醒脑神 促气化针刺治疗卒中后神经源性膀胱取穴思路探讨  

Acupoint Selection of Acupuncture of Refreshing Brain and Promoting Gasification in the Treatment of Post-stroke Neurogenic Bladder

作　　者：于川 YU Chuan(Department of Acupuncture and Moxibustion,Pinggu District Hospital of Traditional Chinese Medicine,Beijing 101200,China)

机构地区：[1]北京市平谷区中医医院针灸科,北京101200

出　　处：《中国中医药现代远程教育》2023年第24期123-125,共3页Chinese Medicine Modern Distance Education of China

基　　金：国家中医药管理局全国中医药创新骨干人才项目[No.国中医人教发〔2019〕91号]。

摘　　要：卒中后神经源性膀胱(PSNB)表现为尿失禁和(或)排尿困难,极大地影响了患者的生活质量。目前尚无针对PSNB的特效药物,针灸和物理治疗是报道较多的方法。卒中后破坏了排尿反射通路,使膀胱-骶反射弧丧失自主控制能力。中医认为,中风后神机失调,脾肾亏虚,膀胱气化不利,脬气不固而出现排尿障碍。在针刺治疗PSNB时,应充分考虑西医发病机制、中医病因病机。现代医学方面要注重调整脑-腰骶髓-外周神经-膀胱的传导通路;中医方面要从醒脑神、健脾补肾,促气化入手,使神机恢复,气化有序,则膀胱固约有权,开阖有度。Post-stroke neurogenic bladder(PSNB)is characterized by urinary incontinence and/or dysuria,which greatly affects the quality of life of patients.At present,there is no specific drug for PSNB.Acupuncture and physical therapy were widely re⁃ported.After stroke,the micturition reflex pathway was destroyed,and the bladder sacral reflex arc lost its ability of autonomous con⁃trol.Traditional Chinese medicine believes that after stroke,spiritual mechanism disorder,loss of viscera function,and unstable uterus lead to dysuria.In the treatment of PSNB by acupuncture,the pathogenesis of Western medicine and Chinese medicine should be fully considered.Modern medicine should pay attention to the adjustment of brain-lumbosacral pulp,peripheral nerve and bladder conduction pathway;Traditional Chinese medicine should start from awakening the brain,invigorating the spleen and tonifying the kidney,promoting gasification,restoring the spirit,and gasification orderly,so that the bladder has the right to be fixed and opened and closed.

关 键 词：遗溺 卒中 神经源膀胱 针刺疗法 

分 类 号：R246.9[医药卫生—针灸推拿学]