卒中后吞咽障碍针刺方案优化探讨  

Protocols Optimization of Acupuncture in Treating Post-Stroke Dysphagia

作　　者：康煜炜 鲁海[1,2] 王媛卓 张春红[1,3] KANG Yuwei;LU Hai;WANG Yuanzhuo;ZHANG Chunhong(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;WU Lianzhong National TCM Inheritance Studio/SHI Xuemin TCM Inheritance Studio, Tianjin 300193, China)

机构地区：[1]天津中医药大学第一附属医院,天津300193 [2]天津中医药大学,天津300193 [3]武连仲全国名中医传承工作室石学敏国医大师传承工作室,天津300193

出　　处：《针灸临床杂志》2021年第2期88-91,共4页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家中医药管理局武连仲全国名中医传承工作室建设项目,编号:人社部发[2017]45号;国家中医药管理局石学敏国医大师传承工作室建设项目,编号:81573849;政府间国际科技创新合作重点专项,编号:2018YFE0181700。

摘　　要：吞咽障碍作为卒中后常见并发症,严重影响患者的生存质量。针刺对于卒中后吞咽障碍的治疗效果斐然,而针刺治疗方案繁多,孰优孰劣现未可知。本研究将从异病同治、分期治疗、辨证论治和辨证(病)与辨症论治4个方面,描述各个针刺方案的的理论思想,并结合临床实际,明确各个方案的优劣,笔者认为最优方案应在选择“通关利窍”针刺法的同时,不特意区分真性与假性延髓麻痹,可根据医者自身选择辨证论治,同时对于吞咽困难症状较重的患者,可联合分期针刺以增强疗效。As a common complication after stroke,dysphagia seriously affects the life quality of the patients.The therapeutic effect of acupuncture on post-stroke dysphagia is remarkable,but there are a variety of acupuncture treatment protocols,which is better or worse is unknown.This study described the ideas of different acupuncture protocols in terms of treating different diseases with the same method,treatment by stages,treatment based on syndrome differentiation and treatment based on syndrome differentiation(disease)and symptom differentiation.It also cleared the pros and cons of each solutions according to clinical practice.The author believed that the optimal protocol was not to differentiate bulbar paralysis or pseudobulbar paralysis deliberately,different syndrome differentiations were chosen according to different practitioners,and treatment by stages could be applied to the patients with severe dysphagia to enhance curative effect.

关 键 词：吞咽障碍 异病同治 分期异治 辨证论治 辨证(病)与辨症论治 理论探讨 

分 类 号：R246.6[医药卫生—针灸推拿学]