下背痛的鑑別診斷與針灸治療

下背痛是現代人常見的問題，分為非特異性與特異性兩大類。不論是屬於哪類的下背痛，都有很多原因可能造成，而在這些原因之中有一些危重疾病必須要優先被排除。針灸治療下背痛由來已久，下背痛對應在中醫古籍中為「腰痛」，早從《黃帝內經刺腰痛論》就記載足三陽、足三陰與奇經八脈引起的腰痛的特點與針刺位置，後世醫家更以此為基礎明確指出穴位。到了現代，關於針灸治療下背痛的療效多年來持續地被研究與証實，除了由十二正經選擇穴位之外，漸漸地有其他理論被建立，如對應穴以及耳穴，此些方法的療效也透過其他研究被證實有正向的效果。

關鍵字

下背痛；鑑別診斷；針刺治療

並列摘要

Low back pain is a common problem nowadays. It is classified into two categories: specific and non-specific. There are many etiologies causing low back pain. Some of them are emergent and should be firstly excluded by history taking and physical exam in the clinic. Acupuncture has been used to treat low back pain for a long time. According to Chinese medical literature, low back pain is assigned to lumbago. The differential diagnosis and treatment of lumbago are recorded in the Huangdi neijing. On the basis of what described in the Huangdi neijing, the characteristic and needled points of the three yang meridians of the foot, the three yin meridians of the foot and the eight extra meridians are used to indicated certain acupoints by ancient doctors. In recent years, the efficacy of acupuncture applied in low back pain is investigated and confirmed. Besides, other therapeutic theories such as holography rule of acupoints and ear points are established gradually. The evident efficacy of these new therapy theories are also confirmed in many researches.

並列關鍵字

low back pain ； differential diagnosis ； acupuncture

參考文獻

Hoy D, Bain C, Williams G et al: A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012 Jun,64(6):2028-37.

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