內科病轉位痛(Reffered Pain)與複雜病因疼痛的探討

Reffered Pain and Pains of Complex Causes

徐福惇(Fu-Tun Hsu) ； 吳文興(Wen-Hsing Wu)

《中醫骨傷科醫學雜誌》 7期 (2008/12) Pp. 47-57

https://doi.org/10.30098/JCOT.200812.0008

摘要

傷科臨床上關於疼痛的處理，偶見骨位已調正，軟組織也已鬆開，疼痛卻未隨著緩解的情形，或者患處全無紅腫熱痛諸見證卻疼痛不已，或者疼痛程度與觸診按壓不相關者。此時病機通常脫出一般骨骼、肌肉或神經學的理學檢查範圍之外，應當留意此疼痛是否為內科因素所導致，亦就是所謂的「轉位痛」或「牽涉痛」，定義為在離開實際神經受損部位相當遠處感受到疼痛的症狀。而這些疼痛常與內科急重症相關聯，在診療上應當慎重待之。本文以傷科處理慣常的部位模式分類，以臨床症狀為主，試圖由尋常之病症處找出不尋常之病因，供臨床治療的參考。

關鍵字

轉位痛 ； 轉移痛 ； 疼痛 ； 臨床疼痛學

並列摘要

This article is to highlight the importance of diagnosis of pain that responds to complicated diseases and pathology. Although there are independent theories and criteria of pain diagnosis in traditional therapy, in some critical situations, these techniques are not necessary an advantage in reliving pains. Describing quality, pattern and place of pain in detail, the authors try to improve accuracy of diagnosis on pain syndromes of specific diseases that are easily neglected and treated as general muscle pains in this article.

並列關鍵字

Reffered Pain ； Pain ； Pains of Complex Causes