針灸治療職業婦女難治型腕隧道症候群之個案報告

Acupuncture treatment for refractory Carpal tunnel syndrome of a career woman: a case report

楊皓雯(Hao-Wen Yang) ； 吳佾璇(Yi-Hsuan Wu) ； 楊鈞百(Chun-Pai Yang)

《中華職業醫學雜誌》 24卷1期 (2017/01) Pp. 57-62

摘要

腕隧道症候群乃因正中神經經過手腕時被壓迫所致。典型的症狀包括：出現手腕手指麻木或疼痛的感覺，症狀分布在正中神經支配的區域，症狀常發生在晚上且有時會因這些症狀而醒來。甩手或搓一搓手通常會減輕症狀。隨著病程的演進會出現手部肌肉無力，手部動作不靈活，或功能不佳等運動方面的症狀。症狀可以為單手或雙手。最好的診斷方式便是執行神經傳導檢查，檢測經過腕橫韌帶的正中神經是否出現在腕部的局部變慢現象。本文報告一個46歲女性案例，其主訴是八個月前開始出現沿著正中神經分布的區域有麻木刺痛感，並於近一個月出現手部動作無力。期間雖然經過口服類固醇，非類固醇止痛藥，及維他命B12等藥物治療仍效果不佳。最後建議病人接受針灸治療，不但症狀緩解，也改善了生活品質。對於那些藥物難治型的病人及不願意提早開刀的病人，針灸治療或許能提供另一項選擇。

關鍵字

針灸 ； 腕隧道症候群 ； 類固醇

並列摘要

Carpal tunnel syndrome (CTS), which results from the compression of the median nerve at wrist. The typical symptoms of CTS include sensory symptoms, such as numbness or pain in the wrist, and fingers within median nerve distribution. These symptoms often occur during sleep and awaken patients occasionally. Shaking or rubbing the hands usually relieves the symptoms. With the progression of the disease, the motor symptoms including weakness of the hand muscle and loss of hand dexterity and function develop. Symptoms can occur unilaterally or bilaterally. The best way to confirm the diagnosis is to carry out a median nerve conduction study (NCS) across the transverse carpal ligament, which demonstrates focal conduction slowing. We presenteda case of 46-year-old female, who suffered from numbness and tingling pain around the median nerve distribution since 8 months ago and followed by hand weakness for 1 month. During this period, she was treated with medicine including oral steroid, NSAIDs and Vitamin B12 but in vain. Finally she was suggested to have acupuncture treatments. The result demonstrated that the patient was relieved from symptoms and her quality of life also great improved. For those treatment refractory patients and those who do not opt for early surgery, acupuncture treatment provides an alternative choice.

並列關鍵字

Acupuncture ； Carpal tunnel syndrome ； Steroid