遠處取穴針刺療法緩解良性陣發性頭位性眩暈之醫案報告

A Case of Distal Acupuncture Points Therapy for Benign Paroxysmal Positional Vertigo

眩暈是門診常見的主訴，但非一種特定疾病，而是許多疾病所共有的一種症狀。30%的眩暈病患兩週內會完全痊癒，但約11%的病患症狀並不會自行減退。其臨床症狀主要是感覺到自己或周遭景物在旋轉、搖動或跳動。此症狀會影響正常的生活功能，嚴重者可能導致患者不敢開車、自行出門或甚至於無法下床，往往會在躺下，或早上睡醒起床時症狀加重。發作時會感覺劇烈且短暫的天旋地轉，通常病患會覺得非常不舒服。良性陣發性頭位性眩暈（benign paroxysmal positional vertigo）屬於末梢性眩暈，為眩暈症最主要發生的原因之一，通常在治療上西醫主要採取保守的物理療法，但臨床上有一定比率無良好改善。本案提出，以遠處取穴針刺陽陵泉、合谷治療一位56歲良性陣發性頭位性眩暈男性患者。患者接受西醫物理治療後，眩暈程度仍嚴重且頭部偏歪向右側而無法自行行走，並需他人攙扶至門診就診。在施與針刺治療後，頭部歪斜並劇烈眩暈的情形改善至頭可自由轉動，且可自行行走不需攙扶。取針後，患者可自己步行離開診間。遠處取穴針刺陽陵泉、合谷治療良性陣發性頭位性眩暈，可立刻觀察針刺後迅速而顯著的療效，與其他療法相比，具有操作簡便、療效迅速、副作用少等優點，為醫者在臨床面對此類病症，值得善加利用的良好方法之一。

Vertigo and dizziness are, after headache and back pain, the most common symptoms in daily clinical practice. Vertigo is not a symptom but frequently noted as symptoms of other neurological, cardiovascular, haematological, and infectious diseases, and as adverse reactions to medical treatment. According to researches, symptoms resolve within 2 weeks in almost 30%. However, the persistence of dizziness and the lack of improvement have been reported in 11%. Patient's daily-life activities may be restricted. Over time vertigo may results in functional problems and secondary symptoms in the musculoskeletal system. Fear of provoking symptoms may lead the patient into a vicious circle with physical and psychosocial consequences influencing life quality. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Although the repositioning maneuver dramatically improves the vertigo, some patients still complain of residual dizziness. This paper describes the successful administration of acupuncture therapy in a male suffering from severe vertigo. A 56-year-old male patient presented with strong onset of severe vertigo 3 days ago. When he came to the outpatient office, he couldn't walk without help. Furthermore, he must always slant his head to the right side to relieve the uncomfortable symptom. He was intractable to many sorts of conventional therapies in the past few days. In the end, his symptoms dramatically improved after acupuncture therapy on points Yanglingquan (GB 34) and Hegu (LI 4). His head could move freely without perceiving positional vertigo and he could walk out of the office without support. Distal acupuncture point therapy can be a viable and acceptable treatment option for patients who suffer from sudden attack of BPPV and fail responding to other therapies. This case emphasizes the importance of acupuncture therapy as a method to control symptom of BPPV.