台北市中医师公会中医药研究论丛

第21大医事团体羽球联谊赛

115年针灸收针程序指引及教育训练

公会简介

282.9针灸合并中药治疗脑脊髓液鼻漏之病例报告

TJ TCM.28(2) : 131-146, 2025

DOI : 10.6516/TJTCM.202509_28(2).0009

针灸合并中药治疗脑脊髓液鼻漏之病例报告

A Case Report of Cerebrospinal Fluid Rhinorrhea with combination of acupuncture and Chinese herbal medicine

曾玮钧1何宗融1,2陈中奎1,*

1佛教慈济医疗财团法人花莲慈济医院，花莲，台湾

2慈济大学学士後中医学系，花莲，台湾

【摘要】

本病例报告描述治疗一位50岁女性脑脊髓液鼻漏且无接受手术即显着改

善之案例。患者曾於2017年时曾发生车祸，当时造成颈椎第三、四节椎间盘凸

出，且伴有身体左半侧麻而无力，当时经手术合并针灸治疗後左半边无力改善

。後於2021年8月底因走路时未注意跌倒而撞到头，3天後开始出现左侧鼻孔

就一直「流鼻水」，并伴随头痛的症状。故於2021年9月中因左鼻水流不止至

嘉义基督教医院求诊，当时CT影像检查显示蝶窦深处颅骨有约9 mm缺损，

因病患暂不考虑手术故仅给予药物治疗，但左鼻水流不停仍未见改善，而且每

天只要头一低，鼻水就像关不住的水龙头般直流，而且连睡觉时也流不停，仰

躺鼻水就倒流，就算侧躺也流不停，故於2021年10月5日至花莲慈济医院神

经外科求诊，因诊断是脑脊髓液鼻漏故收入院观察与进一步检查治疗，并会诊

花莲慈济医院中医科寻求治疗改善鼻水流不止。住院当天即为病患针灸，以改

善脑脊髓液流出，针灸以通任脉为主，搭配补泻手法，以及利水的针法，留针

五至十分钟後，鼻水流不停之状况即有明显改善。第一次的针灸治疗暂时止住

脑脊髓液流出，隔日鼻漏症状又发，但很明显流出的量已减少到一半，所以再

次以针灸补针加强，除了使用前一次方法来针灸外，再加上一些腕踝针，使整

个疗效能维持更久外，也能促时破损的黏膜不断修复，两次针灸治疗後，脑脊

髓液也不再滴滴答答流。尔後在住院期间，除持续针灸治疗外，也搭配一些中

药的服用，并在西医药物同时控制治疗下，已无鼻漏症状，且CT显示蝶窦深处

颅骨缺损缩小至5 mm，故於2021年10月22日出院，并定期回诊追踪治疗中。

【关键词】脑脊髓液鼻漏、中医、针灸、中药

【Summary】

This case report describes the treatment of a 50-year-old woman with cerebrospinal fluid rhinorrhea had obviously improved without any surgery treatments. The patient had a car accident in 2017, which caused the third and fourth cervical discs to bulge, and was accompanied by numbness and weakness in the left half of the body. The left side weakness had improved after surgery and acupuncture treatment. Later, at the end of August 2021, the patient had accidentally fell and hit the head while walking. Three days later of the hit, she began to have a "runny nose" on the left nostril, accompanied by headaches. Therefore, in mid-September 2021, she visited to Chiayi Christian Hospital clinic for treatment due to persistent nasal discharge on his left side. At that time, CT imaging showed that there was a defect of about 9 mm in the skull deep in the sphenoid sinus. Since the patient did not consider to accept surgery at that time, the doctor only gave her some medication. The persistent nasal discharge has not improved, and whenever her lower her head every day, her runny nose like a faucet that cannot be turned off, and it would not stop even when sleeping. Her nasal discharge was backward when her lie on the bed, and it did not stop even if her lie on her ride side. Therefore, she visited to the Neurosurgery clinic of Hualien Tzu Chi Hospital for consultation on October 5, 2021. And then, she was admitted to the ward for observation and further examination and treatment due to she was diagnosed with cerebrospinal fluid rhinorrhea. The doctor of Neurosurgery also consulted the Department of Traditional Chinese Medicine for combined treatment to improve the persistent nasal discharge. The patient was given acupuncture on the day she was hospitalized to improve the cerebrospinal fluid leakage. The acupuncture was mainly used to go through the Ren meridian, and combined with tonifying and purgative method, as well as eliminating dampness. After five to ten minutes of leaving the needle in the acupoints, the continuous flow of nasal fluid was obviously improved. The first acupuncture treatment temporarily stopped the outflow of cerebrospinal fluid, but the symptom recurred in the next day with the amount of outflow which was obviously decreased by 50%, and then the acupuncture treatment was used again to strengthen the efficacy. In addition to using the method of previous day, some wrist and ankle acupuncture treatments were applied to increase efficacy time and promote the continuous repair of damaged mucosa. After two times of acupuncture treatments, the cerebrospinal fluid rhinorrhea had no longer dripped. Afterwards, besides the acupuncture treatment, she was also under the treatments of Chinese herbal medicine during her hospitalization, and under the control of combined with Western medicine treatments. Finally, the CT imaging showed that the defect of in the skull had narrowed to about 5 mm in the sphenoid sinus, she was discharged from the hospital with no longer persistent nasal discharge on December 22, 2021. She regularly visits to our clinic for follow-up, and the treatment has continued to this day.

【Keywords】

Cerebrospinal Fluid Rhinorrhea； Traditional Chinese medicine； Acupuncture； Chinese herbal medicine

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