針刺治療難癒性腰扭傷-病例研究

Acupuncture for Refractory Lumbar Sprain: Case Study

目的：腰扭傷是急性下背痛的最常見原因，現今治療腰扭傷的方法包括藥物、物理治療及針灸，但是並非全然有效。本病例研究的目的是說明針刺結合主動活動腰部的方法用來治療腰扭傷的應用前景。臨床特徵：兩位經過藥物治療無效的急性腰扭傷患者，主訴腰部活動功能減少及疼痛影響到日常生活的品質。治療及結果：我們採用針刺三間穴同時結合主動活動腰部的治療方法，總共一週治療兩次。在接受針刺前、兩次治療結束和兩個月後，分別利用視覺類比量表(Visual Analogue Scale)和羅蘭－摩理斯功能障碍問卷(Roland-Morris Disability Questionnaire)來評估療效。經過兩次治療後，患者的腰痛減少，而且在後續兩個月的追蹤，疼痛沒有再發生，也沒有出現任何的治療副作用。結論：結合針刺和主動活動腰部的治療方法，可能減少腰扭傷患者對於疼痛的感受，並且幫助腰部的活動；對於藥物治療無效的腰扭傷患者，是項安全、簡便及經濟有效的治療方式；未來需要進一步的擴大病例研究。

Objective: Lumbar muscle strains and sprains (LS) are the most common causes of acute low back pain. Current treatments for LS include drug, physical, and acupuncture treatments but they are not effective in all cases. This case study describes the application of acupuncture and active movement for LS. Clinical features: Two patients presented with acute LS caused by physical injury and did not respond to drug treatments. Both patients had reduced ranges of motions and pain affecting qualities of life. Intervention and outcome measurements: We developed a treatment based on LI3 (Sanjian) point acupuncture combined with active movement. Two treatment sessions were performed in one week. Evaluations were conducted at baseline, after the second session, and 2 months after the final treatment using the Visual Analogue Scale (VAS) and the Roland-Morris Disability Questionnaire (RMDQ). The patients reported less pain after treatment and had no pain at follow-up. No adverse effects were observed. Conclusion: The combination of acupuncture with active motion may reduce pain perception and facilitate movement in LS patients. The described treatment could be safe, simple, and cost-effective for LS patients who do not respond to drug treatments. Larger studies are needed to extend beyond these two cases.