台北中医医学杂志

98.3 中药结合西医治疗可逆性脑血管收缩症候群

 

中药结合西医治疗可逆性脑血管收缩症候群
Treatment of Reversible Cerebral Vasoconstriction Syndrome with Traditional
Chinese Medicine (TCM) and Western Medicine
曾玮涵1,2 张凯惟1,3 陈方佩1,3,4 龚彦颖1,3,4*
1 台北荣民总医院传统医学部,台北,台湾
2 中国医药大学中医学系,台中,台湾
3 国立阳明大学传统医药研究所,台北,台湾
4 国立阳明大学医学院医学系,台北,台湾
【摘要】
可逆性脑血管收缩症候群(RCVS)是一种尚未被充分认识的神经系统疾病,其中患者会遭受突然的严重头痛(通常被称为雷击性头痛),并表现出可逆性脑血管收缩。目前Nimodipine 是最常用於治疗该疾病的药物。而中医并无相对应之病名,头痛的叙述却早在《内经》可见,且可分为外伤头痛与内伤头痛,外伤头痛以风邪为多,治法以祛邪为主;内伤头痛则多与肝脾肾有关,治法多着重在扶正。
本篇藉由分享一名45 岁的RCVS 患者,使用Nimodipine 并同时配合中药(以加味逍遥散、清上蠲痛汤为主,配合天麻、蔓荆子、丹叁)调理,使病情趋於稳定,头痛频次、疲劳、呕噁、心悸与胸闷等不适感均获得改善,影像学追踪也有明显变化。
【关键词】可逆性脑血管收缩症候群(RCVS)、加味逍遥散、清上蠲痛汤
 
Wei-Han Tseng1,2Kei-Wei Chang1,3Fang-Pey Chen1,3,4Yen-Ying Kung1,3,4*
1Center of Traditional medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2College of Chinese Medicine, China Medical University, Taichung, Taiwan
3Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
4School of Medicine, National Yang-Ming University, Taipei, Taiwan
【Summary】
Reversible cerebral vasoconstriction syndrome (RCVS) is an underrecognized neurological disease in which patients suffer from sudden severe headache (often called thunderclap headache) and reversible cerebral vasoconstriction. Nimodipine is currently the most commonly used drug to treat the disease. Though there is no corresponding disease name in Chinese medicine, but the description of headache can be seen as early as in the "Huangdi Neijing ", and it can be divided into exogenous headache and introgenous headache. Exogenous headache is mostly caused by pathogenic wind, and the treatment is mainly to dispelling wind; introgenous headaches are mostly related to liver, spleen and kidney. And the treatment is mostly focused on strengthening the body. In this article, by sharing a 45-year-old RCVS patient, taking Nimodipine and at the same time combined with Chinese medicine (mainly with Jia Wei Xiao Yao San, Qing Shang Juan Tong Tang, combined with Tianma, Manjingzi, and Danshen) to stabilize the condition. Frequent headaches, fatigue, nausea, palpitations, chest tightness and other discomforts were all improved, and followup imaging also showed significant changes. This case can provide a reference for the effective clinical experience of treating RCVS with Chinese medicine and western medicine.
 
【Keywords】reversible cerebral vasoconstriction syndrome (RCVS), Jia Wei Xiao
Yao San, Qing Shang Juan Tong Tang