调神开喑法治疗中风后重度构音障碍医案  

Case of Applying Adjusting the Spirit and Recovering the Voice Method in the Treatment of Severe Dysarthria after Cerebral Infarction

作　　者：余阳[1] 郎娟 李雪梅 宋凯 熊凡捷 张虹[1] YU Yang;LANG Juan;LI Xuemei(Chengdu University of Traditional Chinese Medicine,Chengdu Sichuan 610075,China)

机构地区：[1]成都中医药大学,成都四川610075

出　　处：《四川中医》2021年第11期208-210,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家重点研发计划(No.2018YFC1704104);第六批全国老中医药专家学术工作室建设项目。

摘　　要：一般情况:患者黎某,男,78岁。主诉:言语不能8月。现病史:患者8月前出现发音困难,吐字不清,音节不准,表达难以被理解,严重影响人际交流;甚则言而无声,借用纸笔交流;伴头晕,神疲乏力,不能久思;不伴神志改变、肢体功能障碍等。舌质黯红,舌下络脉瘀血,苔少,脉细。中医诊断:中风、中经络(气虚络瘀型)。治则:益气化瘀,调神开喑。治疗方案:电针双侧顶颞前斜线下2/5+廉泉、哑门配合刺络放血、运动针法、温针灸。结果:治疗4个疗程后,患者诵读功能逐渐好转,言语功能恢复,基本不影响人际交流。结论:张虹教授以八纲、经络、脏腑辨证为指导明确诊断基础上,电针双侧顶颞前斜线+廉泉、哑门,配合刺络放血、运动针法、温针灸以"调神开喑"治疗脑梗死后重度构音障碍取得明确疗效。General situation:The patient LI,male,78 years old.Chief complaint:Cannot speak 8+months.History of present illness:8+months ago,the patient suffered from dysphonia,unclear articulation,incorrect syllables,and unintelligible expression,which seriously affected interpersonal communication.the patient can’t even make a sound and can only communicate with pen and paper,accompanied by dizziness,mental fatigue and fatigue,can not think for a long time,not accompanied by mental changes,physical dysfunction,etc.The tongue is dark red,with blood stasis of the vein under the tongue,little coating on the tongue,and thin pulse.TCM diagnosis:Stroke,disease in meridians and collaterals(Qi deficiency and collaterals stasis).Rules of treatment:Tonify Qi and remove blood stasis,regulate the spirit and make it sound again.Therapeutic schedule:Electric acupuncture on bilateral parietal temporal anterior oblique line below 2/5 and RN23,DU15,cooperated with the puncture collateral bloodletting,movement acupuncture,needle warming moxibustion.Results:After 4 courses of treatment,the patient’s reading function was gradually improved,speech function was restored,and interpersonal communication was basically not affected.Conclusion:My supervisor,Professor ZHANG Hong,based on the diagnosis of syndrome differentiation of eight cardinal principles,meridians and viscera,electroacupuncture on bilateral parietal temporal anterior oblique line+RN23,DU15,combined with the puncture collateral bloodletting,movement acupuncture,needle warming moxibustion to"tune the spirit and make it sound again"for the treatment of severe dysarthria after cerebral infarction,achieved a clear effect.It can be used as a reference for clinicians to treat these diseases.

关 键 词：调神开喑 构音障碍 顶颞前斜线 廉泉 哑门 刺络放血 动留针法 

分 类 号：R246.6[医药卫生—针灸推拿学]