《吳醫師保健養生堂第七十八講》 — 阿是穴、觸發點和肌筋膜疼痛吳宇琛

阿是穴、觸發點和肌筋膜疼痛

吳宇琛

SUM WU

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吳宇琛，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，擅長用傳統針灸理傷手法和中藥治療各種新舊損傷痛症，特別採用中醫中藥和現代心理學、營養學相結合調理治療各種慢性病和亞健康。

Ashi point, trigger point and myofascial pain

阿是穴、觸發點和肌筋膜疼痛

Ashi points or sometimes incorrectly called Trigger points are nodules or points in skeletal muscle and surrounding connective tissue that can produce referred pain, tenderness, and other symptoms. The concept of trigger points has been recognized for centuries, and the modern understanding of myofascial pain syndrome (MPS) as a distinct clinical entity developed in the mid-twentieth century. However, the roots of trigger point therapy can be traced back to ancient Chinese medical texts that describe the use of acupuncture and other techniques for the treatment of pain and dysfunction.

阿是穴，有時也被錯誤地稱為觸發點，是骨骼肌和周圍結締組織中的結節或點，可以產生牽扯痛、壓痛和其他症狀。Trigger point可以翻譯為觸發點、扳機點、激痛點、痛點、激發點。觸發點的概念已經被認可了幾個世紀，而對肌筋膜疼痛綜合征（MPS）作為一種獨特的臨床實體的現代理解是在二十世紀中葉發展起來的。然而，觸發點療法的根源可以追溯到中國古代醫學文獻，這些文獻描述了使用針灸和其他技術治療疼痛和功能障礙。

In the ancient text Ling Shu, which is part of the Huang Di Nei Jing , is one of the earliest examples of using acupuncture and topics on the use of acupuncture points for the treatment of various diseases, including pain syndromes.

古代文獻《靈樞》是《黃帝內經》的一部分，是最早使用針灸的例子之一，其中討論了使用穴位治療各種疾病，包括疼痛併發症。

The Nei Jing also describes the use of acupuncture points and their effects on the body’s Qi. At the root of Traditional Chinese Medicine (TCM) style acupuncture, is the concept of Qi, which is the body’s vital energy that flows through it via energy channels or meridians.

《內經》還描述了穴位的使用及其對人體氣的影響。傳統中醫針灸的根源是氣的概念，氣是通過能量通道或經絡在體內流動的身體生命能量。

Acupuncture points are located along the various meridians and stimulating them with acupuncture needles is to promote the free flow of Qi and restore balance to the body. From a modern perspective and with a Western medical point of view, it is roughly analogous for functions that our nervous system, musculoskeletal system, fascial network, and nerves carry out in our bodies.

穴位位於各種經絡上，用針灸刺激穴位是為了促進氣的自由流動並恢復身體的平衡。從現代觀點和西方醫學的角度來看，它大致類似於我們的神經系統、肌肉骨骼系統、筋膜網絡和神經在我們體內發揮的功能。

When it comes to acupuncture for pain, the traditional Chinese concept of “ashi” or “tender points” is similar to the Western concept of trigger points. In traditional Chinese medicine, ashi points are considered to be areas of the body where the flow of Qi is blocked or stagnant, leading to pain and dysfunction. Stimulating these points with acupuncture needles or other techniques will help restore the free flow of Qi and promote healing and break up adhesion. Not all ashi points are trigger points, but all trigger points are ashi points.

說到針灸止痛，中國傳統的“阿是穴”或“壓痛點”概念與西方的觸發點概念相似。在中醫中，阿是穴被認為是身體中氣流動受阻或停滯的區域，導致疼痛和功能障礙。用針灸針或其他技術刺激這些穴位將有助於恢復氣的自由流動，促進癒合，打破粘連。並非所有阿是穴都是觸發點，但所有觸發點都是阿是穴。

Acupuncture Points and Trigger Points Overlap

針灸穴位和觸發點重疊

Acupuncture points and trigger points share anatomical locations and can overlap in the treatment of musculoskeletal pain. Trigger points are often found in the same areas as acupuncture points, and needling these points can elicit a therapeutic response. One 2016 study found that there was a high degree of overlap between acupuncture points and myofascial trigger points (MTPs). The study suggested that the overlap of acupuncture points and MTPs may explain the efficacy of acupuncture for musculoskeletal pain and that needling MTPs using the dry needling technique may be a useful adjunct to traditional acupuncture therapy.

針灸穴位和觸發點共享解剖位置，在治療肌肉骨骼疼痛時可以重疊。觸發點通常與針灸穴位位於同一區域，針刺這些點可以引發治療反應。2016年的一項研究發現，穴位和肌筋膜觸發點（MTP）之間存在高度重疊。該研究表明，穴位和MTP的重疊可能解釋了針灸對肌肉骨骼疼痛的療效，使用乾針技術針刺MTP可能是傳統針灸療法的有用輔助手段。

The History and Evolution of Trigger Points in Western Medicine

西醫觸發點的歷史與演變

In Western medicine, physicians such as John Hilton, J. M. Charcot, and Sir James Paget described tender nodules in muscle tissue that could produce referred pain. However, it was not until the mid-twentieth century that the modern understanding of trigger points and their role in chronic pain and dysfunction was established. Drs. Janet Travell and David Simons published a textbook on myofascial pain in 1983, which established the modern understanding of trigger points and their role in chronic pain and dysfunction. In their research, Travell and Simons identified trigger points as key players in a variety of musculoskeletal disorders, and developed new techniques for the diagnosis and treatment of MPS.

在西醫中，約翰·希爾頓、J·M·夏科和詹姆斯·佩吉特爵士等醫生描述了肌肉組織中可能產生轉移疼痛的壓痛結節。然而，直到二十世紀中葉，對觸發點及其在慢性疼痛和功能障礙中的作用的現代理解才得以確立。Janet Travell和David Simons博士於1983年出版了一本關於肌筋膜疼痛的教科書，建立了對觸發點及其在慢性疼痛和功能障礙中作用的現代理解。在他們的研究中，Travell和Simons將觸發點確定為各種肌肉骨骼疾病的關鍵因素，並開發了診斷和治療肌筋膜疼痛綜合征（MPS）的新技術。

Key points timeline

關鍵點時間線

In the mid-19^th century, Dr Hilton described the concept of referred pain from muscles to other parts of the body, and identified specific muscles that were associated with this phenomenon.
在19世紀中葉，Dr Hiton描述了將疼痛從肌肉轉移到身體其他部位的概念，並確定了與這種現象相關的特定肌肉。
By the end of the 19^th century, Dr Charcot described the phenomenon of “myotomes,” which were bands of muscle fibres that could cause pain and other symptoms when they became contracted.
在19世紀末，Dr Charcot描述了“肌節”現象，肌節是肌肉纖維帶，當它們收縮時可能會引起疼痛和其他症狀。
In the early 1900s, Dr Henry Gowers and Dr James Mackenzie described tender points in the muscles that could be palpated and were associated with pain.
在20世紀初，Dr Henry Gowers和Dr James Mackenzie描述了肌肉中可以觸診的壓痛點，這些壓痛點與疼痛有關。

These early descriptions and observations laid the groundwork for what would develop into the concept of myofascial pain syndrome and trigger points.

這些早期的描述和觀察為後來肌筋膜疼痛綜合征和觸發點概念的發展奠定了基礎。

In the 1920s, doctors are aware of an symptom of “referred pain” from muscles to other parts of the body, and proposed that it was caused by trigger points.
•20世紀20年代，醫生們意識到了從肌肉到身體其他部位的“牽涉痛”症狀，並提出它是由觸發點引起的。
In the 1930s, research describing “tender points” in muscles that were associated with pain and could be relieved by injections of saline solution.
20世紀30年代，研究描述了與疼痛相關的肌肉“壓痛點”，可以通過注射鹽水來緩解。
In the 1940s and 1950s, Janet Travell began studying the phenomenon of “myofascial pain” and identified trigger points as a key component. She developed the concept of referred pain from trigger points and developed injection techniques to treat them.
在20世紀40年代和50年代，Janet Travell開始研究“肌筋膜疼痛”現象，並將觸發點確定為關鍵組成部分。她提出了從觸發點轉移疼痛的概念，並開發了治療這些疼痛的注射技術。
Myofascial trigger points (MTrPs) were first described by Dr. Janet Travell and Dr. David Simons in 1942.
肌筋膜觸發點（MTrPs）最早由Janet Travell博士和David Simons博士於1942年描述。
In the 1950s and 1960s, David Simons worked with Travell and continued to develop the concept of trigger points and their role in myofascial pain. They published their seminal work, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” in 1983
在20世紀50年代和60年代，David Simons與Travell合作，繼續發展觸發點的概念及其在肌筋膜疼痛中的作用。他們於1983年發表了他們的開創性著作《肌筋膜疼痛和功能障礙：觸發點手册》

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