TJ TCM.25(1) : 73-84, 2022
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中西医结合治疗重度头部外伤之病例报告
Combined Therapy of Traditional Chinese
Medicine and Western Medicine in Severe Traumatic Brain Injury: A Case Report
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陈冠澧1 郑宇真2 周仁杰2 黄仲谆2*
1 童综合医疗社团法人童综合医院中医科，台中，台湾
2 佛教慈济医疗财团法人台中慈济医院中医部，台中，台湾
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【摘要】
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创伤性脑损伤（Traumatic brain injury, TBI）为因撞击、头颅穿刺等外伤所造成的脑部组织损伤，严重性TBI 病人的病情好转机率仅为25~33%，更有高达33% 的死亡率，後续照护也造成大量经济及医疗资源的消耗。本篇为一重度（GCS：6）TBI 病人，在台中慈济医院以袪痰化瘀开窍为治疗核心，使用温胆汤为主方加减用药，进行中西医共同照护，病患於3 个月後GCS恢复至15 分，并於5 个月後移除鼻胃管，自主进食，可以助行器行走并自理生活。藉此病例提出以祛痰化瘀开窍法作为治疗颅脑损伤的治疗思路，及脑中风治疗上的相异之处，提供各位医师同道叁考。
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【关键词】创伤性脑损伤、重度脑损伤、祛痰化瘀开窍法、中西医共治
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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
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【Summary】
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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
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251.6 中西医结合治疗重度头部外伤之病例报告
