頸肩綜合症的鑑別診斷與中醫療法簡介

Neck and Shoulder Pain Syndrome – the Differential Diagnoses and Treatments of Traditional Chinese Medicine

任東輝(Tung Hui, Jen)；李佳蓉(Chia Jung, Lee)

頸肩綜合症 ； 頸痛 ； 肩頸痠痛 ； 鑑別診斷 ； 治療 ； Neck pain ； Muscle Stiffness ； Differential Diagnosis ； Treatment ； Traditional Chinese Medicine

中華針灸醫學會雜誌

20卷3-4期（2017 / 12 / 01）

25 - 38

繁體中文

頸肩綜合症為現代文明病之一，出現頸項肩背酸痛、僵硬、沈重感、活動受限等一系列症狀。根據統計，超過半數的人在一生中曾經歷過頸部疼痛，而台灣勞動部調查發現受僱者痠痛情形普遍，且以肩頸處比例最高。累及頸椎及周圍軟組織的疾病均可導致肩頸痛，須謹慎排除外傷、感染、癌症、椎動脈剝離、心血管疾病等「紅旗」警訊後加以鑑別診斷。中醫對於頸肩綜合症的病因病機主要有四，一則因外傷導致筋脈受損，經氣運行不暢；二則因勞損、姿勢不良，氣血失和則痛；三則年老或耗損過度，肝腎虧虛，筋失濡養，脊骨不利；四則外加感受風寒濕邪，風寒濕邪留而為痹，筋脈痹阻。依據不同病因病機給予適當之正骨、理筋、針灸、刮痧、拔罐、薰洗、膏藥、內服藥等治療，結合衛教，相輔相成，療效持久。

Neck and shoulder pain syndrome is common in modern society, which causes a series of symptoms such as pain, soreness, stiffness, heaviness and limit range of motion of neck, upper back, and shoulders. Statistically, more than half of general population have experienced neck pain in the lifetime. In the investigation of Taiwan Ministry of Labor, workers commonly suffer from pain problems, especially neck and shoulders. Any disorder involving cervical vertebrae and surrounding soft tissues could cause neck pain. It is important to rule out ‘red flag’ situations such as injury, infection, tumor, arterial dissections and cardiovascular diseases before the following differential diagnoses.In Traditional Chinese Medicine, the cause and mechanism of neck pain including four aspects: Traumas and injuries damaging the channels and sinews; Qi-blood disharmony due to overusing and inadequate postures; Aging and excessive consumption causing liver and kidney depletion, resulting in undernourishment of muscle and insufficiency of bone; Affected by the wind, cold, damp evils contributing to impediment. According to different causes and mechanisms, we could apply suitable treatments including manual manipulations, acupuncture, scraping, cupping, herbal stimming, herbal plaster and oral herb medication, combine with health educations to achieve lasting healing efficacy.

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