橫斷性脊髓炎之中醫治療病例報告

A case report of transverse myelitis treated by Acupuncture and Chinese herbs

橫斷性脊髓炎是一種脊髓發炎後損傷之疾病，造成受傷脊神經控制之下肢感覺異常、下身麻痺、半身不遂，嚴重會發生二便功能失常之癱瘓症狀。西醫治療上以類固醇為主。 這是一位45歲的男性病患，為一成衣廠老闆，96年2月初發生類似外感之症狀，之後10天內漸行性產生下肢感覺異常、無力、癱瘓與大小便失禁現象，診斷為橫斷性脊髓炎（transverse myelitis），施予大劑量類固醇使病情得到控制，但仍有下肢無力行走，下肢肌力不足，腳麻，腹脹，排便不順的症狀。故於96年3月5日會診中醫，隨後兩天以針灸處理，3月7日加入服用中藥治療，病況逐漸改善，其間偶因患者症狀改善後繼續工作而產生下肢無力及疲倦、心悸、盜汗之現象，均能以中藥及針灸處理而得到良好之療效，患者於3月7日出院，其後於門診陸續追蹤治療至96年4月9日，病況獲得改善，目前病人之生活及工作皆能自如。由此患者之治療病程可知，中藥與針灸對於橫斷性脊髓炎有不錯之療效。

Transverse myelitis is a neurological disorder caused by inflammation on segment of the spinal cord and contribution to paresthesias, paraparesis or paraplegia below the affected level of spine. Urinary retention and loss of bowel control were noted in severe case. Corticosteroid was prescribed in most case of transverse myelitis in Western medicine. The patient, 45 y/o male, a factory boss, seemed to suffer from common cold in February 2007. Then, paresthesias, paraplegia, muscle weakness, urinary retention and loss of bowel control were noted in 10 days. Transverse myelitis was diagnosed and high dose steroid was received. The illness was under control but weakness of lower limbs, numbness, abdominal distension, and defecation difficulty were still observed. After consultation, acupuncture and Chinese herbs were received. Gradually, the condition was much improved. Because patient worked hard at that time, lower limbs weakness, malaise, palpitation, sweating were relapsed. Fortunately, the symptoms got improved after treatment by acupuncture and Chinese herbs. Patient was discharged in March 7, 2007 and followed up in OPD until April 9, 2007. Illness was much improved so that patient lives and works freely. In the course of disease and treatment, we learned that effect of acupuncture and Chinese herb in transverse myelitis is affirmative.