遠處取穴針剌療法治癒產後頸項痛之醫案報告

A Medical Case Report of Distal Acupuncture Points Therapy in Alleviating Postpartum Cervicalgia

百分之二十八的人曾發生急性頸項疼痛，而其中以頸部肌肉扭傷或僵凝較為常見，臨床上常使用非類固醇類消炎藥（nonsteroidal anti-inflammatory drugs, NSAIDs），與物理治療來緩解疼痛，然而遠處取穴療法治療產後急性劇烈疼痛的臨床實證研究仍不多。本病例報告提出，以遠處取穴的針刺療法治療一產後急性劇烈頸項痛的37歲初產婦，產後媽媽因初產情緒較焦慮，加上疑似頸部戚受風寒而引起由兩側風池、肩頸不可碰觸的劇烈疼痛，且頸部因疼痛而無法轉動，其憂鬱量表指數偏高且自評有較差的睡眠及生活品質，在門診施與針刺治療後，病患症狀即刻緩解至僅左側風池微有壓痛。起針後，患者已可舒服的轉動頸部，當晚睡眠品質良好，隔日醒來已無不適，診察其兩側風池無壓痛感。遠處取穴針刺大陵、合谷治療產後急性持續4天的劇烈頸項痛，觀察到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、少副作用等特點，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。 About 28% of people have a experience of cervicalgia, which the most common etiology are the strain and spasm of cervical muscle. Both nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy are often used in clinical treatment for pain easement. However, the empirical study had not been conducted to show the effectiveness of distal acupuncture point therapy in treating postpartum cervicalgia. We described a 37 year-old postpartum woman who was sustained from acute cervicalgia, with critical painful points over the whole neck and shoulder and limited the range of motion of her neck. Identification of the cervicalgia based on the symptoms and the characteristics of the course, diagnosis of exterior cold was made which might get worse and worse by both postpartum depression and sleep disturbance. After the acupuncture therapy at daling acu-point (PC7) & Hegu acu-point (LI4), the pain dramatically relieved, and she can rotate her neck freely without perceiving any pain sensation. Her sleep quality improved at that night, and she felt no longer cervicalgia when she awake the next morning. The case highlights the effectiveness of distal acupuncture point therapy for postpartum cervicalgia and the importance of considering acupuncture as an alternative therapy.