从调神论治持续性姿势知觉性头晕  

Treatment of persistent postural perceptual dizziness from the theory of regulating the mind

作　　者：章子豪 丁淑强[1] ZHANG Zihao

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300192

出　　处：《中医临床研究》2024年第8期86-89,共4页Clinical Journal Of Chinese Medicine

摘　　要：持续性姿势知觉性头晕是近年来被新定义的一种由行为因素介导、精神心理因素参与并造成功能性障碍的前庭疾病,临床以非旋转性眩晕或伴不稳感为常见表现。该病病因可能与焦虑人格相关,症状维持机制包括姿势控制策略改变和视觉空间多感觉整合转变。持续性姿势知觉性头晕多迁延难愈,患者常感到困苦不堪,生活质量受到严重影响。该病的西医治疗以抗焦虑为主,药物治疗包括五羟色胺再摄取抑制剂和五羟色胺去甲肾上腺素再摄取抑制剂,但这种治疗起效较为缓慢,疗程较长,且常有不良反应发生,因此患者接受度较低,依从性差。丁淑强导师结合自身的临床经验,认为“神明失用”是持续性姿势知觉性头晕的核心病机,运用针药结合,主以针灸调其神,配合方药调其脏,从调神论治本病,取得了良好的疗效。故文章以“调神”为中心思想,论述了神的基本内涵、神与持续性姿势知觉性头晕的联系,介绍了针灸调神治疗此病的主要穴位,选用上星穴、印堂穴、百会穴以醒脑神,太冲穴、合谷穴以调气机,内关穴、神门穴以安心神,最后附验案一则,并在按语中分析该病诊断、辨证、治疗思路,以期为临床的相关治疗提供理论和经验参考。Persistent postural perceptual dizziness(PPPD)is a newly defined vestibular disease in recent years,which is mediated by behavioral factors,participated by psychosocial factors and caused functional disorders.The clinical manifestations are nonrotational vertigo or accompanied by instability.The etiology of the disease may be related to anxiety personality,and the symptom maintenance mechanism includes the change of posture control strategy and the change of visual spatial multi-sensory integration.PPPD is often protracted and difficult to recover,and patients often suffer from hardship,and their quality of life is seriously affected.Western medicine mainly focuses on anti-anxiety.Drug treatment includes serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor.However,this treatment has a slow onset,a long course of treatment,and often has adverse reactions.Therefore,the patient’s acceptance is low and compliance is poor.Tutor DING Shuqiang,based on many years of clinical experience,believes that the loss of spirit is the core pathogenesis of PPPD.With the combination of acupuncture and medicine,acupuncture and moxibustion is mainly used to regulate the spirit,and prescription and medicine are used to regulate the internal organs,has achieved good results in treating PPPD from the theory of regulating the mind,so this article,taking regulating the mind as the central idea,discusses the basic connotation of the mind,the relationship between the mind and PPPD,introduces the main acupoints for acupuncture and moxibustion to regulate the mind,selects Shangxing acupoint(DU23),Yintang acupoint(EX-HN3)and Baihui acupoint(DU20)to wake up the mind,Taichong acupoint(LR3)and Hegu acupoint(LI4)to regulate the Qi(气)movement,Neiguan acupoint(PC6)and Shenmen acupoint(HT7)to calm the mind,finally attaches one test case,and analyzes the diagnosis,syndrome differentiation and treatment ideas of the disease in the notes,it is expected to provide reference for clinical practice.

关 键 词：持续性姿势知觉性头晕 针药结合 调神 眩晕 

分 类 号：R255.4[医药卫生—中医内科学]