脊椎融合術後併發垂足針刺治療探討

A Case Study on Acupuncture Therapy on Drop Foot Caused by Spinal Fusion

10.6516/TJTCM.202303_26(1).0008

吳伯濬(Po-Chun Wu)；蔡德豐(Te-Feng Tsai)

針灸 ； 治痿獨取陽明 ； 痿證 ； 周邊神經損傷 ； 垂足 ； acupuncture ； Yangming acupoints for atropic debility ； atrophic debility ； Peripheral Nervous System ； drop foot

中醫藥研究論叢

26卷1期（2023 / 03 / 30）

91 - 101

繁體中文;英文

足下垂，亦稱垂足，是指腳踝關節背屈無力，可能是肌肉、骨骼或者神經系統的問題導致。藉由理學檢查可以判斷是上運動神經元或下運動神經元傷害，輔以西醫肌電圖和神經傳導速率檢查可以更精準定位受傷位置。西醫治療垂足大多採保守治療，包括物理治療和副木輔具，若療效差則考慮手術治療。垂足屬於中醫痿證範疇，本案針對手術後踝部無力的背曲，主要藉由針刺膽經與胃經的穴道，加上電針，獲得良好的療效。

Drop-foot, also known as foot-drop, means having difficulty accomplishing ankle dorsiflexion; it can be caused by malfunctions at the level of muscle, skeleton or nerve system. Physical examination can differentiate a damage at upper motor neuron from a lower motor neuron one, and the damaged locale can be further determined with the help of Electromyography and Nerve Conduction Velocity Examination. When facing with this condition, modern medication is limited to conservatory treatment such as physical therapy and assistive equipment, and surgery is usually considered only after the failure of the aforementioned methods. Traditionally, TCM associate Drop-foot with the ancient term "atrophic debility (痿證)." In this case study, I apply electric acupuncture on acupoints at Gallbladder meridian and Stomach meridian to treat drop foot caused by spinal fusion, and the result is sufficiently satisfying.

1. Baima, J,Krivickas, L(2008).Evaluation and treatment of peroneal neuropathy.Curr Rev Musculoskelet Med,1,147.
2. Baima, J,Krivickas, L.(2008).Evaluation and treatment of peroneal neuropathy.Curr Rev Musculoskelet Med,1,147.
3. Brandon, M.,Christopher, G.,Ross, S.(2018).Acute Exertional Compartment Syndrome with Rhabdomyolysis: Case Report and Review of Literature.Am J Case Rep,19,145-149.
4. Fukuda, H.(2006).Bilateral peroneal nerve palsy caused by intermittent pneumatic compression.Intern Med,45,93.
5. Kida, K,Hara, K,Sata, T(2013).Postoperative palsies of the common peroneal nerve and the tibial nerve associated with lateral position.Masui,62,217.
6. Morris, TR,Keenan, A,Baldwin, K.(2015).Peroneal nerve palsy.Current Orthopaedic Practice,26,155.
7. Poage, C,Roth, C,Scott, B(2016).Peroneal Nerve Palsy: Evaluation and Management.J Am Acad Orthop Surg,24,1.
8. 王英芳(2003)。淺談《甲乙經》論治痿證。國醫論壇，18(5)，40。
9. 佟雪,陳春梅,劉春,張楚,陳新華(2016)。紀青山教授針刺治療痿證。長春中醫藥大學學報，32(5)，890-892。
10. 陳榮洲(2016).中醫內科證治學.弘祥出版社.
11. 楊杰科(2016)。李延芳教授針刺治療痿證經驗淺析。內蒙古中醫中藥，14，136-137。