方剑乔教授辨治原发性颈部肌张力障碍的辨证思路  

Professor FANG Jianqiao's clinical experience in the treatment of primary cervical dystonia

作　　者：李晓宇 孙海榉 方剑乔[1] LI Xiaoyu;SUN Haiju;FANG Jianqiao(Third School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学第三临床医学院,杭州310053

出　　处：《中国针灸》2018年第9期985-988,共4页Chinese Acupuncture & Moxibustion

基　　金：全国名老中医药专家传承工作室建设项目:国中医药人教发[2013]47号;浙江省名老中医专家传承工作室建设项目:GZS 2012014

摘　　要：初步总结方剑乔教授辨治原发性颈部肌张力障碍的临证经验。方教授在西医辨病、中医辨证的基础上,结合针灸经络辨证,构建出针灸临床"辨病、辨证、辨经"三维诊治体系,认为对于原发性颈部肌张力障碍的诊治,神经系统体格检查、中医辨证、经络辨证不可偏废其一,并指出原发性颈部肌张力障碍的关键病机在于气血闭阻,经筋失养,基于此提出了"祛外邪,调气血,通经筋"的治疗原则。方教授在治疗时,强调要兼顾肌张力异常疾病的发病部位和影响因素进行针灸,局部选穴以颈部异常运动所涉及的责任肌肉附近的穴位为主,选取经验效穴"新设"穴,远端取穴则根据三维诊治体系进行选穴,同时在受累肌肉的起止点或交汇处使用经皮穴位电刺激疗法,从而起到理气养血,舒经通络的作用。Professor FANG Jianqiao＇s clinical experience in the treatment of primary cervical dystonia based on the syndrome differentiation of TCM was explored preliminarily. Based on the disease identification of western medicine and the syndrome differentiation of TCM, in combination with the differentiations of meridians and collaterals of acupuncture, Professor FANG proposes the three-dimensional system of diagnosis and treatment of acupuncture, named ＂disease differentiation, TCM syndrome differentiation and meridian differentiation＂. Regarding the diagnosis and treatment of primary cervical dystonia, the physical examination of nerve system, TCM syndrome differentiation and meridian differentiation are equally important. It is pointed out that the key pathogenesis of the disease is qi and blood obstruction and the malnutrition in the muscle regions of meridians. Hence, the treating principle is proposed as eliminating the exogenous pathogens, regulating qi and blood and unblocking the muscle regions of meridians. Professor FANG also stresses that the affected sites and the factors of dystonia should be considered in acupuncture treatment. The local points are mainly those adjacent to the responsible muscles with the motor disturbance in the neck region. ＂Xinshe＂ point（Extra） is taken as the empirical point. The distal points are selected in accordance with the three-dimensional system of diagnosis and treatment. At the same time, the percutaneous acupoint electric stimulation is applied to the starting and ending points or the conjunctive points of the affected muscles, acting on regulating qi, nourishing blood and promoting the circulation in meridians and collaterals.

关 键 词：原发性颈部肌张力障碍 痉挛性斜颈 针刺 方剑乔 临床经验 

分 类 号：R246.2[医药卫生—针灸推拿学]