出血性腦中風急性期中醫介入治療經驗──三個病例報告

Early TCM Interventional Treatment Experience of Hemorrhagic Stroke: Three Case Reports

腦血管疾病中出血性腦中風不但預後較差，並且在亞洲的發生率高於西方國家，造成家庭和國家龐大的醫療負擔，如何減少患者後遺症狀，加強肢體活動能力，使之恢復生活自理能力、降低社會照護成本是現醫療努力的目標。本病例報告為三個重度出血性腦中風中醫早期介入治療案例，經治療患者神經功能皆獲得改善。中醫治療上，根據本院多年臨床觀察治療經驗，歸納出「辨病」治療模式：急性期藉由恢復人體中焦氣機，改善腦部出血後的標症──氣逆痰瘀化火，治以化痰醒腦開竅。

Introduction: According to the American Stroke Association, Cerebrovascular accident(CVA) is the leading cause of disability and the fifth cause of death. Compared to ischemic stroke, hemorrhagic stroke leads to higher mortality and more severe disability. Patients with GCS scored 8 or below are defined as severe stroke, which might lead to poor outcome, increase social and economic burden. Early intervention of integrated treatment of TCM and western medicine for severe stroke is essential to decrease mortality and disability rate. Case description: We present three cases of severe hemorrhagic stroke, including aneurysm rupture, hypertensive cerebral hemorrhage and pontine hemorrhage. The initially GCS were all below 8, and all of them received Chinese medicine within four days after onset. After several months of treatment, their neurological function has improved. Discussion: In our experience, integrated treatment of TCM and western medicine can improve their self-care ability, and make better recovery for hemorrhagic stroke patients. Our hypothesis is that TCM can restore human qi circulation, and accelerate brain repair. We hope to share these cases of early TCM interventional treatment for stroke to reduce mortality and disability rate.