针刺治疗瘤样脱髓鞘病变验案一则
Treatment of Tumefactive Demyelinating Lesions with Acupuncture: A Case Report
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1.首都医科大学附属北京中医医院针灸中心&针灸神经调控北京市重点实验室,北京 100010
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杜鑫, 付渊博. 针刺治疗瘤样脱髓鞘病变验案一则[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43085476&Fpath=home&index=0
DU Xin, FU Yuanbo. Treatment of Tumefactive Demyelinating Lesions with Acupuncture: A Case Report[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43085476&Fpath=home&index=0
杜鑫, 付渊博. 针刺治疗瘤样脱髓鞘病变验案一则[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43085476&Fpath=home&index=0 DOI:
DU Xin, FU Yuanbo. Treatment of Tumefactive Demyelinating Lesions with Acupuncture: A Case Report[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43085476&Fpath=home&index=0 DOI:
病史摘要,2,患者王某某,男性,66岁,2021年5月31日因“右侧口眼歪斜伴左侧肢体无力进行性加重2周”入院。2周前患者无明显诱因出现右侧口眼歪斜,右眼视物重影等症,就诊当地医院眼科,考虑“眼外肌麻痹”,治疗后症状未见改善。患者自觉口眼歪斜、肢体无力逐渐加重,就诊当地医院急诊科,诊断为“急性脑梗死”,予抗血小板聚集、降脂稳斑等治疗1周后未见好转。2天前就诊于我院急诊科,诊断为“脑干及左侧桥臂病变”,为求中医针灸治疗收治入院。四诊信息:患者右侧额纹消失,右额抬举无力。右眼闭合无力,闭目露白睛,视物重影,右眼活动受限,外展不及边。右侧鼻唇沟消失,右侧口角下垂,右侧鼓腮漏气,伸舌稍右偏。左侧肢体无力,左下肢可抬离床面但不能对抗外力,行走左偏。偶有头晕,纳可,夜眠安,小便调,大便干。舌淡红、苔白厚腻,脉弦滑。中医诊断 中风病(风痰阻络证)。西医诊断 瘤样脱髓鞘病变。干预措施 中医治疗以化痰熄风,疏经通络为法,予毫针、芒针透刺治疗。西医予激素治疗。疗效转归 患者口眼歪斜、肢体无力等症状基本消失。随访1年半,未见复发复发。
Summary of case history, patient Wang, a 66-year-old male, was admitted on May 31, 2021 due to "progressive exacerbation of right eye and mouth deviation with left limb weakness for 2 weeks". Two weeks ago, the patient had no obvious cause of right eye deviation or double vision in the right eye. They sought medical attention from a local hospital's ophthalmology department and considered "extraocular muscle paralysis". After treatment, the symptoms did not improve. The patient felt that their mouth and eyes were skewed and their limb weakness gradually worsened. They went to the emergency department of the local hospital and were diagnosed with "acute cerebral infarction". After one week of treatment with antiplatelet aggregation, lipid lowering, and plaque stabilization, no improvement was observed. Two days ago, he visited the emergency department of our hospital and was diagnosed as "brain stem and left pontine arm disease". He was admitted to the hospital for the treatment of traditional Chinese medicine acupuncture and moxibustion. Symptoms and signs: The patient's right frontal crease disappears and the right frontal lift is weak. Right eye closure is weak, with white eyes exposed when closed, resulting in ghosting of visual objects, limited right eye movement, and limited abduction. The right nasolabial sulcus disappears, the right corner of the mouth droops, the right bulging cheek leaks air, and the tongue extends slightly to the right. Left limb weakness, left lower limb can be lifted off the bed surface but cannot resist external forces, walking left leaning. Occasionally experiencing dizziness, nocturnal sleep, irregular urination, and dry stools. The tongue is light red, the fur is white and thick, and the veins are smooth.,TCM diagnosis, apoplexy (wind sputum blocking collaterals).,Western medicine diagnosis, tumefactive demyelinating lesions.,Therapeutic methods, traditional Chinese medicine treatment focuses on resolving phlegm and calming wind, dredging meridians and unblocking collaterals, and is treated with penetrating needling with filiform and awn needles. Western medicine provides hormone therapy.,Clinical outcomes, the patient's symptoms such as mouth and eye deviation and limb weakness basically disappeared. Follow up for 1 and a half years showed no recurrence.
瘤样脱髓鞘病变脱髓鞘假瘤瘤样炎性脱髓鞘病中风针刺透刺法
tumor like demyelinating lesiondemyelinating pseudotumortumor like inflammatory demyelinating diseasestrokeacupuncturepenetrating needling method
中国免疫学会神经免疫分会,中华医学会神经病学分会神经免疫学组,中国人民解放军科委会神经内科学专业委员会神经免疫学组.中枢神经系统瘤样脱髓鞘病变诊治指南[J].中国神经免疫学和神经病学杂志,2017,24(5):305-317.
李欣囡,武霞,刘建国.中枢神经系统瘤样脱髓鞘病的发病机制与临床研究进展[J].中国神经免疫学和神经病学杂志,2022,29(1):57-61.
国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55-56.
杜凯,努娜,沈燕,等.金针王乐亭治疗中风病学术思想探寻[J].中国针灸,2018,38(6):637-640.
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