台北市中醫師公會中醫藥研究論叢

第21大醫事團體羽球聯誼賽

115年針灸收針程序指引及教育訓練

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282.9針灸合併中藥治療腦脊髓液鼻漏之病例報告

TJ TCM.28(2) : 131-146, 2025

DOI : 10.6516/TJTCM.202509_28(2).0009

針灸合併中藥治療腦脊髓液鼻漏之病例報告

A Case Report of Cerebrospinal Fluid Rhinorrhea with combination of acupuncture and Chinese herbal medicine

曾瑋鈞1何宗融1,2陳中奎1,*

1佛教慈濟醫療財團法人花蓮慈濟醫院，花蓮，台灣

2慈濟大學學士後中醫學系，花蓮，台灣

【摘要】

本病例報告描述治療一位50歲女性腦脊髓液鼻漏且無接受手術即顯著改

善之案例。患者曾於2017年時曾發生車禍，當時造成頸椎第三、四節椎間盤凸

出，且伴有身體左半側麻而無力，當時經手術合併針灸治療後左半邊無力改善

。後於2021年8月底因走路時未注意跌倒而撞到頭，3天後開始出現左側鼻孔

就一直「流鼻水」，並伴隨頭痛的症狀。故於2021年9月中因左鼻水流不止至

嘉義基督教醫院求診，當時CT影像檢查顯示蝶竇深處顱骨有約9 mm缺損，

因病患暫不考慮手術故僅給予藥物治療，但左鼻水流不停仍未見改善，而且每

天只要頭一低，鼻水就像關不住的水龍頭般直流，而且連睡覺時也流不停，仰

躺鼻水就倒流，就算側躺也流不停，故於2021年10月5日至花蓮慈濟醫院神

經外科求診，因診斷是腦脊髓液鼻漏故收入院觀察與進一步檢查治療，並會診

花蓮慈濟醫院中醫科尋求治療改善鼻水流不止。住院當天即為病患針灸，以改

善腦脊髓液流出，針灸以通任脈為主，搭配補瀉手法，以及利水的針法，留針

五至十分鐘後，鼻水流不停之狀況即有明顯改善。第一次的針灸治療暫時止住

腦脊髓液流出，隔日鼻漏症狀又發，但很明顯流出的量已減少到一半，所以再

次以針灸補針加強，除了使用前一次方法來針灸外，再加上一些腕踝針，使整

個療效能維持更久外，也能促時破損的黏膜不斷修復，兩次針灸治療後，腦脊

髓液也不再滴滴答答流。爾後在住院期間，除持續針灸治療外，也搭配一些中

藥的服用，並在西醫藥物同時控制治療下，已無鼻漏症狀，且CT顯示蝶竇深處

顱骨缺損縮小至5 mm，故於2021年10月22日出院，並定期回診追蹤治療中。

【關鍵詞】腦脊髓液鼻漏、中醫、針灸、中藥

【Summary】

This case report describes the treatment of a 50-year-old woman with cerebrospinal fluid rhinorrhea had obviously improved without any surgery treatments. The patient had a car accident in 2017, which caused the third and fourth cervical discs to bulge, and was accompanied by numbness and weakness in the left half of the body. The left side weakness had improved after surgery and acupuncture treatment. Later, at the end of August 2021, the patient had accidentally fell and hit the head while walking. Three days later of the hit, she began to have a "runny nose" on the left nostril, accompanied by headaches. Therefore, in mid-September 2021, she visited to Chiayi Christian Hospital clinic for treatment due to persistent nasal discharge on his left side. At that time, CT imaging showed that there was a defect of about 9 mm in the skull deep in the sphenoid sinus. Since the patient did not consider to accept surgery at that time, the doctor only gave her some medication. The persistent nasal discharge has not improved, and whenever her lower her head every day, her runny nose like a faucet that cannot be turned off, and it would not stop even when sleeping. Her nasal discharge was backward when her lie on the bed, and it did not stop even if her lie on her ride side. Therefore, she visited to the Neurosurgery clinic of Hualien Tzu Chi Hospital for consultation on October 5, 2021. And then, she was admitted to the ward for observation and further examination and treatment due to she was diagnosed with cerebrospinal fluid rhinorrhea. The doctor of Neurosurgery also consulted the Department of Traditional Chinese Medicine for combined treatment to improve the persistent nasal discharge. The patient was given acupuncture on the day she was hospitalized to improve the cerebrospinal fluid leakage. The acupuncture was mainly used to go through the Ren meridian, and combined with tonifying and purgative method, as well as eliminating dampness. After five to ten minutes of leaving the needle in the acupoints, the continuous flow of nasal fluid was obviously improved. The first acupuncture treatment temporarily stopped the outflow of cerebrospinal fluid, but the symptom recurred in the next day with the amount of outflow which was obviously decreased by 50%, and then the acupuncture treatment was used again to strengthen the efficacy. In addition to using the method of previous day, some wrist and ankle acupuncture treatments were applied to increase efficacy time and promote the continuous repair of damaged mucosa. After two times of acupuncture treatments, the cerebrospinal fluid rhinorrhea had no longer dripped. Afterwards, besides the acupuncture treatment, she was also under the treatments of Chinese herbal medicine during her hospitalization, and under the control of combined with Western medicine treatments. Finally, the CT imaging showed that the defect of in the skull had narrowed to about 5 mm in the sphenoid sinus, she was discharged from the hospital with no longer persistent nasal discharge on December 22, 2021. She regularly visits to our clinic for follow-up, and the treatment has continued to this day.

【Keywords】

Cerebrospinal Fluid Rhinorrhea； Traditional Chinese medicine； Acupuncture； Chinese herbal medicine

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