中西醫聯合治療小兒腸病毒感染重症之經驗

AN EXPERIENCE OF CHINESE AND WESTERN MEDICINE INTEGRATED APPROACH FOR TREATMENT OF ENTEROVIRUS INFECTION

長庚中醫與小兒加護病房合作，聯合治療三例腸病毒71 型感染重症兒，其臨床表現各不相同，分屬中醫辨證濕熱型及寒濕型兩種極端，符合中醫小兒暑溫重症病程發展規律。治療方式上，濕熱型採用清心化痰、開竅熄風、益氣救陰固脫以及清濕熱化痰濁；寒濕型採用健脾燥濕、芳香開竅、益氣溫陽等法。三位患兒均在一週內意識恢復清醒，兩週內四肢肌力恢復正常，其中較早會診中醫治療的兩位患兒，更於住院三個月後，成功脫離呼吸器出院，而吞嚥能力亦明顯進步。中西醫合作治療效果顯著，能明顯縮短恢復期，改善後遺症，可供臨床參考。Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, in cooperated with the intensive care unit of Chang Gung Children’s Hospital, treated 3 children with severe enterovirus 71 infection. Clinical evidence observed in these 3 cases can be classified into 2 different pattern types in terms of Chinese medicine pattern identification (damp-heat and damp-cold). Treatment methods used for the “damp-heat” pattern are “clearing the heat and transforming phlegm; opening the orifices and extinguishing wind; boosting qi, supplementing yin and stemming desertion”; while treatment methods used for the “damp- cold” pattern are “fortifying the spleen and drying dampness, transforming turbidity and opening the orifices with aroma, boosting qi, supplementing yang”. After applying the above treatment protocol, all 3 patients recovered consciousness in 1 week, and muscle power returned in 2 weeks. The 2 cases who received early intervention with Chinese medicine recovered and left the hospital respirator-free after a 3-month period of admission. This experience shows the possibility of shortening recovery and controlling sequelae with a Chinese/western medicine integrated treatment approach for severe enterovirus infection.