感覺障礙的臨床診查之文獻回顧

感覺障礙（sensory impairment）涵蓋多種疾病，是重要的醫學與社會問題，造成病患痛苦、失能、與醫療成本負與社會競爭力、經濟損失。臨床門診中，患者常以個人主觀感受的自覺症狀，如：感覺麻木（numbness）、「針刺感」、「麻刺感」（tingling）、「燒灼感」，甚至各種異常感覺的疼痛感，如刺痛、束帶感、閃電樣刺痛感、刀割樣、扭轉感、衝壓感、牽拉感、緊繃感、熾熱感等等，作為主述；臨床醫師似乎是約定成俗，常以「感覺不良」（dysaesthesia或dysesthesia）與「感覺異常」（paresthesia）這兩個複數形式的詞彙來表達，但深究其義，涵蓋多種症狀，並無助於臨床病灶定位、診斷；尤其感覺障礙見於多種疾病，在治療上單純的西醫治療常常面臨瓶頸。本文旨在結合中西醫學，促進臨床療效，尋求精準醫療的發展優勢，透過回顧內科學與神經醫學教科書，結合現今在中西醫結合神經醫學會，在治療上的進展，提出回顧性成果。

關鍵字

感覺障礙；感覺不良；感覺異常；感覺減退；感覺缺失；感覺過敏；感覺過度；感覺分離；痛覺過敏；痛覺過度

並列摘要

Sensory impairment covers a variety of diseases and is an important medical and social problem that causes suffering, disability, and negative medical costs, social competitiveness, and economic losses for patients. In clinical outpatient clinics, patients often experience subjective symptoms, such as: numbness, ＂pins and tingling＂, ＂tingling＂, ＂burning＂, and even all kinds of abnormal pain. Such as tingling, banding, lightning-like tingling, knife cutting, twisting, punching, pulling, tightness, hot, etc., as the main statement; the clinician seems to be convention, often It is expressed in the plural forms of ＂dyssensation＂ (dysaesthesia or dysesthesia) and ＂paresthesia＂, but it covers a variety of symptoms and does not help clinical focus positioning and diagnosis; especially sensory disorders It is found in many diseases, and the treatment of simple western medicine often faces bottlenecks. This article aims to combine Chinese and Western medicine, promote clinical efficacy, and seek the development advantages of precision medicine. Through reviewing internal medicine and neuromedicine textbooks, combined with the current treatment progress in the Taiwan Chinese-Western Medicine Neurology Association, and presenting retrospective results.

並列關鍵字

sensory impairment ； dysaesthesiap ； aresthesia ； hypoesthesia ； anesthesia ； hyperesthesia ； hyperlpathia ； dissociated anesthesia ； hyperalgesia ； hyperpathia