脑动脉瘤破裂导致蛛网膜下腔出血并伴有脑室内出血的四肢瘫痪病例报告,经 Tonggyuhwalhyeol-tang-gagambang 等韩医治疗后好转

Seong-hyeon Jeon, Eun-soo Park, Yu-bin Kim, Ji-su Lee, Eun-yeong Park
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摘要

本研究报告了一例因脑动脉瘤破裂、蛛网膜下腔出血和脑室内出血(IVH)而导致四肢瘫痪的患者,该患者接受了韩医治疗。患者接受了针灸、中药(主要是通瘀散-汤加甘)、西药、艾灸、拔罐和康复治疗 75 天,用药后病情有所好转。治疗后,徒手肌力测试等级从 4/4-/3+/3 提高到 4+/4+/4+/4+,韩国版改良巴特尔指数评分从 9 分提高到 100 分,美国国立卫生研究院卒中量表评分从 2 分提高到 0 分,全面恶化量表评分从 3 分提高到 2 分,韩国版迷你精神状态检查评分从 22 分提高到 30 分。用药期间,患者没有出现抽搐、休克或意识丧失,生命体征稳定在正常范围。我们对脑部计算机断层扫描结果进行了 2 次随访,发现韩药治疗后没有明确的颅内出血或 IVH 或再破裂或再出血证据。本研究表明,活血化瘀中药韩方治疗是改善脑动脉瘤破裂和蛛网膜下腔出血所致四肢瘫痪的一种安全有效的干预方案。
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A Case Report of Quadriparesis due to Subarachnoid Hemorrhage with Intraventricular Hemorrhage due to Cerebral Aneurysm Rupture Improved after Treated with Korean Medicine Treatment Including Tonggyuhwalhyeol-tang-gagambang
This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health’s Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.
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