- 期刊
雷射針灸治療蹠骨疼痛病案討論
Laser Acupuncture for Metatarsalgia: A Case Report
摘要
本案例是一位26歲男性患者，於2015年10月開始使用橢圓機健身器材，二個月後發現雙腳第四蹠趾關節疼痛，第一二及四五蹠骨間肌肉悶痛不舒，腳趾關節屈伸不利，接受物理治療包括電療及超音波五個月，其間曾嘗試拔罐及針灸治療，但症狀仍無明顯緩解，患者前來就診時，溝通後給予雷射針灸治療（RJ LaserPen 551A, gallium aluminum arsenide 150 mW, 810nm, 5W/cm^2, pulsed wave）。依循中醫經絡、臟腑辨證精神，根據患者的症狀辨證施治，選用了陽陵泉、足三里、豐隆（Bahr2，10秒/每穴位），太衝、丘墟、足臨泣（Bahr3，10秒/每穴位），第四蹠趾關節（Nogier D'，40秒），第一第二蹠骨間肌、第四第五蹠骨間肌（Nogier C'，60秒/每部位），每週約三次，治療二週後，已無疼痛，恢復正常運動，且追蹤6個月均無復發。透過此案例治療經驗，可作為雷射針灸治療運動傷害的臨床經驗參考。
並列摘要
This 26 y/o male reported pain over bilateral 4^(th) metatarsal pharyngeal joint and muscle fullness over metatarsals between the 1^(st) and 2^(nd) digit, and between the 4^(th) and 5^(th) digit, and limited motion of metatarsal pharyngeal joints in December 2015. At that time, he had been using elliptical trainer for two months. He received physical therapy including TENS and ultrasound, and he tried vacuum cupping and acupuncture treatment for 5 months. However, there was no prominent regression of his symptoms. He came to the Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and received laser acupuncture (RJ LaserPen 551A, gallium aluminum arsenide 150 mW, 810nm, 5W/cm^2, pulsed wave) after well communication. According to patient's symptoms, the TCM meridian and viscera syndrome differentiation was applied. Laser acupuncture was carried out with the LaserPen on acupoints including GB34, ST36, ST40 (Bahr2, 10sec/ point), LI4, GB40, GB41 (Bahr3, 10sec/ point), and on local tender areas including 4^(th) MTP joint (Nogier D', 40s), interosseous muscle between 1^(st) and 2^(nd), and between 4^(th) and 5^(th) metatarsal. (Nogier C', 60s/ area). The treatment frequency was three times per week. The pain and the limitation of the range of motion of metatarsal pharyngeal joints were improved after the two-week treatment. He was able to do exercise as usual without pain. Besides, the symptoms did not recur during the six-month follow up. This case report could be the reference for the future application of laser acupuncture in treating sports injuries.