2) : 133-144, 2021
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阴阳辨证合并肉毒杆菌注射指引针刺治疗
中风後上肢痉挛病例报告
A Case Report of Acupuncture Treatment in Upper Limb Spasticity in Stroke Patients Based
on Differential Diagnostics of Yin-yang Combined with Botulinum Toxin Injection Guide
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杨文杰1*
1 台北荣民总医院新竹分院传统医学科，新竹，台湾
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【摘要】
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本病例为63 岁男性脑中风上肢痉挛患者。此病患就诊时左上肢手肘屈曲、拳头紧握、无法伸展。思考如何选择穴位来缓解此病患的上肢痉挛程度。医者依据阴阳辨证并叁考肉毒杆菌注射指引选取相近之穴位，对病患施予中医针刺的治疗。经过5 个月的中医针刺和复健治疗，病患Modified Ashworth Scale 从3 分进步到1 分，患者左上肢痉挛状况获得改善。中风患者施打肉毒杆菌素治疗肢体痉挛，每次花费新台币1 万元至2 万元之间，相对昂贵且需要重复治疗。此病患在无施打肉毒杆菌的情形下，进行中医针刺和复健的治疗。针刺的选穴方式采用中医的阴阳辨证并叁考西医的肉毒杆菌注射指引所建议之肌肉注射部位进行取穴，结果可缓解此病患上肢痉挛。中医针刺以根据阴阳辨证合并肉毒杆菌注射指引取穴，将可提供中风痉挛患者便宜有效的治疗选择。
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【关键词】中风、痉挛、针刺、中医、肉毒杆菌注射指引
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Wen-Chieh Yang1*
1Department of Chinese Medicine, Taipei Veterans General Hospital, Hsinchu Branch,
Hsinchu, Taiwan
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【Summary】
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This is a 63-year-old male with upper limb spasticity caused by stroke. At the time of consultation, the elbow of the left upper limb was flexed, the fist was clenched, and the elbow and fingers were difficult to extend. Consider how to choose acupuncture points to relieve the upper limb spasticity of this patient. We select the acupoint points based on the yin-yang differentiation and refer to botulinum toxin injection guide. After 5 months of acupuncture and rehabilitation treatment, the patient’s left upper limb spasticity improved and the Modified Ashworth Scale improved from 3 to 1. A stroke patient’s limb spasticity is treated with botox, which each time costs NT$10,000 to NT$20,000, which is relatively expensive and requires repeated treatment. The patient underwent acupuncture and rehabilitation without botox injection. The method of acupoint selection is based on yin-yang differentiatal diagnostics and refer to the botox injection guidelines to select similar acupoints. Acupuncture based on the differential diagnostics of yin-yang combined with botulinum toxin injection guide will provide a cheap and effective treatment option for stroke patients.
【Keywords】Stroke; Spasticity; Acupuncture; Traditional Chinese Medicine; Botulinum Toxin Injection Guide
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