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題名:針刺療法合併西醫診治泛視神經脊髓炎之病例報告
書刊名:中醫藥雜誌
作者:李容妙呂友文廖科儒廖崇智
作者(外文):Li, Jung-miaoLu, Yu-wenLiao, Ke-juLiao, Chung-chih
出版日期:2015
卷期:26:2
頁次:頁(9)1-(9)11
主題關鍵詞:泛視神經脊髓炎中醫針刺療法Neuromyelitis optica spectrum disorderNMOSDTraditional Chinese medicineAcupuncture therapy
原始連結:連回原系統網址new window
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視神經脊髓炎是一種罕見的去髓鞘疾病,過去台灣很少發表過中西醫聯合治療此疾病之報導。我們報告一位 34歲女性,最初以腹部脹痛為表現至急診就診,入院後陸續出現癲癇、急性呼吸衰竭、四肢無力等症狀,轉入加護病房觀察,經插管治療,並根據臨床表現追蹤脊髓磁振造影與 AQP4抗體,確診為泛視神經脊髓炎的個案。經給予類固醇、血漿置換術與免疫抑制劑療法兩週後,情況轉趨穩定,但四肢肌力仍差且無法脫離呼吸器。經會診中醫施行針刺療法近兩個月療程中,病患順利拔管且四肢肌力進步甚多,半年後追蹤影像學檢查亦有顯著的改善。由此可見,針刺療法介入罕見的神經性疾病,亦可獲得滿意療效,藉此也希望未來台灣醫療環境可提供更寬廣的中西醫合併診療平台。
Neuromyelitis optica (NMO) is a rare demyelinating disease of central nervous system. It hasseldomly been reported in Taiwan which was treated by acupuncture combined with WesternMedicine. We studied on a case of 34-year-old woman who had abdominal pain, followed by seizure attack, acute respiratory failure, and quadriplegia. She received endotracheal intubation in theIntensive Care Unit (ICU). The neuromyelitis optica spectrum disorder (NMOSD) was diagnosedbased on clinical manifestations, a contiguous spinal cord lesion on MRI extending more thanthree segments, and seropositivity for aquaporin-4 (AQP4) autoantibodies. Her condition wasstabilized within two weeks after glucocorticoids administration, plasmapheresis, and systemicimmunosuppression. However, there was no any apparent improvement on muscle strength, andshe was still ventilator-dependent. During approximately two-month of acupuncture therapy,the patient received endotracheal extubation and her limb muscle markedly strengthening. Theinterval changes were significantly showed on the six-month follow-up MRI image. We observed thesatisfactory therapeutic response to treat such rare neurological disease with acupuncture. Hopethat we can create a better medical care environment to combine Traditional Chinese Medicine and Western Medicine in Taiwan in the future.
期刊論文
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2.Palace, J.、Leite, M. I.、Jacob, A.(2012)。A practical guide to the treatment of neuromyelitis optica。Pract. Neurol.,12,209-214。  new window
3.Etemadifar, M.、Nasr, Z.、Khalili, B.、Taherioun, M.、Vosoughi, R.(2015)。Epidemiology of neuromyelitis optica in the world: a systematic review and meta-analysis。Mult. Scler. Int.,2015,1-8。  new window
4.賴彥州、劉文勝、林詩凡、郭璨銘、廖恪修、賴彥廷(20101200)。以神經根痛為最初表現的視神經脊髓炎:病例報告。臺灣復健醫學雜誌,38(4),263-267。  延伸查詢new window
5.許正澂、林彣芷、劉天慧、賴明琪、洪榮斌、周偉倪(20100300)。復健治療對一位十一歲女童罹患戴維克症候群之臨床療效:病例報告。臺灣復健醫學雜誌,38(1),41-47。  延伸查詢new window
6.Matà, S.、Lolli, F.(2011)。Neuromyelitis optica: an update。J. Neurol. Sci.,303,13-21。  new window
7.馬廣斌(2010)。中西醫結合治療視神經脊髓炎探微。光明中醫,2010(4)=25,659-660。  延伸查詢new window
8.許堯欽、賴明琪、朱祺仁、郭世芳、莊智翔(20080600)。神經精神型系統性紅斑性狼瘡中西結合治療病例。中西整合醫學雜誌,10(1),29-40。  延伸查詢new window
9.Kim, S. K.、Bae, H.(2010)。Acupuncture and immune modulation。Auton. Neurosci.,157,38-41。  new window
10.Ding, S. S.、Hong, S. H.、Wang, C.、Guo, Y.、Wang, Z. K.、Xu, Y.(2014)。Acupuncture modulates the neuro-endocrine-immune network。QJM: An Int. J. Med.,107,341-345。  new window
11.Rabinstein, A. A.、Shulman, L. M.(2003)。Acupuncture in clinical neurology。Neurologist,9,137-148。  new window
12.樊永平、胡蕊、鮑顯慧、吳畏(2013)。63例視神經脊髓炎患者臨床特點和中醫證型分佈。中國中西醫結合雜誌,2013(3)=33,322-325。  延伸查詢new window
13.王英、申鵬飛(2011)。針灸、中藥結合治療視神經脊髓炎的體會。貴陽中醫學院學報,2011(2)=33,90-91。  延伸查詢new window
14.黃麗春(20050900)。耳穴療效與治療手法的體會。臺灣中醫臨床醫學雜誌,11(3),226-230。  延伸查詢new window
15.林健蓉、林高士、王麗香、黃怡嘉、張慈文(20090300)。橫斷性脊髓炎之中醫治療病例報告。臺灣中醫醫學雜誌,8(1),70-79。  延伸查詢new window
16.Vaghela, S. A.、Donnellan, C. P.(2008)。Acupuncture for back pain, knee pain and insomnia in transverse myelitis--a case report。Acupunct. Med.,26,188-192。  new window
17.Pittock, S. J.、Lennon, V. A.、de Seze, J.、Vermersch, P.、Homburger, H. A.、Wingerchuk, D. M.、Lucchinetti, C. F.、Zéphir, H.、Moder, K.、Weinshenker, B. G.(2008)。Neuromyelitis optica and non organ-specific autoimmunity。Arch. Neurol.,65,78-83。  new window
18.Berkowitz, A. L.、Samuels, M. A.(2014)。The neurology of Sjögren's syndrome and the rheumatology of peripheral neuropathy and myelitis。Pract. Neurol.,14,14-22。  new window
19.韓雲、林嫩釗、林琳(2005)。中醫藥在機械通氣治療慢性阻塞性肺疾病呼吸衰竭中的運用思路。中醫雜誌,2005(3)=46,226-229。  延伸查詢new window
20.陳稼洺、李佳穎、許博期、羅綸謙(20140600)。中西醫照護幫助患者脫離呼吸器--病例報告。中醫藥雜誌,25(1),113-124。new window  延伸查詢new window
21.Oleson, T.(2002)。Auriculotherapy stimulation for neuro-rehabilitation。Neurorehabilitation,17(1),49-62。  new window
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圖書
1.林昭庚(2001)。針灸學新論。台中:中國醫藥學院針灸研究中心。  延伸查詢new window
2.林昭庚、李德茂、孫茂峰、許昇峰、陳必誠(2009)。新編彩圖針灸學。台北:知音出版社。  延伸查詢new window
3.陳榮洲、陳建仲、沈建忠、游智勝、葉慧昌、田莒昌、李克成(2003)。中醫內科證治學。台中:弘祥出版社。  延伸查詢new window
4.黃麗春(1991)。耳穴診斷治療學。北京:科學技術文獻出版社。  延伸查詢new window
 
 
 
 
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