中西醫結合治療因急救後缺氧性腦病變之麻痺性腸阻塞病例報告

Intervention with Integrated Chinese and Western Medicine in Paralytic Ileus: A Case Report

本病例報告為一位71歲急救後缺氧性腦病變的男性病患，意識木僵，生活無法自理，長期由養護機構照顧。因突發嘔吐及嚴重腹脹，且腹部X光顯示大量腸氣滯留，懷疑為麻痺性腸阻塞而住院。經本院胃腸肝膽科半個月支持性治療後，雖鼻胃管灌食恢復正常，反抽無殘留，但腹脹仍甚，腹部X光追蹤後仍提示為麻痺性腸阻塞，故會診中醫針灸科。經中西醫結合治療半個月後，病人順利出院。此病例我們將探討麻痺性腸阻塞中醫病因、病機與治則。整理運用針刺、電針、艾灸、穴位注射、中藥內服、灌腸或穴位外敷等各種中醫治療方式，並討論中西醫合治的優勢。此中醫結合西醫保守治療的經驗，可作為中西醫合作縮短腸阻塞病患等待排氣的時間、減少病患住院天數以及提升療效之參考。

This is a 71- year-old male patientwith hypoxic brain injury after giving resuscitate. Because of stupor consciousness, he needed long-term care by the conservation organization. He was hospitalized due to sudden vomiting, severe abdominal distension and suspected paralytic ileus. After admission, he received two weeks of supportive therapy including medicine and nasogastric tube insertions. His intake was normal without vomiting, however, he was still very bloating. Therefore, a consultation with the Traditional Chinese Medicine (TCM) Acupcture physician was requested by his family. The patient was discharged after Integrated Chinese and Western medicine. In this case report, the cause, mechanism and principle of treatment of paralytic ileus from the TCM perspective were discussed. Variouskinds of Chinese medicinal treatments for ileus including acupuncture, electro-acupuncture, moxibustion, acupoint injection, and Chinese herbs were reviewed. The experience could be the reference treatment of the combination of Modern Medicine and TCM for ileus.