Page 27 - journal_12-3_Full

227

damine ‡¢â“®ÿ¥Ωí߇¢Á¡ ‚¥¬«—¥ pain threshold °àÕπ º≈‡∑à“°—∫ 94.8%
·≈–À≈—ß°“√√—°…“∑ÿ°√Õ∫ √«¡ 3 √Õ∫°“√√—°…“ æ∫
26,31
À≈—°°“√√—°…“Õ“°“√ª«¥‡Õ«√â“«≈ߢ“
«à“°≈ÿà¡∑’Ë„™âΩí߇¢Á¡Õÿàπ¡’°“√‡ª≈’ˬπ·ª≈ߢÕß pain
°“√∑–≈«ß‡ âπ≈¡ª√“≥ ·°â‰¢°“√μ‘¥¢—¥ ¢—∫≈¡
threshold μ≈Õ¥®π¡’Õ“°“√·≈–Õ“°“√· ¥ß∑“ß
≈“¬§«“¡‡¬Áπ °√–μÿâπ°“√‰À≈‡«’¬π™’Ë √–ß—∫ª«¥
§≈‘π‘°¥’¢÷Èπ°«à“Õ’° 2 °≈ÿà¡ Õ¬à“ß¡’π—¬ ”§—≠ (P<0.01)
29 ‡≈◊Õ°®ÿ¥∫π‡ âπ≈¡ª√“≥‡∑â“∑à“¬À¬“ß·≈–‡∑â“´à“«
Liu BL. ‰¥â»÷°…“º≈°“√√—°…“ºŸâªÉ«¬
À¬“߇ªìπÀ≈—° ‚¥¬¡’®ÿ¥ªí°‡¢Á¡ 2 ≈—°…≥– §◊Õ
sciatica ®”π«π 70 √“¬ ‚¥¬·∫àߺŸâªÉ«¬·∫∫ ÿà¡
1. ®ÿ¥À≈—°: ª√–°Õ∫¥â«¬ ®ÿ¥ ShenShu (BL
‡ªìπ 3 °≈ÿà¡ ‡ªìπ°≈ÿà¡∑¥≈Õß 1 °≈ÿà¡ ®”π«π 30 √“¬
23), QiHaiShu (BL 24), DaChangShu (BL 25)
√—°…“¥â«¬°“√Ωí߇¢Á¡®ÿ¥ ShenShu (BL 23),
À√◊Õ HuaTuoJiaJi (EX-B 2) √–¥—∫°√–¥Ÿ° —πÀ≈—ß
DaChangShu (BL 25), HuanTiao (GB 30),
‡Õ«∑’Ë 2-5, CiLiao (BL 32), ZhiBian (BL 54),
Weizhong (BL 40), ChengShan (BL 57),
HuanTiao (GB 30) ®ÿ¥ Ashi „π°“√ªí°®ÿ¥
KunLun (BL 60) μ“¡¥â«¬°“√≈𬓠·≈–°≈ÿà¡
HuaTuoJiaJi (EX-B 2) „Àâªí° 3 ®ÿ¥ §◊Õ μ”·Àπàß∑’Ë
§«∫§ÿ¡ 2 °≈ÿà¡ °≈ÿࡧ«∫§ÿ¡∑’Ë 1 ®”π«πºŸâªÉ«¬ 20
¡’欓∏‘ ¿“æ μ”·Àπà߇Àπ◊Õ·≈–„μâμàÕ欓∏‘-
√“¬ „Àâ√—∫ª√–∑“𬓠nimesulide 100 mg. «—π≈–
¿“æ
2 §√—Èß °≈ÿࡧ«∫§ÿ¡∑’Ë 2 ®”π«πºŸâªÉ«¬ 20 √“¬ „™â
2. ®ÿ¥‡ √‘¡: ¡’°“√„™âÕ¬Ÿà 2 ·∫∫
¬“©’¥μ”√—∫ 654-2 ©’¥‡¢â“®ÿ¥Ωí߇¢Á¡‡À¡◊Õπ°≈ÿà¡
2.1 μ“¡√–∫∫‡ âπ≈¡ª√“≥
∑¥≈Õß ∑—Èß 3 °≈ÿà¡ ∑”°“√√—°…“∑ÿ°«—πμ‘¥μàÕ°—π 10
„Àâªí°‡¢Á¡‰ªμ“¡·π«‡ âπ≈¡ª√“≥
«—π‡ªìπ 1 √Õ∫°“√√—°…“ À¬ÿ¥æ—° 3 «—π ·≈⫇√‘Ë¡°“√
´÷Ëßμ√ß°—∫·π«∑“߇¥‘π¢Õ߇ âπª√– “∑μ“¡°“¬«‘¿“§
√—°…“μàÕ√«¡ 3 √Õ∫°“√√—°…“ æ∫«à“°≈ÿà¡∑’Ë„™âΩí߇¢Á¡
∑’Ë¡’Õ“°“√ª«¥ ¡’¥â«¬°—π 2 ‡ âπ∑’Ë«‘Ëß≈߉ª∑’Ë¢“ §◊Õ
¡’°“√‡ª≈’ˬπ·ª≈ߢÕß pain threshold ¥’¢÷Èπ°«à“Õ’°
1) ‡ âπ≈¡ª√“≥°√–‡æ“–ªí “«– ´÷Ëß
2 °≈ÿà¡Õ¬à“ß¡’π—¬ ”§—≠
30 μ√ß°—∫·π«∑“߇¥‘π¢Õ߇ âπª√– “∑ posterior tibial:
Zhang RZ. ‰¥â»÷°…“ºŸâªÉ«¬ sciatica
®ÿ¥∑’Ë„™â YinMen (BL 37), Weizhong (BL 40),
®”π«π 58 √“¬ ·∫à߇ªì𙓬 38 √“¬ À≠‘ß 20 √“¬
ChengShan (BL 57), KunLun (BL 60)
Õ“¬ÿ√–À«à“ß 18-72 ªï ªÉ«¬‡ªìπ‚√§¡“μ—Èß·μà 2 «—π∂÷ß
2) ‡ âπ≈¡ª√“≥∂ÿßπÈ”¥’ ´÷Ëßμ√ß°—∫
5 ªï ‚¥¬„™â‡¢Á¡Õÿàπ∑’Ë®ÿ¥Ωí߇¢Á¡À≈—° §◊Õ Huantiao
·π«∑“߇¥‘π¢Õ߇ âπª√– “∑ common peroneal: „™â
(GB 30), Yanglingquan (GB 34), Weizhong (BL
®ÿ¥ FengShi (GB 31), YangLingQuan (GB 34),
40) ®ÿ¥‡ √‘¡μ“¡μ”·Àπàߪ«¥ §◊Õ Chengshan (BL
YangJiao (GB 35), XuanZhong (GB 39)
57), Zusanli (ST 36), Xuanzhong (GB 39),
2.2 μ“¡°“√«‘π‘®©—¬·¬°°≈ÿà¡Õ“°“√
Kunlun (BL 60) «—π≈– 1 §√—Èßμ‘¥μàÕ°—π 7 «—π‡ªìπ 1
1) ≈¡‡¬Áπ™◊Èπ√ÿ°√“π ˄仾ሂ⒯Ⱙ˅
√Õ∫°“√√—°…“ „™â‡«≈“√—°…“ 2-3 √Õ∫°“√√—°…“ º≈
ºŸâªÉ«¬°≈ÿà¡π’È¡’Õ“°“√ª«¥‡¬ÁπÊ √â“«®“°
°“√√—°…“À“¬¢“¥ 41 √“¬ (70.7%) ¥’¢÷Èπ 14 √“¬
‡Õ«≈߉ª¢“ ‡§≈◊ËÕπ‰À«≈”∫“° Õ“°“√¡“°¢÷Èπ‡¡◊ËÕΩπ
(24.1%) ‰¡à‰¥âº≈ 3 √“¬ (5.2%) √«¡Õ—μ√“°“√√—°…“‰¥â