遠絡治療在疼痛治療之應用：中國針灸之結構化公式化之修改

Overview of Collateral Meridian Therapy in Pain Management: A Modified Structured Formulated Chinese Acupressure

遠絡治療是留日台灣麻醉醫師柯尚志根據傳統中醫針灸整合西昏的知識而發展出來的。遠絡醫學不同於傳統中醫之針灸治療，提供臨床上疼痛治療之另一方法。本綜論簡介遠絡治療的學說，遠絡穴位點之介紹和一般之治療法則，並提出幾篇已發表之論文提供參考。遠絡治療有三大方面不同於傳統的中醫針灸。第一：提供一結構性公式化之治療法則，不同於傳統針灸需靠經驗且不同之病人相間之疾病可能有不同之治療方法。第二：利用絡穴C點來連接疾病經絡與健康之治療經絡，然後按壓治療之功能F點來除去疼痛。第三：在四肢體表主要有108個穴位點，根據解剖位置易於定位，而中醫針灸則有361穴位。遠絡治療主要是利用遠端經絡來平衡阻塞之疾病經絡使得生命體流能流動順暢，而由病人本身之自癒能力來移除病痛。速絡治療對於肌肉骨骼相關之疼痛相當立即且有效，對於臨床上難治性之疼痛如，帶狀殖疹後之神經捕，複雜性區域性疼痛徵候群等本團隊均有治療之文獻報告。另外，柯醫師將遭絡醫學之穴位點及治療方式均化為英文字母來表示能廣泛使用且能推廣於現代醫學之病歷記載。本團隊多年之臨床經驗及發表之病例已顯示遠絡治療在疼痛治療之有效性。當然需進一步的進行嚴格控制隨機對照之研究才能更加提昇遠絡治療之科學證據，而進一步推廣於臨床醫學。

Collateral meridian therapy (CMT) is a recent developed technique according to the traditional Chinese medicine (TCM) experiences; it differs from traditional Chinese acupuncture (TCA) in many ways. In addition to TCA, CMT offers an alternative for different types of pain management. This article introduces the theory of CMT, acupoints localization, general treatment protocol principle, and some published reports. CMT is developed by Dr. Shan-Chih Ko, he combined the TCM and Western medicine, by using two-point acupressure technique, manipulating the control C-point and treatment functional F-point. CMT differs from TCA in three major points. CMT follows a standard formulated treatment protocols, instead of individual experiences in TCA. Secondly, CMT is based on a two-point acupressure maneuver on the C-point and F-point rather than manipulation of a single point as advocated by TCA. The third, CMT provides a standard set of 108 acupoints, instead of 361 in TCA. It allows redistribution of body energy, 'Qi' , from one meridian to another in order to augment or remove the unbalanced 'Qi' . CMT has been used effectively in our pain clinic to treat musculoskeletal pain and even intractable pains. Dr. Ko simplifies the theory and technique that makes CMT easy to learn and perform, by using English letters, it can be used world-widely. The role of CMT in pain management is promising for both acute and chronic pains. Randomized controlled trials are needed to strengthen its scientific evidence.