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髂关节失衡（Sacroiliac Joint Dysfunction）通常会引起髂关节疼痛症候群，常容易被误认为脊椎问题或是梨状肌症候群，最常见疼痛部位位於髂後上棘（Posterior superior iliac spine）附近，然而髂关节疼痛并非局限於髂後上棘的疼痛，可能辐射至上腰部（6%），腹股沟（4%），下腹部（2%）。髂关节多种症状被认为是由很多复杂因素共同造成的。根据国外研究发现
下背痛患者亦有髂关节疼痛问题约是15~25%。台湾尚无公共卫生统计，大约5 成民众受下背痛困扰，其中2 成属髂关节疼痛，推测台湾的盛行率约10%。髂关节疼痛症候群跟职业上没有直接相关性，主要是与髂关节稳定度有关。治疗一般分为保守治疗、药物及手术治疗。本病患左侧下背臀部酸痛已一年，109 年07 月29 日在台中慈济医院神经外科诊断左侧髂关节炎，之後执行患处神经烧灼手术（高频热凝疗法Radiofrequency, RF）。术後病人觉得患处疼痛稍许减轻，视觉类比量表（Visual Analogue Scale:VAS）VAS：7-8 分，神经烧灼术後效果不佳需要作髂关节融合术，因病人对开刀另有考虑，而至台中慈院中医部伤科治疗，使用中药内服、针刀疗法及腰臀核心肌群训练，经过两个多月治疗，病人疼痛减轻（VAS：2-3 分）很多。中医治疗关节炎疼痛有显着疗效，临床病例上中医治疗髂关节炎较不常见，故提出此案例给中医师治疗之叁酌。
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Chun-Yao Cheng1Yi-Che Cheng1*
1Department of Chinese medicine Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taichung, Taiwan
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Sacroiliac joint imbalance usually causes sacroiliac joint pain syndrome, which is often mistaken for spinal problems or piriformis syndrome. The most common pain site is located near the posterior superior iliac spine. Sacroiliac joint pain is not only limited to the pain of the posterior superior iliac spine but also radiate to the upper lumbar (6%), groin (4%), and lower abdomen (2%). According
to studies, it is found that patients with lower back pain also suffer from sacroiliac joint pain, which is about 15-25%. There are no public health statistics in Taiwan. About 50% of the people suffer from lower back pain, of which 20% are sacroiliac joint pain. It is estimated that the prevalence rate in Taiwan is about 10%. The sacroiliac joint pain syndrome is related to the stability of the sacroiliac joint. The treatment of sacroiliitis includes conservative treatment, medication and surgical treatment. The patient’s left lower back buttock has been sore for a year. On July 29, 109, he was diagnosed with left sacroiliitis at the Department of Neurosurgery, Taichung Tzu Chi Hospital. After that, perform a radiofrequency operation, the patient felt that the pain in the affected area was slightly relieved. Visual Analogue Scale (VAS) 7-8 points. Poor postoperative results require sacroiliac joint fusion.
Because the patient has other considerations about surgery, he went to the TCM Traumatology Department of Taichung Tzu Chi Hospital. After more than two months of treatment with traditional Chinese medicine, needle-knife therapy and waist-butt core muscle training, the patient’s pain has been reduced a lot. VAS：2-3 points. Traditional Chinese medicine has a significant effect in treating arthritis pain. The treatment of sacroiliac arthritis by Chinese medicine is relatively uncommon in clinical cases. Therefore, this case is presented for consideration by physicians.
【Keywords】Sacroiliitis; Chinese Medicine; Lizhong Decoction; Acupotomy
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241.13 中医治疗髂关节炎之病例报告
