针刺治疗颈肩腰背部肌筋膜疼痛综合征临床研究进展  

Clinical Research Progress of Acupuncture in the Treatment of Neck-Shoulder-Waist-Back Myofascial Pain Syndrome

作　　者：杨子纯 沈永勤[2] 顾燕华[3] YANG Zi-chun;SHEN Yong-qin;GU Yan-hua(Qinghai University,Xining,Qinghai,China,810000;Qinghai Province Hospital of TCM,Xining,Qinghai,China,810001;Nanjing University of CM,Nanjing,Jiangsu,China,210000)

机构地区：[1]青海大学,青海西宁810000 [2]青海省中医院,青海西宁810001 [3]南京中医药大学,江苏南京210000

出　　处：《河南中医》2020年第3期482-486,共5页Henan Traditional Chinese Medicine

摘　　要：针刺治疗颈肩腰背部肌筋膜疼痛综合征(myofascial pain syndrome,MPS)以局部选穴、远部选穴及直接针刺激痛点为主,辨证选穴应用不多,可能与MPS辨证分型尚不完备有关,因而针刺补泻亦无统一标准。针刺治疗肌筋膜疼痛综合征的特色针法有:"金钩钓鱼"针法,"董氏奇穴"针刺法,滞针法,阻力针法,排针刺法,管氏特殊针刺法等。亦有根据针刺时间治疗的方法有:根据就诊时间采用灵龟八法开穴,子午流注择时取穴。大多针刺后采用平补平泻法,个别穴位在针刺时会强调补泻,一些特殊针法操作时会有特殊补泻要求。笔者认为,应针对患者的年龄、体质等进行辨证选穴,并施以相应的补泻手法。此外,针刺后留针是针刺疗法的重要组成部分,而留针时间长短对疗效的影响不可小觑,针刺后留针时间从不留针到留针2 min、15 min、20 min、30 min、40 min等不尽相同。对于针刺激痛点后是否留针、留针多久存在争议,有待进一步研究。In the treatment of myofascial pain syndrome(MPS)of neck,shoulder,back and back,selection of adjacent point(s),selection of distant point(s)and direct needle stimulation pain points of acupuncture are mainly used.The application of selecting points based on syndrome differentiation is not much,which may be related to the incomplete syndrome differentiation of MPS,so there is no unified standard for acupuncture reinforcing and reducing.The special acupuncture therapies in the treatment of MPS are as follows:"gold hook fishing"acupuncture manipulation,"Master Dong′s extra point"acupuncture manipulation,sticking of needle,withdrawing needle method,obstructed needling method,and Master Guan′s special acupuncture manipulation.There are also methods according to the time of acupuncture:according to the time of treatment,including the eightfold method of the sacred tortoise,the ebb and flow of midnight and midday.Most of them adopt the method of even supplementation and drainage after acupuncture.Some points will emphasize supplementation/drainage when being acupunctured,and some special acupuncture operations will have special requirements for supplementation/drainage.The author thinks that the points should be selected according to the age and constitution of the patients,and the corresponding supplementation or drainage methods should be applied.In addition,needle retention after acupuncture is an important part of acupuncture therapy,and the effect of the length of needle retention on the curative effect cannot be underestimated.The time of needle retention after acupuncture is not the same from never retaining needle to retaining needle for 2 min,15 min,20 min,30 min,even 40 min,etc.However,whether or not and how long to keep needles after needling the pain stimulating points are controversial and need further study.

关 键 词：肌筋膜疼痛综合征 针刺疗法 “金钩钓鱼”针法 “董氏奇穴”针刺法 滞针法 阻力针法 排针刺法 管氏特殊针刺法 灵龟八法 子午流注 

分 类 号：R274.9[医药卫生—中西医结合]