腰大肌综合征医案分析与探讨  

Exploration and analysis of psoas major muscle syndrome

作　　者：李鉴[1] 潘赐明 李枝鑫 李德光[1] 汪康 耿春梅[1] LI Jian

机构地区：[1]昆明市中医医院,云南昆明650000 [2]云南中医药大学,云南昆明650500

出　　处：《中医临床研究》2023年第13期142-144,共3页Clinical Journal Of Chinese Medicine

基　　金：2020年昆明市卫生健康委员会卫生科研课题项目(2020-10-01-011);云南省科技厅科技计划项目中医联合专项(202101AZ070001-273)。

摘　　要：腰大肌是连接躯干和腿之间的主要肌肉,对我们的身心健康至关重要。腰大肌强度不足会导致周围肌肉补偿和过度使用,过紧或过度伸展还会导致许多病证,如腰背痛、骨盆痛、痛经、站姿扭曲、排便困难等。目前,腰大肌综合征缺乏专家意见或诊断标准。由于腰大肌综合征症状很难与其他背痛和髋部疼痛区分,患者往往被误诊。临床发现,急慢性腰痛为主诉的患者常伴有腹部、髋部、大腿部等腰丛神经支配区域不同部位的疼痛或异常感觉。与以往的一些疾病有所不同,检查患者腰大肌有明显压痛感并向腰丛神经支配区扩展。腰大肌综合征从病因病机而言,为病邪入络,导致络脉痹阻,不通则痛;故治疗上应该松解病变部位的粘连和卡压,活血化瘀、疏通经络,恢复络脉运行、输布及渗化气血津液的生理功能,达到通则不痛的效果。文章结合临床实践,并通过文献调查,初步拟定5条腰大肌综合征的诊断标准,以期更好地为临床诊疗提供参考。The psoas is the main muscle connecting trunk and legs,and is essential to our physical and mental health.The lack of psoas muscle strength can lead to compensation and overuse of the surrounding muscles,and too tight or excessive extension can also lead to many diseases,such as back pain,pelvic pain,algomenorrhea,distorted standing posture,and difficult defecation.Currentlly,there is no expert opinion or diagnostic criteria for psoas major syndrome.As psoas syndrome symptoms are difficult to distinguish from other back and hip pain,and patients are often misdiagnosed.The author found that the main complaint of acute and chronic low back pain is often accompanied by pain or paresthesia in different parts of the lumbar plexus innervation area such as the abdomen,hip and thigh.Different from some previous diseases.On examination,the patient had significant tenderness and radiation pain to the innervation area of the lumbar plexus.Different from some previous diseases,the examination patient had a significant pressure pain feeling.And that feeling expanded to the innervation area of the lumbar plexus.The etiology and pathogenesis of psoas major syndrome is pathogenic factors invading collaterals,which leads to obstruction of collaterals and pain.Therefore,the treatment should release the adhesion and entrapment of the lesion site,activate blood circulation and remove blood stasis,dredge the meridians,restore the physiological function of collaterals,and achieve the therapeutic effect.This paper,combined with clinical practice and through literature investigation,has preliminarily formulated five diagnostic criteria for psoas major muscle syndrome,aiming to provide a better reference for clinical diagnosis and treatment.

关 键 词：腰大肌综合征 诊断 标准 治疗 医案 展望 

分 类 号：R249[医药卫生—中医临床基础]