顏面骨折手術後頭痛的中西醫整合治療病例報告

Management of Postoperative Headache by Integrated Chinese and Western Medicine: A Case Report

現代醫學長期以來對於頭面部損傷後所致軟組織腫脹、疼痛，主要使用抗發炎、止痛與預防感染的處置，並等待血腫自然吸收，於臨床上缺乏積極有效的治療方法。本報告提供使用中醫藥會診輔助治療顏面骨折術後疼痛之一個案例，患者為一名14歲男性，因車禍造成股骨與顏面骨之骨折與多處挫傷，後於加護病房照護並進行手術修復骨折，但術後頭痛持續發作，使用嗎啡類等止痛劑亦無良好之止痛效果。考量患者頭痛病因為車禍與手術後之創傷，並伴有天冷不欲蓋被及便秘等實證，會診中醫後擬診為血瘀證型之頭痛，故以活血化瘀為治則擬定處方協同治療，使患者頭痛臨床症狀緩解。中醫藥協同西醫處理對於骨折手術後之疼痛具有療效，值得進行更深入之研究與探討。 Anti-inflammatory agents, analgesia, antibiotics and passively spontaneous resolution of hematoma have been the main treatments of modem medicine for soft tissue swelling and pain after facial injuries for a long time. Complementary therapy with Chinese medicine for the relief of pain after operation for facial bone fracture was presented in this case: 14-years-old male suffered from facial bone fracture due to traffic accident, headache was noticed after surgical operation and the headache symptom continued after analgesic agents such as opioids were administered. The patient was then diagnosed blood stasis subtype headache by doctors from department of traditional Chinese medicine. Patient was given herb medicine and then the clinical presentation of headache reduced. Integrated Chinese and Western medicine is effective to treat postoperative headache and worthy of further investigation.