針灸治療股外側皮神經卡壓綜合症一例

ACUPUNCTURE THERAPY OF LATERAL FEMORAL CUTANEOUS NERVE ENTRAPMENT – A CASE REPORT

目的：針灸可有效治癒股外側皮神經卡壓綜合症，以及股外側皮神經可能以腰痛來表現，因此明確的鑑別引起腰痛的原因為臨床上一項重要的課題。臨床表現及治療結果：一位62 歲女性患者，因提重物而隔日開始感覺右邊下腹部酸痛不舒服，合併有右側下背酸痛。經臨床理學檢查後，診斷為股外側皮神經卡壓綜合症，並開始針灸治療療程，以鬆解卡壓黏連為目的。經治療兩次後患者疼痛感減輕，但未完全緩解，且其右側下背酸痛感未完全改善。考量神經走向，加針刺背部俞穴，經治療一次後患者疼痛感明顯減少，持續治療一個月後患者腰部及右下腹股溝疼痛感完全緩解，觀察一個月均無再發作。結論：下腰痛為針灸科常見疾病，有時候許多問題與腰部疼痛有密切的相關性。以此病人為例，針灸在治療股外側皮神經卡壓綜合症時可達到良好的效果，若是在腰痛的鑑別診斷上能更加明確分辨，則臨床可明顯提升治療的成效。objective: Lateral femoral cutaneous nerve entrapment can be treated by acupuncture effectively, but the clinical symptoms may present with low back pain. Therefore, a carefully diagnosis should be made on dealing with low back pain. clinical feature, Intervention and outcome: A 62-year-old female patient began to feel uncomfortable on her right groin with right waist pain the next day after carrying heavy luggage. Physical examination showed tinel’s sign on her right anterior superior iliac spine. We began to use acupuncture treatment under the impression of lateral femoral cutaneous nerve entrapment. After acupuncture treatment twice, the patient felt better and pain released, but not disappeared completely. However, the patient still complained her right lower back pain. We chose a few additional acupuncture points for her low back pain based on nerve route. The patient felt completely resolved significantly, including right groin pain, after the first treatment. We had continuously treated the patient twice a week for another two weeks. The pain on her right waist and right groin were relieved. The pain doesn’t occur again in the following observation for a month. conclusion: Low back pain is a common clinical problem, and some symptoms are closely related to it. In this case, acupuncture is an alternative choice for the lateral femoral cutaneous nerve entrapment. A better outcome can be made if diagnosis is more detailed.