透過您的圖書館登入
IP:3.147.73.35
  • 期刊

針傷合治腰椎間盤突出症:一病例報告

Acupuncture Combined with TCM Traumatological Manipulation in Lumbar Disc Herniation:A Case Report

摘要


這是一位33歲女性病患,103年6月5日因腰腿痛來院急診,疼痛評估視覺類比量表(visual analogue scale, VAS)為5分。103年6月16日核磁共振攝影(亦稱磁振造影,magnetic resonance imaging,MRI)確診L5-S1腰椎間盤突出症,患者外用酸痛凝膠Etofenamate gel止痛,服用消炎止痛劑(Neproxen)及肌肉鬆弛劑(Methocarbamol),然而疼痛症狀未改善,骨科建議手術治療。患者因不願手術治療,故於103年8月14日患者至本院中醫門診就診,經每週2至3次針灸及傷科手法治療,持續治療半年,症狀逐漸改善。104年3月27日MRI影像顯示患者幾乎無腰椎間盤突出,疼痛評估視覺類 比量表0分。3個月後隨訪,腰腿痛未再復發。本案例的治療結果,令人滿意。

並列摘要


The case was a 33-year-old female who visited EDAH emergency department on 2014- 06-05 and complained her back and leg pain and the visual analogue scale was 5. She was diagnosed as left paracentral HIVD at L5-S1, with severe lateral recess and neural foramen stenosis and degenerative disc disease of L4-5 with posterior annular tear by MRI. Etofenamate gel, Neproxen and Methocarbamol were given to relieve her pain. However, the pain was not relieved. Orthopedic surgery was recommended by Orthopedic surgeons. Because of refused operation, the patient visited outpatient service at Chinese Medicine Department on 2014-08- 14. She was treated by acupuncture and TCM traumatological manipulation two to three times a week, continuing treatment for six months. Therefore, the symptoms were gradually improved. MRI showed that the patient with lumbar disc herniation has subsided on 2015-03-27 and the visual analogue scale was 0. After 3 months of follow-up, the pain did not recur.

參考文獻


Richard A. Deyo, Sohail K. Mirza: Herniated Lumbar Intervertebral Disk. N Engl J Med, 2016, 374(18): 1763-1772.
蔡曜鍵、楊哲彥、羅明江、陳朝宗,急性腰椎間盤突出症之中醫住院治療,臺北醫學雜誌,2007;04(08):779-785。
Ropper AH, Zafonte RD.Sciatica: N Engl J Med, 2015, 372(13): 1240-1248.
Sørensen IG, Jacobsen P, Gyntelberg F et al: Occupational and other predictors of herniated lumbar disc disease-a 33-year follow-up in the Copenhagen male study, Spine, 2011, 36(19):1541-6.
Zhu Z, Huang P, Chong Y, George SK et al: Nucleus pulposus cells derived IGF-1 and MCP-1 enhance osteoclastogenesis and vertebrae disruption in lumbar disc herniation, Int J Clin Exp Pathol, 2014, 7(12):8520-8531.

延伸閱讀