急性期缺血性腦中風中醫證候與西醫診察指標的相關性研究

林建雄
長庚紀念醫院
腦中風(stroke)古稱卒中，取其突發之意。最早的文獻記載見於《內經》，歷代醫家對腦中風的病因病機有著不同的創見與發現。從唐宋之前的"外風"說，到唐宋之後"內風"論，而明•張景岳主張"中風非風"，突顯其不同。一直至今，名醫對腦中風的辨證各有所長，各有所見。據統計，自1982年以來，臺灣腦中風疾病仍高居國人十大死亡原因的第二位，但臨床上有關腦中風的中醫辨證分型尚且不清，大陸國家中醫藥管理局醫政司腦病急症科研組於1994年公告《中風病辨證診斷標準》，經過臨床執行評估，證明它已具備客觀性、可計量性與重覆性。現代依腦中風的腦病理變化分為出血性中風與缺血性中風，傳統中醫則依症狀是否有意識障礙將腦中風病類診斷分為中臟腑與中經絡。這些病理性變化與中醫證候的相關性如何，又急性期腦中風的證候分布為何，近幾年來相關的研究報導甚多，但急性期缺血性腦中風中醫證候與西醫診察指標的相關性研究卻是闕如。希望透過此計畫的研究，探討急性期缺血性腦中風中醫證候與西醫診察指標的關聯性，確定中醫辨證在腦中風診斷上的意義及其重要性，並對腦中風的治療提供方向與策略。
關鍵字：缺血性腦中風；證候；相關性

The study of the correlation between the patterns of Chinese medicine and the diagnostic factors of Western medicine in acute ischemic stroke

Lin,Chien-Hsiung
Chang Gung Memorial Hospital
Stroke in ancient China was originally called "sudden stroke" , on account of its sudden occurrence. It earliest extant appearance in literature is found in the Huang Di Nei Jing. Over the centuries, Chinese physicians have contributed numerous ideas and discoveries on the subject of this disease. Before the Tang and Song, the disease was explained in terms of "external wind;" after that period it was explained in terms of "internal wind." Later, Zhang Jing-Yue claimed that "wind strike is not wind," but due to other causes. To this day, famous physicians have held different opinions about stroke. According to statistics, since 1982, stroke holds second position in the top ten fatal diseases of Taiwan. However, Chinese medicines pattern identification scheme for the disease is still not clear. In 1994, the Administrative Bureau for Chinese Medicine of China issued a "Diagnostic Criteria for Wind Strike." After clinical evaluation, these criteria have proven to have the qualities of objectivity, quantifiability, and repeatability. Distinction is nowadays made between hemorrhagic and ischemic stroke.
關鍵字：ischemic stroke；pattern；correlation