何謂彈弓手

| 11-23-2015

《何謂彈弓手 ─ 解構「指屈肌腱腱鞘炎」的成因》

香港防癆會中醫診所暨香港大學中醫臨床教研中心  莊朝安 醫師


           手指屈肌腱腱鞘炎,又稱『彈響指』、『扳機指』,屬中醫『傷筋』範疇。好發於拇指、食指和中指,少數患者為多個手指同時發病。家庭主婦或從事手工勞動者等經常反復勞損手指,易見此問題。

【解構】

           腱鞘就是圓筒狀套管,包裹著肌腱,就好像隧道一樣。正常情況下,隧道管道(腱鞘)足夠空間,便能順暢地讓肌腱通過而不會出現阻塞。

什麼原因令管道狹窄?

中醫角度
  • 局部勞作過度或受寒涼
    積勞傷筋,或受寒涼、氣血凝滯,氣血不能濡養經筋則發病。
西醫角度
  • 手指頻繁的伸屈活動
    頻繁活動使屈肌腱與腱鞘容易反復摩擦、擠壓;
  • 長期用力握持硬物
    使腱鞘受硬物與掌骨頭的擠壓。


因此,管腔狹窄,兩端膨大呈葫蘆狀,並形成疼痛。


【典型症狀】
手指屈伸活動受限、扳機樣彈跳動作、彈響聲以及疼痛。

triggerfinger

圖1,2為正常的肌腱和腱鞘;
圖3,4為發病後腱鞘腫脹,肌腱呈葫蘆形腫大,手指主動屈曲時,遠側膨大擠過窄的韌帶時,發生彈響;手指由屈曲而伸直時也同樣發生彈響。

【治療】
一般中醫手法以理筋手法針灸等。

【保養】
多注意手部動作要緩慢,避免勞累以及長期作頻繁的屈伸活動(如扭毛巾等),少用涼水,以減少局部刺激。

文章內容僅供參考,不能作為診斷及治療的醫據。
如需獲得健康方面的幫助,請諮詢中醫師及醫護人員的專業意見。

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