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| 題 名 | 從一則高齡腦瘤合併中風先兆病案 探討中醫安寧緩和照護之策略=The Role of CM in Long-Term Palliative Cares--Insights from a Case Study of a Nonagenarian with a Brain Tumor and Stroke Prodromes |
|---|---|
| 作 者 | 簡鸞瑤; | 書刊名 | 中國鍼灸學雜誌 |
| 卷 期 | 13:1 2025.12[民114.12] |
| 頁 次 | 頁78-82 |
| 分類號 | 413.28 |
| 關鍵詞 | 中風先兆; 安寧緩和照護; 腦腫瘤; 陰虛陽亢; 迂迴策略; 高齡醫學; Chronic renal failure; Entero-renal axis; Microvascular obstruction; Diabetes; Insulin resistance; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6528/CAMS.202512_13(1).0007 |
| 中文摘要 | 本文探討一位92歲高齡女性,罹患惡性腦瘤並選擇純中醫安寧緩和照護。病患初期的腫瘤陽亢調控穩定後,開始在95至96歲反覆出現中風先兆,表現為急性高血糖、躁動難眠、平衡感差等。此乃高齡體虛,HPA軸(下視丘-腦下垂體-腎上腺軸)功能鈍化,導致SNS(交感神經系統)失衡,呈現陰虛陽亢之證候。中醫治療並非直接抑制症狀(見火制火),而是採用迂迴策略(Detour Strategy),亦即中醫釜底抽薪之治本思維。透過補腎疏肝法(增強HPA軸儲備兼緩解SNS亢燥),使病患的生理儲備得以基本維持,自然平復亢奮的交感神經系統,病患血壓血糖自然穩定下來,終其一生沒有發生嚴重腦中風,並在96歲時於睡夢中安詳離世,順利完成一段有尊嚴的臨終旅程。本案顯示中醫在老年緩和醫療中,能填補現代醫療關鍵的治療缺口,顯著提升病患的末期生活品質與尊嚴。 |
| 英文摘要 | This paper explores the unique role of Chinese Medicine (CM) in geriatric palliative care. A significant challenge in this field is the shift in focus from "curing the disease" to a new goal: empowering patients to live with their chronic conditions for an extended period, while maintaining quality of life and prolonging life. This case study provides valuable insights from a practical approach that demonstrates how CM can achieve this objective. We detail the case of a 92-year-old female patient with a malignant brain tumor whose family opted for pure CM palliative care for her final five years. During this period, she experienced recurrent episodes of acute hyperglycemia and stroke prodromes. We applied a unique CM approach we call the "Detour Strategy"-a philosophical approach of "addressing the root cause" ("釜底抽薪"). This strategy focuses on restoring the body's foundational resilience, analogous to rebuilding the HPA axis (CM's Kidney-Yin), thereby eliminating the need for an over-activated sympathetic nervous system (CM's Liver-Yang). Through this proactive intervention, the patient's physiological markers stabilized, her agitation and insomnia improved, and she remained free from a major stroke for the remainder of her life. She ultimately passed away peacefully at age 96, demonstrating that CM can successfully provide comfort and dignity while prolonging life with a chronic illness. This case illustrates CM's valuable role in complementing conventional care by offering a holistic approach that enhances a patient's well-being in their most vulnerable state. |
本系統中英文摘要資訊取自各篇刊載內容。